Background & Objective : Promoting health has always been considered as one of the basic priorities in international, national, regional and local policies. Moreover, retention and promotion of individual health requires a good knowledge of essentials and priorities of the future. Consequently, determining heslth priorities and devising public health programs and policies is just one of the crucial issues to be considered and implemented by the organizations involved. So a fundamental revising of the health care services based on health promotion indices seems to be necessary in order to increase the influence of health interference programs, extend the quality of health care services and improve activities concerning public health.

  Methods: This project started in 2001 and was defined by precise planning of its organization chart. Its two basic concerns included the current status of health and determining its priorities. The first point, that is the current status of health was performed through investigating the previous researches as well as qualitative and field studies. In this phase of research 1000 urban and 1000 rural families were interviewed about different aspects of health including population characteristics, nutrition, risk factors, treatment habits and so forth. To measure the parameters such as hemoglobin, hematocrite, sugar and lipids, blood samples were taken from members of 200 families who were above 15. Weight, height and blood pressure of all the subjects who were above 15 years of age and weight, height and Mid Arm Circumference (MAC) of the children aged below 6 were measured. The data were collected and scored based on scientific indices and finally the research priorities in the field of health were determined. It should be noted that many people and organizations participated in this research.

  Results : The findings indicated that mortality of children under 5 years of age, casualties, accidents, etc. were among 34 most essential health priorities.

  Conclusions : Regarding the great experience of determining health priorities which was conducted through need assessment and wide cooperation of the public and organizations, it seems important to conduct such researches once in some years and transfer their findings to other sectors in order to prevent wastage of costs, time and labor. This will also lead the researches towards the real needs and necessary interference in order to promote public health.

  Background & Objective : Palpable thyroid nodules are found in almost 5% of the adults. Regarding the high prevalence of this condition, recognizing and evaluating them are important for physicians. Fine Needle Aspiration (FNA) is the first easy and cost-effective way for recognizing pathologic nature of the nods. The present research was an attempt to investigate the epidemiology and evaluate the pathological findings among patients using FNA.

  Methods : This is a descriptive study conducted on all 145(113 female and 32 male) patients referring to the endocrinology clinic of Ardabil in the period between October 1999 to October 2002. The data were collected using a questionnaire, the physical examination of the patients, noting down the clinical finding, doing FNA and its report presented by a pathologist. The data were then analyzed with descriptive statistics and frequency tables using SPSS software.

  Results : Most of the patients (36.5%) were 30-40 years old. FNA of 115 patients (79.4%) was reported as benign and that of 6 patients (4.1%) was malignant, 16 patients (11%) had a doubtful FNA, and in 8 patients (5.5%) the sample was not enough. Among patients with benign FNA, 102 cases (70.6%) had nodular goiter, 8 cases (5.5%) had colloid cyst, 3 cases (2%) had follicular adenoma and 2 cases (1.3%) had thyroiditis. Among patients with malignant FNA 1 case (0.7%) had follicular carcinoma and 5 cases (3.4%) had papillary carcinoma.

  Conclusions : The results indicated that most of the malignant lesion is papillary carcinoma, which has a lower prevalence compared to similar studies. Regarding the higher prevalence of thyroid carcinoma in middle ages it seems necessary to investigate the thyroid nodules in this age- group.

 Background & Objective: Hypertension and diabetes mellitus coexist more commonly than predicted by chance and the synergistic effect of these two diseases is the cause of early disability and high rate of mortality in these patients. Controlling the blood pressure has a critical role in decreasing cardiovascular mortality in diabetic hypertensive cases. The goal of this study is to determine the rate of recognition and treatment of hypertension in type II diabetic subjects referring to diabetes clinic of Bou-ali hospital, Ardabil.

 Methods: In this cross-sectional study 300 type II diabetic patients were examined in terms of blood pressure control.

 Results: The patients who participated in this study ranged between 28 to 80 years of age (mean: 55.5 ± 11.4). About 61.6% of diabetic patients had hypertension (BP>140/ 90 mmHg) 76.7% of these patients were aware of their hypertension. Only 8.8% of these patients with hypertension had a well-controlled blood pressure and the rest of them (91.2%) had a poorly- controlled blood pressure (BP>130/80 mmHg). About 21.8% of hypertensive diabetics although aware of their hypertension were not on any anti- hypertensive agents.

 Conclusions: This study indicates poor control of hypertension in diabetic patients. It seems that reconsidering CME programs for the physicians, emphasizing the control of risk factors especially in high-risk groups and educating the diabetic patients will improve the control of hypertension in these patients.

  Temporal arthritis (TA) is a systemic inflammatory vasculitis with unknown etiology, which involves large and medium sized arteries. A wide spectrum of systemic, neurological and ophthalmological complications appears in the course of the disease the most serious of which is visual impairment leading to permanent blindness in 60% of the cases.

  TA is diagnosed through an elevated ESR (>60 mm/Hg) and pathological findings of arterial biopsy. It is considered as one of the urgent neurological cases in which the patient should be treated with corticostroid immediately after diagnosis. The subject of this research was a 62-year-old male who had had headache associated with fatigue, night sweats and low mood for four month. The diagnosis of TA was made considering an elevated ESR and temporal artery biopsy findings. Treatment with prednisolone was initiated and continued for 19 months resulting in complete recovery.

 Background & Objective: World health organization (WHO) has paid a special attention to the reproduction health, which plays a crucial role in women health care and its promotion. The purpose of this study is to determine reproductive factors among Ashayer women in Ardabil province.

 Methods: Part of the plan entitled Investigating health and disease among Ashayer in Ardabil which was conducted in 2003 aimed at determining the reproduction indices using a structured questionnaire. The present research was a cross-sectional study in which the data regarding the reproductive status of the Ashayer women were extracted, collected and analyzed using SPSS software and descriptive statistics.

 Results: 268 women at the age of 10-49 completed the questionnaire. Mean age of marriage among women was 18.2, 8.6% of them had a history of stillbirth, 18.1% abortion and 38.19% unwanted pregnancy. 31.4% of the subjects did not have any reproductive health care, and 67.6% of those who did so were taken care less than four times.

 Conclusion: Improvement of reproductive indices among these women requires proper health care programs in order to enhance family planning services as well as reproductive health. This can prevent future outcomes such as unwanted pregnancy and other related complications.

Background & Objectives: In young females, especially among university students because of the physiological needs, the intake of energy and essential nutrients is very important. Some changes happen in the life style of these students, which can affect their nutritional status. In this study the nutritional status, energy and nutrients intake of young female students living on and off campus were investigated.   

Methods: In this descriptive-analytical study nutritional status of 82 on-campus female students and 74 off-campus ones (Age range=18-24) were assessed and compared using anthropometrics measurements and three-day dietary records method including one day off. Nutritional values were analyzed  using FP₂ computer program and statistical analyses were carried out by EPI₆.

Results: The findings indicated no significant difference between the daily average energy intake of on-campus and off-campus students (2247±24) and (2192±21 kcal respectively).    Energy intake of on-campus students from carbohydrates was significantly higher than that of off-campus students, whilst energy intake from protein and fat was significantly lower (p<0.001). 34.2% of on-campus students and 58.1% of off-campus ones received more than 30% of their energy from fat. Besides, 85.4% of on-campus students and 44.6% of off-campus ones received less than 15gr of fiber every day. Results also indicated that mean intake of, calcium, magnesium, vitamins A, C and folacin for on-campus students was significantly lower than off-campus students (p<0.001).

Conclusions: The findings indicated that in both groups the intake of some essential micronutrients was lower than recommended levels. However, in general the nutritional status of off-campus students was better than on-campus ones. On the basis of these results the improvement of university food service programs would be beneficial.           

  Background & Objective : Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status.

  Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1^st, 5^th, 10^th and 15^th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA.

 Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1^st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5^th minute Propofol was 9.2 ± 0.7 and Thiopental was 9.1 ± 0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups.

  Conclusions : Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.

 Background & Objective: Most of the acute poisonings are mild with no complication but in some rare cases they can be life threatening. About 70% of acute poisoning happens in children. More than 90% of these toxic exposures are incidental and easily preventable. The factors leading to acute poisoning are variable based on cultural and socioeconomic differences among the population. The increasing production and distribution of new drugs and chemicals change the etiologic factors. This study was conducted to investigate common acute poisonings and their victims in Tabriz.

 Methods: In this retrospective study 306 cases of acute poisoning were reviewed from April 1999 to March 2002, in Tabriz Pediatric Medical Center. The factors that were considered included: age, gender, manner (incidental versus intentional), agents route of intoxication, residential area (rural versus urban), duration of admission, clinical presentation, date of first admission and mortality.

 Results: 306 patients (53.3% male and 46.7% female) were studied in this research. Most of the cases (31%) were 1-2 years old, and the fewest (1.3%) were under 6 months of age. About 95% of the cases were incidental, and 5% intentional suicide attempts among children above 10 years of age. 63% of the subjects were living in Tabriz, 29.5% of them were from rural areas and the rest (7.5%) were dwelling small towns. Poisons in the order of prevalence included: drugs (45.5%), hydrocarbons (26%), organo phosphates (7%), atropinic material and datura intoxication (6%), Rodenticides (3.6%), Opiates (2.9%), Carbon monoxide (2.2%) and alcohol, mushrooms, animal bites, acids & alkalines (6.8%). Average duration of hospitalization was 2 days and the total mortality rate was 3 cases.

 Conclusions: The most common etiologic factor was drug poisoning followed by hydrocarbons as the second most prevalent factor in this regard. It seems that mass media especially TV programs can play a key role to increase the public knowledge about this issue.

 Background & Objective: The nationwide amblyopia prevention program is performed by prevention deputy of welfare organization every year. In this analytic report practical results of screening program in 1998-2001 were presented and compared with similar findings in other countries. The results were also compared with the findings of previous similar researches in Iran.

  Methods : The amblyopia screening program was performed on all 3-65 year-old children in day-care centers as well as those referring to the visual acuity measuring centers. The first examination was accomplished by trainers. In the second step doubtful cases were referred to optometrist by trainers and amblyopia was diagnosed by an optometrist and confirmed by an eye specialist after excluding organic causes.

 Results: 608 out of 8427(7.21%) children examined by trainers in 2001 were referred to an optometrist because of suspected visual disorders. The prevalence of amblyopia in different cities of Ardabil province was 2%-15%. The figures in 2000-2001 were 10% (Rangs=1%-13%), respectively. In 1998 it was 11% (Range =5%-13%). In the second phase of amblyopia plan the prevalence of visual problems was estimated about 21%, 45%, 47%, and 74% in 1998-2001, respectively. In the third phase of the plan the amblyopia prevalence for children examined by eye-specialist in 1999-2001 were 1.6%, 1.41% and 1.25% respectively.

 Conclusions: In this research the prevalence of amblyopia was found to be 1.42% which has a conformity with the findings of other countries. Moreover, the higher variation in the estimation of the prevalence of visual disorders in this province requires further comparative researches.

  Background & Objective : Failure To Thrive (FTT) refers to the insufficient physical growth or inability in keeping the desired growth rate in a period to time.

  It is a problem in Iran as far as hygienic nutrition is concerned. FTT is a multifactor problem which is caused by various organic and nonorganic agents. This study was conducted to pinpoint the major risk factors involved in the growth of children under 2 years of age who are the most vulnerable age-group in terms of growth disorders.

  Methods: This case-control study was conducted in 2002-2003 on 120 infants (60 cases with FTT and 60 controls) in Namin health centers. The case group was under the third percentage of their growth chart or they had -2SD in growth chart at least in three months. The control group was composed of infants with normal growth chart.

  The demographic characteristics of parents, and the nutritional and antropometric (height/weight, head circumference) characteristics of the subjects were measured. The collected data were analyzed by SPSS software, using chi-square and ANOVA.

  Results: The findings indicated higher frequency of respiratory infections, diarrhea and vomiting in case group (p<0.05). The control group, on the other hand, outnumbered the case group in terms of the number of infants under 6 months who were exclusively breast-fed (p<0.05). Most of the infants with FTT had a lower birth weight than control group (p<0.05). The number of mothers with lower level of education and those who were housewives and also the number of family members were significantly higher in case group than control group (p< 0.05). However, no significant difference was observed between two groups in terms of frequency of breast feeding and birth rank.

  Conclusions : The results indicated that some risk factors such as respiratory infections, birth weight, education, mother ُ s knowledge, exclusive breast feeding and the frequency of diarrhea and vomiting have far more important role in growth disturbances in children compared to factors such as frequency of breasr feeding and birth rank.

  Backgrand & Objective: Enterobius vermicularis is a common helminthic infection and its prevalence in Iran is 25 to 92 percent.The aim of this study was to determine the prevalence of E. vermicularis infection among children going to daycare centers in Ardabil.

  Methods : This cross-sectional study was carried out in 2003 on 400 children who were selected from 10 daycare centers using Graham's scotch adhesive tape technique. A questionnaire was filled for every subject and the results were analyzed by Chi-square test.

  Results : The prevalence of enterobiosis in the children under study was 18.3%. The highest rate (21.62%) was observed among 3-4 year-old children and the lowest rate (16.19%) was seen among 5-6 year-old ones. The infection rate of males and females were 16.4% and 21.2%, respectively. Prevalence of enterobiosis in children of illiterate mothers (54.5%) was higher compared to literate mothers (12.4%) (p< 0.05).

  Conclusions : In order to prevent this infection, health education especially for illiterate parents or those who have lower level of education is necessary.

 Background & Objective: Carotid baroreflex is the most important system of moment-by-moment control of blood pressure. In the past, in order to test carotid baroreflex, invasive methods were incorporated. In 1975 Eckberg introduced a non-invasive apparatus for testing carotid baroreflex sensitivity . The main objective of the present research was to design and construct a more progressive version of the Eckberg's model apparatus. This apparatus would be able to stimulate cervical baroreceptors through sucking the neck. This device will enable physiologists and pharmacologists to perform many researches about carotid baroreceptors.�

 Methods: In this apparatus advanced electronic and mechanical ciruits apply negative controlled pressure on the carotid sinus and increase the blood pressure. By application of negative pressure in front of neck, it stretches the soft cervical tissues including carotid sinus. One of the major modifications included was using resistant rubber instead of lead sheets for making the neck chamber. The whole system was controlled by a computer, which made our system more advanced as compared to the original model suggested by Eckberg. In order to test the apparatus, 12 young male volunteers received a -30mmHg to -90mmHg neck chamber pressure for 10 seconds. Any changes in cardiac cycles during the suction were being recorded using cardiopen II. So the charges could be evaluated.

 Results: The findings showed that stimulation of carotid baroreceptors increased the length of cardiac cycles abruptly. This increase is significantly different from the baseline( p<0.003) and shows the correct functioning of the equipment.

 Conclusion: The final tests confirmed the capability of the apparatus in stimulating carotid baroreceptors. This device can be used in other universities and research centers.

  Background & Objective : The role of circulating lipids in the pathogenesis of ischemic stroke remains unclear despite 3 decades of research. Since ischemic stroke is one of the important causes of death or disability in the world. Finding its risk factors can play a crucial role in health interferences.This study was conducted to investigate the relationship between blood lipids and ischemic stroke.

  Methods : This was�a case-control study conducted in 2002. The case group were patients who were definitely diagnosed to have ischemic stroke for the first time. An equal number of control subjects (with the same age and sex) were selected from other hospital wards. These two groups were compared in terms of the blood lipids. The collected data were analyzed using SPSS software (release 12) and statistical methods such as ANOVA and multivariate regression.

  Results : In this research 132 cases were compared with equal number of control subjects. The subjects in both groups were 64.1 years old on average. The mean level of total cholesterol was significantly higher in case group (p=0.001). The mean level of Triglycerides had no significant difference in two groups.

  Conclusions: Regarding the findings of the present research, offering strategies to lower the chlestrol level through primary prevention as well as drug interferences especially in the groups with other risk factors of stroke, seems to have a significant role in the prevention of ischemic stroke.

  Background & Objective : Malignant skin tumors are highly prevalent cancers all over the world. Iran can be regarded as an area in which skin malignancies are so common because of severe sunlight, and occupational requirements of farmers with long exposure to sunlight. This study was an attempt to evaluate the frequency of malignant skin tumors in Urmia.

  Methods : In this descriptive and retrospective study 61496 pathological reports collected from pathology centers in Urmia between March 1991 and March 2001 were examined. Among these reports, 1099 cases with skin malignancies (including BCC, SCC and CMM) were identified and classified based on factors such as age, sex, job, the location of lesion and patient ’ s, residential area. In order to accomplish the incomplete data, the researchers referred to cancer registry center in health deputy of the province.

  Results : Among 1099 cases, 1076 patients (97.9%) had solitary lesion and 23 cases (2.1%) had multiple lesions. The ratio of male to female is 1.7:1 in all skin tumors. Most patients were farmers (28.02%). BCC was mainly observed on nose (26.2%), SCC was around mouth (36.78%) and CMM was mostly in extremities (45.09%). BCC was mostly on upper half of the face and SCC on the lower half. Most patients age ranged from 60 to 69 years. BCC was the most common histopathological type of tumors (71.62 %). 52.61% of patients lived in Urmia and the rest were from other cities. Comparing the first and second 5-Year periods of this research indicated a 25% increase in the frequency of tumors.

 Conclusions: According to the increased incidence of malignant skin tumors in this area some measures should be taken to prevent this disease, reduce the risk factors and diagnose these tumors earlier.

 Background& Objective: Animal bites are considered to be an important threat to human health. Ardabil province in north-western Iran has the highest incidence rate of animal bites in Iran. This study was an attempt to investigate the epidemiological features of animal bites in Ardabil province during a one-year period from April 1999 to April 2000.

 Methods: In this descriptive study a special questionnaire was filled for all cases of animal bites reported during a one year period in Ardabil province. The questionnaire included questions regarding rabies, age, sex, job, etc. The data were analyzed using SPSS software (release 9). Descriptive statistics was used in the form of frequency tables and graph in order to summarize the data.

 Results: The total number of exposed persons to animal bites were 4331. Males comprised 75% of cases (3259) and 1072 persons (25%) were females. The highest incidence rate was seen among 30-50 year-olds. Animal bites were more common in summer. In 3078 cases (17%), legs were the main site of bite. Dog bite was the most common type (95%).

 Conclusions: This study confirms that animal bite such as dog bite is an important public health problem in Ardabil province. Regarding the importance of this issue it is necessary to take serious measures in order to control and prevent this health thereat.

 Background & Objective: Postpartum depression is a problematic and important disease and if not recognized and treated on time, it can be aggravated or chronic. Exercise is strongly recommended in this regard to prevent any family disorders and improve the health of mother, child and family. The aim of this study was to determine the effect of exercise on mild postpartum depression among women referring to Ardabil health centers.

  Methods : This study was a double blind clinical trial. About 50 subjects with normal vaginal delivery were selected. The subjects had referred to health canters in the second week after delivery and were diagnosed to have mild depression using Beck depression test. They were randomly divided into two groups (exercise and non-exercise). Then Beck test was done 6 weeks after delivery again and the results were compared in two groups.

  Results : The findings indicated that between mildly depressed mothers, 36% were 26-30 years old, 82% were housekeeper, 44% had under diploma education, 60% had two previous deliveries. 56% of exercise group and 32% of non-exercise group were treated. 8% of experimental subjects and 18% of control ones needed psychological consultation 6 weeks after delivery. T-test showed significant differences between two groups (p<0.05).

  Conclusion : Results showed that exercise had a positive effect on the treatment of mild postpartum depression. As a result it is recommended strongly in postpartum care.

  Background & Objective :Depression is one of the most common disorders which can affect every individual. However some individuals (including the students of medical sciences) who are involved in health issues are more vulnerable in this regard. The early diagnosis of this disorder among the students can lead to primary prevention and avoid any further progression and deteriration. This in turn can result in mental health among these students as well as the society. The present study set out to investigate the rate of depression among the students of Ardabil university of medical sciences.

  Methods : This research is an analytic-descriptive study conducted on 324 students from Ardabil University of Medical Scinces. A questionnaire including two sections was used to collect the data. The first section was about the demographic information and the second section included questions about depression based on Beck depression test. The data were analyzed by SPSS soft waire using descriptive and analytical statistics.

  Results : The results showed that 57.4% of total subjects (186 students) suffered from various degrees of depression. 128 of these students were suffering from clinical depression. The prevalence of depression among midwifery students was 21.4 %. Chi- square test showed a significant relationship among prevalence of depression in these students with their educational semester , the number of their siblings, any kind of major physical disorder in the subject or, a serious psychological problem among their family members , as well as any significant event during the previous year.

  Conclusions : According to obtained results there was a high degree of depression among medical university students and serious measures should be taken in the future in order to prevent this social concern.

 Background & Objective: The emergence of multi-drug resistant salmonella strains h ave made t h e treatment of typhoid fever difficult all over the world. It is even more complicated w h en t h e hi g h cost of newly marketed antibiotics, their side effects and arising bacterial resistance to them are considered. Knowledge of antibiotic sensitivity and resistance of salmonella can make prevention of side-effects and emergence of resistance as well as the treatment measures more effective in this region.

  Methods : This descriptive study was performed in a 6-year period between 1992-97 on 397 patients who were culture positive (blood and stool) in terms of typhoid. The drug resistance was determined based on the anti-biogram of salmonella separated from blood and stool culture of the patients.

  Results: The total number of patients was 397 (237 males, 160 females). All of the subjects were above 12 years old. The resistance of strains of salmonella separated from the blood and stool culture to an antibiotic was 76.9 and 79.6 percent respectively. Resistance to ampicillin, amoxicillin, co-trimoxazole and chloramphenicol was highest among others. There were 60 strains with multi-drug resistance 34 of which (8.57% of all patients) were separated from blood culture and 26 (6.55% of all patients) from stool-culture. The amount of microorganisms multi-drug resistance separated from blood and stool was 6.55% and 8.57% respectively (15.12% in total).

  Conclusions : Using antibiotics without the knowledge of bacterial resistance and sensitivity can complicate the issue.

 Background & Objective: Bell ’ s palsy (BP) is a relatively common disease characterized^�by the sudden onset of facial paralysis. In this disease, the facial muscle is paralyzed and the patient cannot close the eye or control the saliva in the involved side._�The incidence rate of this disease in the world is between 11.5-40.2 cases per 100,000. The cause of this disease is yet to be found. This study is an attempt to investigate the demographic. Characteristics of these patients as well as the environmental factors involved in this disease in Ardabil.

 Methods: In this cross-sectional study which was cauducted in Ardabil province during a 2-year period (2001-2003) all the patients referring to neurology clinics were evaluated by a questionuaire in terms of demographic features and whether they were affected by the disease.

 Results: 140 cases (out of 6550) were affected by Bell ’ s palsy. The incidence rate was high among 20-30 year-olds (17.85%) and was equal among females and males. Incidence of BP was higher in cold seasons. A high incidence was also observed among farmers, who sweat abundantly due to their job nature.

 Conclusions: The results are consistent with hypotheses regarding viral etiologies [e.g., reactivation of herpes simplex] of Bell ’ s palsy and it can be activated by cold exposure. The results also indicated that the disease is more prevalent in cold seasons.

 Background & Objective: Ardabil province is the main area of Iran affected by relapsing fever (RF) for which Borrelia Persica is the most common cause. The aim of this study was to determine the epidemiologic characteristics of the disease, and the frequency of infection among ticks in this region in order to take necessary measures to decrease it is incidence and increase awareness about the characteristics of this disease.

 Method: In this study a total of 391 patients who were diagnosed to have been effected by tick borne relapsing fever were investigatated in terms of clinical epidemiology between 1998 and 2001. The kind of Borrelia as well as the clinical characteristics of the disease were observed. The kind and prevalence of Borrelia infection was determined in 1,421 ticks collected from 130 indoor and 14 outdoor sites. The ticks were crushed and the suspension obtained was injected into the peritoneum of two mice and two guinea pigs to determine the frequency of infection among the ticks living in this region. Data including the tick species determination were collected through a questionnaire and analyzed using Chi-square and ANOVA tests.

 Results: The most prevalent clinical manifestations were fever, chills and headache. Other findings included nausea, vomiting, sweating, abdominal pain, arthralgia, cough, photophobia, eosinophilia, hematuria, jaundice, petechiae and sclera congestion. Laboratory tests performed on 60 patients showed leukocytosis, high erythrocyte sedimentation rate (ESR) and anemia. Of the 1,421 ticks collected, 45.9%, 40.3% and 13.8% were infected by Ornithodoros lahorensis Ornithodoros tholozani and Argas persicus species, respectively. The prevalence of ticks was highest in Khanadabil village. The ticks collected from three villages were found to be infected with Borrelia.

 Conclusions: The clinical manifestations were similar to those reported in other studies. Petechiae occurred less frequently in our study compared to louse-borne RF. The high frequency of anemia in this region, which was not stated in other reference articles, requires further investigation.