Background & Objectives: Otosclerosis is one of the causes of conductive hearing loss in different ages, the diagnosis of which sometimes becomes difficult using clinical and audiological symptoms. The early diagnosis and surgical treatment of this disorder will give a normal hearing to the patient. The goal of this study was to determine the role of exploratory tympanotomy in revealing the patients with hearing loss as a result of otosclerosis which is impossible to be diagnosed based on clinical and audiological, symptoms.

 Methods: This prospective study was conducted on 33 patients (18 females and 15 males) with conductive hearing loss suspected to otosclerosis, who were admitted to oto-rhino-laryngology department of Imam Khomeini hospital from 1999 to 2003 and underwent exploratory tympanomy. In 30 patients (16 females) otosclerosis was revealed during operation all of these patients underwent stapedectomy. During three weeks after surgery, the patients were examined in terms of facial paralysis, non-response to treatment, deterioration of hearing ability, dizziness, the probability of tympanic perforation and other complications. Audiological tests were also studied. The obtained data were recorded and compared with findings of other researches.

 Results:�The prevalence of the disease in women was more than men, and the majority of the patients had referred to be treated in the third and fourth decade of their life, while they had a history of hearing loss from the second or third decade of their life. The positive family history was below compared to other studies, but conductive hearing loss was more prevalent. This treatment led to hearing improvement in majority of the patients.

 Conclusions: Considering the proper time for stapedectomy is very important since better results can be abtained if the patients are operated with lower degrees of hearing loss. Thus, exploratory tympanotomy leads to early diagnosis and treatment in patients with conductive hearing loss suspected to otosclerosis.

 Background & Objectives: Atherosclerotic stenosis of carotid territory is the most common cause of ischemic stroke. A higher frequency rate of intracranial arterial stenosis in African and Far East races has been reported.

 Methods: This double center and prospective study was carried out in 304 geriatric ischemic stroke patients admitted in Mackenzie Hospital, Canada and the same number of geriatric ischemic stroke patients with similar sex ratio admitted in Valie-Asr Hospital, Birjand during 2003-2005. The cause of brain infarction in carotid territory was made by neurologists was vasular origin. All of the patients underwent transcranial and carotid doppler studies based on the standard method by a neurosonologist. Topography of arteriosclerotic stenosis in bilateral Internal Carotid Artery (ICA) territories was determined. Fisher exact test served for statistical analysis and p<0.05 declared as significant.

 Results: In Iranian group 71 patients (23.3%) and in North American group 83 patients (27.3) had extracranial ICA stenosis without a significant difference p=0.3, df=1, OR=0.81, 95%CI(0.56- 1.17). Sever ³ 70% extracranial ICA stenosis was found in 14 Iranian patients (4.6%) and 23 North American patients (7.5%) without a significant difference . p=0.17, df=1, OR=0.59, 95%CI(0.3-1.77). In Iranian group, 14 cases (4.6%) and in North American group 5 cases (1.6%) had intracranial ICA territory stenosis which had a significant difference p=0.038, df=1, OR=2.9, 95%CI(1-8.1). Mixed intracranial and extracranial ICA territory stenosis was found in 2 Iranian and 1 North American patients.

 Conclusion: Atherosclerotic stenosis of intracranial ICA territory is more common in Iranian than in North American populations.

  Background & Objective: Mycobacterium leprae is the cause for leprosy which is a contagious disease in many developing countries. These diseases have always been a dreadful one for its unpleasant clinical symptoms and the disabilities it causes. It has the most prolonged cell division time of all bacteria (12-14 days). Its incubation period is long (3-5 years) even 40 years has been reported. The complications which it leaves are irreversible and it bears a heavy socio-mental burden on the individual and the society. WHO has listed 91 countries with leprosy. The goal of the present study was the early diagnosis of the disease before the emergence of unpleasant clinical symptoms and popularizing molecular method of PCR in place of the conventional method of slit skin smear which is not a precise or reliable method.

  Methods: In this study 40 slit skin smear and the same number of skin biopsies were taken from patients referring Bababaghi Hospital and samples from ear lobes and eyebrows were taken. Slit skin smears were stained with Zeihl-Neelsen method and examine microscopically. At the same timy biopsy specimens were extracted.

 Results: Of 40 samples, three slit-skin specimens (7.5%) had positive smear result, while 14 (35%) biopsies had PCR positive result. The rest (11 cases) probably had TT or borderline forms of BB, BT, BL).

 Conclusion: The results showed that SSS is not a precise and reliable method for diagnosing leprosy especially in TT form which is always negative direct smear. Also direct smear method and clinical symptoms are not accurate or reliable methods in estimating the rate of disease prevalence.

Background & Objective: Many factors interfere in liver fibrosis one of which is hepatitis B.The aim of our study was to determine the parameters serum iron, TIBC and ferritin of patients with hepatitis B and fibrosis of the liver

Methods: Study involved 50 cases with liver fibrosis and viral hepatitis type B (2002-2004)
and 26 controls. Iron concentration, Total iron-binding capacity and Ferritin concentration were measured by standard biochemical methods. To compare the results of the two groyps a student t-test was used and considering p< 0.05 the difference between two groups was significant.

Results: The results showed that serum ferritin increase 243.7±16.7 micro gr/L and 238.7±13.9 micro gr/L in man and women patients with chronic hepatitis B virus infection compared to the control group, 198.5±14.3 and 182.7 ±14.3 mg/L in man and women, respectively. No significant difference was found between serum Iron and TIBC in both groups. there was a significant relationship between them.

Conclusion: Increased serum ferritin concentration and liver fibrosis induced by hepatitis B virus infection. Also, determination of serum ferritin could help in diagnosis of liver fibrosis.

  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 and objectives: Leptospirosis is a very common zoonosis in the world. Early diagnosis of leptospirosis is critical because just early treatment will be effective. It's culture is very slow and serological assays are not applicable because of lack of antibodies in the first week of the disease, therefore PCR is the only option for the early diagnosis. In this study, sensitivity and accuracy of a non-quantitative conventional PCR for diagnosis of leptospirose in first week sera of patients, is evaluated

  Methods : Seventy first week sera sample of patients with clinical diagnosis of leptospirosis which were negative in MAT but positive for the second time after one weeks (seroconversion) were selected and studied.

  Results : We observed twenty four positive sera in PCR test. Sensitivity of the test was 74.5% and accuracy was 100 bacteria /ml.

  Conclusion : Result of our study shows that PCR is the only choice for the early diagnosis of Leptospirosis while other assays are not applicable but its sensitivity is low.

  Background & Objectives: Malassizia furfur (pityrosporum ovale/orbicular) and other related species are ethologic agents of tinea versicolor and pityrosporosis in normal individuals but fungal infections due these yeasts are a major cause of mortality in immunocompromised and cancer patients. Catheter-related fungemia or foliculitis is most common mycoses in immunocompromised cases, but malassezia Spp., has been frequently implicated as the causative agent of peritonitis, septic arthritis, mastitis, and sinusitis and variety ocular infections. In this study we surveyed Pityrosporom ovale in dandruff of patients with leukemia underlying chemotherapy.

  Methods: Over a one year period, 100 scale samples were obtained from 50 patients with leukemia underlying chemotherapy. All samples were stained using Metilin Blue method. In direct microscopic examination, seeing budding yeast cells with certain numbers, (bottle bacillus) on epithelial cells were reported positive sample.

  Results: Pityrosporosis were dtected in %78 patient with Leukemia. Most of patients were range of 21-30 years old (27%), that suffering from increased scale.

  Conclusion: Malassezia fur fur is one of more common noncandidal yeasts causing a variety of fungal infection. This organism is a lipophilic yeast that colonizes superficially in human skin and causes superficial mycoses such as tinea versicolor, rarely catheter– related sepsis, foliculitis and other systemic mycoses. Most reported cases of systemic mycoses due to this yeast have been in neonates or adults with malignancy or immunocompromised patients, who were receiving parenteral lipids via a central vascular catheter, undergo chemotherapy and BMT. As pityrosporosis were positive in over than 82% of studied patients, suggested that for prevention of serious fungal infections and mortality in immunocompromissed patients, it must be considered a suitable anti fungal protocol for these cases such as using shampoo or other drugs containing antifungal agents for treatment of patient underlying chemotherapy.

 The OHS is characterized by hypersomnolence, hypoxia, polycytemia, headache and edema. Polysomnography is the gold standard diagnostic test. Overnight oximetry with significant oxyhemoglobin desaturation is reasonable to begin treatment. Weight reduction and Non invasive positive pressure ventilation (NIPPV) has evolved as the mainstay of treatment.

 Obesity is a risk factor for deep vein thrombosis (DVT). Heparin and warfarin are the drugs that used for treatment of DVT. HIT typically appears as a 50% or greater reduction in the platelet count after the first exposure to heparin. This case is a obese man with extreme DVT that diagnosed by duplex sonography and symptoms of obesity hypoventilation syndrom.

 In overnight pulseoximetry oxyhemoglobin desaturation was occurred more than 15 times per hours and treatment begins with NIPPV. Patients thrombosis were treated with heparin and warfarin. Heparin induced thrombocytopenia (HIT) and cutaneous necrosis was occurred and drug therapy withdrawn. After healing of cutaneous necrosis low dose warfarin was started.

 NIPPV promote airway occlusion and improve hypercapnia.hypoxia and quality of life and reduced cardiovascular complications.

  Uterus leiomyomas are the most common benign tumors and usually are asymptomatic. This article is a report of an approximately large Myoma (12 × 12 × 21 cm). The subject was a 40-year-old woman with pelvic fracture. While examining, a large mass was found in the pelvic. The patient was transferred to the operation room to further examination. During the surgery an almost constant but stiff mass was found in hypogastrium that overextended to the umbilicus. For the last few months, the patient had some disorders such as constipation and oligomenorrhea but these disorders were not important and discomfortable complaining for the patient. Patient was clinically assumed to have ovarian tumor and referred for laparotomy. After surgery, pathological examination showed that it was a subserosal Myoma.

  Background & Objectives: The first Laparoscopic Cholecystectomy surgery was performed by Erich Muhe in 1985.Nowadays in developed countries, more than 90% of cholecystectomy surgeries are done by Laparoscopic method and it is one of the most common elective surgeries. The aim of this study is to evaluate the frequency and side effects of this method and the rate of conversion to open surgery patients undergoing laparoscopic cholecystectomy surgery in Sabalan and Arta hospitals in Ardabil province.

  Methods: This descriptive analytical study was performed between October 2006 and January 2009. We have studied 200 patients (24 male, 176 female) with cholecystitis (symptomatic gallstones) treated by Laparoscopic Cholecystectomy surgery. Data were collected through questionnaires and telephone calls (at least 6 months after surgery). Data analysis was done by SPSS statistical software and chi-square test. p<0.05 was considered as significant.

  Results: The average age of patients was 44.6 years. In the final diagnosis, 168 patients (84%) had chronic cholecystitis and 32 patients (16%) had acute cholecystitis. The rate of conversion to open surgery was 8 patients (4%). Eight cases (4%) were suffered organic side effects including: four cases (2%) jaundice after surgery, 1 case (0.5%) postoperative fever, 1 case (0.5%) leakage of bile, 1 case (0.5%) slight leaking of serum from the surgical site and 1 case (0.5%) associated with increased liver enzymes that had no other symptoms. About the risk factors for conversion to open surgery, there was significant correlation between acute cholecystitis and male gender. Information about the satisfaction of patients after surgery showed that, 89.5% were completely satisfied, 2.5% were completely dissatisfied and 8% were relatively dissatisfied. No deaths were seen.

  Conclusion: Laparoscopic Cholecystectomy is a standard selective treatment method for gallbladder stones. It has many advantages including reduced duration of hospitalization, less pain, reduced morbidity and less side effects than open surgery, lower recovery period and faster return to normal life.