[ relationship between sensorimotor function of hemiplegic lower limb and independency in daily living activities in hemiplegic patients]

Background and Aim: The aim of the present study was to find out the relationship between the various components of sensorimotor function of hemiplegic lower limb and independency in daily living activities in stroke patients

Materials and Method: This was a cross-sectional study which included 40 hemiplegic patients. The patients were between 30 and 70 years of age and selected on a non random basis from rehabilitation clinics in Tehran. We used Fugel-Meyer assessment in order to assess sensorimotor function of hemiplegic lower limbs. Evaluation of independency in basic and instrumental activity of daily living was performed by using Barthel Index and Lawton Instrumental Activities of Daily Living Scale. The correlation was analyzed by Spearman coefficient

Results: There was a significant relationship between hemiplegic lower limb motor function and independency in BADL [P=0.002, r =0.482] and IADL [P=0.001, r =0.494]. There was also a significant correlation between hemiplegic lower limb corrdination and speed and independency in BADL [P<0.001, r =0.601] and IADL [P<0.001, r =0.557]. Hemiplegic lower limb joint pain had significant correlation only with independency in BADL [P=0.009, r =0.410]. Hemiplegic lower limb sensation and passive joint motion had no significant correlation with independency in BADL and IADL. There was a significant correlation between hemiplegic lower limb sensorimotor function and independency in BADL [P=0.002, r =0.477] and IADL [P<0.001, r =0.495]

Conclusion: The results of our study showed a relationship between hemiplegic lower limb sensorimotor function and independency in daily living activities in the stroke patients. Therefore, different components of the lower extremity sensorimotor function should be considered in the rehabilitation programs for the hemiplegic patients

Non-syndromic multiple odontogenic keratocyst: a case report

Odontogenic keratocyst [OKC] is a common developmental odontogenic cyst affecting the maxillofacial region. Multiple OKCs are usually seen in association with nevoid basal cell carcinoma syndrome [NBCCS] but approximately 5% of patients with OKC have multiple cysts without concomitant syndromic presentation

This report represents a case of multiple OKCs in a non-syndromic patient

Effectiveness of life skills training on subjective well being of the female teenagers: short report

Life skills include group of skills and abilities which help individuals resolve issues in their lives and control conflicts in interpersonal relationship. The aim of this study was to determine the effectiveness of the method of life skill training on subjective well_being of female high school students. This semi-experimental study was conducted as a post test, and two pre-test surveys [at one-month follow up]. Statistical population comprised all female high-school students of Rafsanjan city in 2010 and the sampling method was multi-stage cluster sampling. Among 148 students who filled the questionnaires, 30 students who had the least subjective well being score were randomly separated into two groups of 15 students [here called intervention and control groups]. The data was gathered by revised subjective well_being Questionnaire prepared by Molavi in 2008 which involves 39 expressions, from 1 to 5 Likert scale, and also by the researcher's own questionnaire containing demographic information. The intervention group took part in 8 of 90-minute training sessions and the pre test and one-month follow up scores were then analysed by co-variance test using SPSS software. The pre- test data from the two groups showed no significant difference, however, the post test and one-month follow up scores were significantly higher than control group [p=0.0001].This difference was also observed in follow up survey [p=0.0001]. The results of this study show that life skills training courses can improve the feeling of happiness and life satisfaction

[ nested-PCR based detection of cutaneous leishmaniasis vectors in Jask county, Hormozgan, Iran]

The city of Jask in south east of Iran has been considered an endemic focus of leishmaniasis. PCR-based techniques can detect lower parasite burdens, reducing the number of false negatives and improving the quantification of Leishmania parasites in the sand fly. The aim of this epidemiological study was to detect vector[s] by PCR techniques in the city of Jask located in Hormozgan province. Sand flies were captured using CDC miniature light traps and sticky papers during 2007-2008 and identified by their morphology. DNA extraction performed by Proteinase K and Phenol/Chloroform/Isoamyl Alcohol methods. Leishmania kinetoplast minicircle DNA was amplified by two Nested-PCR techniques using species-specific primers [LINR4-LIN17-LIN19] and [CSB1XR-CSB2XF-LiR-13Z].These primers could differentiate among Leishmania species of Iran. A total of 8123 sand flies were collected. The fauna was identified as eight species [3 Phlebotomus and 5 Sergentomyia]. Phlebotomus papatasi, P. salehi and Sergentomyia theodori were the three most dominant species [59.91%, 17.21% and 7.32% respectively]. 60, 50 and 40 parous unfed female specimens of P. papatasi, P. salehi and S. theodori were investigated for Leishmania DNA infection. Leishmania major DNA was detected in 3 [5%] specimens of P. papatasi and 2 [4%] specimens of P. salehi. Anthropophilic index of these two species were 29.6 and 18 percent, respectively. This study was the first molecular study for detection of cutaneous eishmaniasis vectors in Hormozgan province in Iran. According to the findings of the present study P. papatasi and P. salehi are probable vectors of cutaneous leishmaniasis in this focus

[Effects of meta-cognitive therapy on symptoms of social phobia patients]

Social phobia is an anxiety disorder, which can be described as a strong, persisting fear of situations where humiliation or embarrassment may occur. The purpose of this study was to determine the effect of meta-cognitive therapy [MCT] on symptoms of social phobia [SP] patients. This semi-experimental study was conducted in 2010. with pretest-posttest and follow-up design, using control group. From all social phobia disorder [SPD] patients referring to psychology clinics in Shiraz, Iran in 2010, 19 patients were selected through the objective sampling method and were randomly divided into two experimental and control groups. The Social Phobia Symptoms Assessment Questioner [SPSAQ] and Fears of Negative Evaluation Scale [FNE] were used as the pretest measures. The experimental group received 8 weeks of Wells' meta-cognitive therapy sessions. The control group was in the waiting list until the end of the follow up. The same measures were used for post-test and follow-up [after 3 months]. The results of analysis of multivariate covariance showed that MCT had a significant effect in reducing the symptoms of SPD [p<0.001]. This intervention is believed to reduce symptoms of social phobia [SP] patients by facilitating transmission from the object mode to the meta cognitive mode and enhancing the efficient and flexible coping skills

[Practical hospital disaster planning]

Considering the importance of emergency medical practice as a therapeutic specialty taking into account our country's being the fourth Asian country in regard to frequency of Natural disasters and 10th country in the world, an emergency reaction program has been prepared and executed in one of referral hospitals in Tehran. In the current study a formerly prepared procedure used in European hospitals is taken as the base on which the study is conducted. The modes are then modified as dictated by climatic, cultural and clinical conditions of Iran. An aerial map of Imam Hossein Hospital is used to depict the positions of field units and command centers when it's partially dilapidated. Necessary training based on this procedure was provided to the staff and the program was followed to the practice phase and a maneuver was then conducted. The program should be prepared in such a way to constitute immediate establishment of crisis committee comprised of: 1] head of the hospital, 2] Para clinic unit [including laboratory, Radiology and blook bank], 3] nursing unit [triage, coordination], 4] guarding unit and sentinels, 5] dispatching and discharging unit, 6] psychiatric and social work unit, 7] freezers and refrigeration unit, 8] emergency evacuation unit, 9] installations and maintenance unit, 10] logistics and transport unit, 11] communication unit, 12] public relations and media unit, 13] reception unit, 14] bio Nucleuchemical unit, 15] specialized units. Each unit is headed by a director for whom 3 surrogates should be designated who would immediately take the director's place if and when necessary. After preparing such plan extensive and comprehensive training should be given to hospital staff or whoever which would be engaged in such reaction. Eventually the readiness of the staff should be evaluated through simulated situations and maneuvers. It's hoped that god willing we could reduce losses caused by Natural disasters in the future

[Gerbillid rodents fauna [muridae: gerbillinae] and detection of reservoir host[s] of zoonotic cutaneous leishmaniasis using a nested-PCR technique in Jask city in Hormozgan province in 2008]

Gerbillid rodents [Rodentia: Muridae: Gerbillinae] are the most important reservoir hosts of Leishmania major which is the causative agent of zoonotic cutaneous leishmaniasis [ZCL]. Different gerbil species are reservoirs of ZCL in different parts of Iran. Since Jask City is the most important endemic area in Hormozgan Province and eastern part of Iran, the present study was designed to identify the gerbils' fauna in this city and detect the reservoir hosts of ZCL in Jask City. This was a descriptive study and the rodents were caught in rectangular wire-mesh traps from different areas of the city. The trapped animals were euthanized under choloroform anesthesia. Duplicate impression smears were prepared from the external ears and their morph metric characteristics were measured and recorded. After dissection of the abdomen of the animals by a scalpel liver and spleen of each animal were removed and preserved in a tube containing 70% ethanol and the whole body was incubated in another tube containing 10% formalin and sent to zoology lab for taxidermy and identification of different species. Impression smears were examined for leishman body by means of a light microscope after Giemsa staining. Small parts of spleen and liver of the animals were homogenized and used for DNA extraction. Whole DNA extracted using Proteinase K and Phenol/Chloroform/Isoamyl alcohol methods. The variable segment of minicircles of kinetoplast DNA was proliferatied by means of nested-PCR techniques using species-specific primers [LIN R4-LIN 17 - Lin 19]. All the 106 rodents in this study belonged to five species. Meriones persicus was the dominant species [27.35%]. Microscopic examination detected the leptomonads in a female specimen of Tatera indica [3.7%], a female specimen of Meriones hurricane [3.85%] and a male specimen of Gerbillus nanus species [5.88%], while leishmania kinetoplast DNA was detected in one femalespecimen of T.indica, 2 female specimens [7/69%] of M. hurrianae, and one female and one male specimen [11/76%] of G.nanus species. The parasites were identified as L. major. Different species of gerbil rodents are active and abundant in the vicinity of human residential areas in Jask City. T. indica, M. hurricane and G. nanus species are reservoir hosts of ZCL in this endemic area. In this study we used molecular assay for detection of ZCL reservoir hosts for the first time in south east part of the country. Infection of G. nanus by L. major was detected for the first time in the world

[Studying the epidemiology of traumatic patients referring to Valie-Asr hospital in Arak]

Nowadays, trauma has considered as one of the important cause of mortality and disability in different countries. Due to identify the importance of this problem spread, it is vital to plan some strategies in each region in order to prevent and decrease trauma. Therefore, the aim of this study was the epidemiological assessment of traumatic patients referring to Arak Valie-Asr Hospital in 2006. In this cross-sectional and descriptive study, the data of 813 traumatic patients, who were admitted to the Arak Valie-Asr Hospital in 2006, were extracted by hospital trauma database. The data were such as: demographic variables, location of trauma and its type, type of trauma [blunt or penetrating], smoking or taking drugs, using safety belt in car accidents, and how to transfer patients to the hospital. According to the findings: the most common cause of trauma was car accidents [351, 43%] followed by occupational accidents [171.21%]; 74% of patients were males; 53% were between 20-44 age-group and 64% didn't get diploma. Most of traumas have occurred outside of the town [704, 87%]; 609 patients [69%] had been transferred to the hospital by people; about 693 [85%] of traumas were blunt type. In car accidents, 16 patients [5%] were smoking and 6 patients [2%] using narcotics. Only 64 patients [18%] had used safety belt. The agents of accidents were as follow: about 57% car vehicle [200]; 18% human [65] and also 25% objects and obstacles [86]. The present findings showed like other studies, the most common cause of trauma in the mentioned hospital was car accidents and most young meals are at high risk. The second cause was occupational accidents. Traumas and accidents injuries are one of the serious challenges of public health. Hence, training and developing culture for the use of safety belt, helmet and also safety measures at work could be the most important preventive factors

Comparison of three methods for diagnosis of cutaneous leishmaniasis

Leishmaniasis is one of the infectious parasitic diseases of highest incidence in the world. Cutaneous Leishmaniasis [CL] has long been reported in Shiraz, Southern Iran. There is a need to find a sensitive and specific method for treatment and control of the disease. We have compared the sensitivity of the conventional methods microscopy and cultivation of lesion scrapes against PCR amplification of parasite kinetoplast DNA from these samples. The samples [n=219] were obtained from the patients clinically suspected of CL. The smears were stained with Giemsa for microscopy and cultured in Novy-Nicolle-McNeal [NNN] blood agar for promastigote growth. For PCR, the dry smears were scraped off the slides and DNA was extracted. The positive rates from 219 specimens were 76.71%, 50.68%, and 93.61% for microscopy, cultivation, and PCR, respectively. The highest correlation was found between PCR and microscopy method [P= 0.014]. In PCR assay, 95.61%, 3.9%, and 0.49% of the samples were identified as Leishmania major, L.tropica, and dermatropic L.infantum, respectively. The PCR method appears to be the most sensitive for the diagnosis of CL and is valuable for identifying the other species of Leishmania with confusing dermatropic signs

Study of the demography of transferred patients to Tehran Imam Khomeini hospital by relief helicopter

Using of airplane or helicopter could play an important role in decreasing patients' mortality regarding the importance of reducing time of transmission and treatment. This paper aims to study the transferred patients' demography to Imam Khomeini hospital of Tehran by relief helicopter in order to make good use of facilities for injured triage. In this research patients files transferred to the Imam Khomeini hospital by air rescue and relief, were studied in terms of trauma epidemiology and how emergency services were done since the established air emergency on June 2000 to the end of March. About 92% of 158 patients were hurt in the accident. According to the results, the most common injured organs were the extremities, head and neck. And the worst damage was seen in multiple trauma patients who suffered from the injury to head, neck and thorax. Also, it takes about 23 minutes between the arrival of a patient to the emergency and her/his first visit. Most patients were treated with general surgery and orthopedic services. It is necessary to use appropriate criteria for patients screening in air rescue and relief. The large number of patients are in urgent need of orthopedic and general surgery services, so it is essential that the air rescue and relief should be equipped with facilities

Correlation between myometrial thickness and the latency interval in preterm premature rupture of membranes

In order to predict the time of labor in patients with preterm premature rupture of membrane [PPROM], different factors have been studied resulting in different detection rates. Recently, sonographic measurement of myometrial thickness [MT] has been introduced and studied as an applicable and noninvasive method in predicting the length of latency interval [LI] of labor [the period from PPROM to start of labor]. The objective of our study was to determine the correlation between MT and LI in pregnant women with PPROM led to oligohydramnios. This was a cross-sectional study on 24 cases with PPROM. The sonographic measurement of myometrial thickness and the latency interval of patients with PPROM without labor pain were recorded. Gestational age was between 26-34 weeks and amniotic fluid index [AFI] was less than 5 percentile. The data were analyzed using SPSS software. The mean +/- SD maternal age was 29.2 +/- 1.2 years. The AFI in all women was less than 5% percentile of normal fluid for that gestational age. The mean +/- SD of gestational age was 29.1 +/- 2.2 weeks. The mean +/- SD of MT was 6.5 +/- 1.5 mm interiorly, 7.9 +/- 4.2 mm fundal, 6.6 +/- 1.7 mm in the lower segment and 7.8 +/- 2.2 mm laterally. The mean LT was 545 +/- 4.7 hours. Our study showed that there is no significant correlation between MT and LI in pregnant women with PPROM and reduced AFI

[Accuracy of ultrasound in diagnosis of molar pregnancy in patients admitted to Mahdieh hospital 2001-2006]

Hydatidiform mole is the commonest type of gestational trophoblastic diseases. Diagnosis of molar pregnancies is essential since molar pregnancies might be associated with maternal complication and would result in malignant trophoblastic disease. Recently, there has been a significant change in clinical presentation of hydatidiform mole due to use of ultrasound in early pregnancy before onset of systemic manifestations. The aim of this study was to assess the accuracy of systemic ultrasound in early diagnosis of molar pregnancies. This was a review of patients with molar pregnancies admitted to Mahdieh hospital from 2001 to 2006. Women with histologically-proven hydatidiform moles were evaluated by their age, gestational age, clinical manifestations and ultrasound findings. All data were analyzed with SPSS. The sensitivity and positive predictive value of ultrasound in diagnosis of hydatidiform mole was calculated. The mean mother's age was 24.84 +/- 6.26 years old. The mean gestational age at the time of evacuation was 12.3 +/- 3.85 weeks. The most common symptom was vaginal bleeding [76.2%]. Basically, there were 49.5% of cases whom were histologically confirmed as complete hydatidiform mole, while 50.5% had partial hydatidiform mole. 81.3% of patients had pre-evacuation sonography compatible with hydatidiform mole. The sensitivity and positive predictive value of ultrasound in detecting the histologically-proved hydatidiform moles were 90% and 100%, respectively. In this study, ultrasound had high accuracy in diagnosis of molar pregnancies. Therefore, sonography is highly recommended in all patients with vaginal bleeding in their first trimester

Chrysomya bezziana as a causative agent of human myiasis in Fars Province, Southern Iran

Myiasis is the invasion of body tissues of humans or animals by the larvae of the Diptera or two-winged flies. The various forms of myiasis may be classified from clinical or entomological point. This study describes the existence of Chrysomya bezziana [Diptera: Calliphoridae] cases as a causative agent of myiasis in 18 and 87 year-old men in two different regions in Fars Province. To our knowledge, this is the first observation of mentioned species in this province

prevalence of Toxoplasma infection among free-ranging chickens in Southern Iran using IFA and nested-PCR

As consumption of chicken meat may be as one of the sources of human infection, this study was undertaken to determine the prevalence of T. gondii in farm chickens[Gallu gallus domesticus] in Shiraz, southern Iran. Two hundred and thirty one blood samples were collected from farm chickens by a cluster random sampling method and tested for toxoplasmosis by indirect fluorescent antibody technique [IFAT]. The samples of the brain, heart, and liver of the chickens were tested by a Nested PCR method. The results were analyzed by SPSS software using Chi-Square test and a P value <0.05 was considered statically significant. Out of 58 seropositive chickens, 29 [1:16 in eight, 1:32 in 14, 1:64 in five and 1:128 in two birds] and out of seronegative chickens, three were enrolled in the study. The most infected tissue was liver [27 out of 29] and the lowest was the heart [16 out of 29] [alpha =0.05, P=0.002]. None of the seronegative chickens was positive in PCR method. Only 2 out of 8 cases with a titer of 1:16 [as cut off point] were negative in PCR method whereas the remained were positive. Based on cultural and food habits in our area, the meat and viscera of chicken may be important sources of infection in human when consuming semi-cooked meats. Considering the high prevalence of toxoplasmosis in chickens, standards in chicken breeding, education of environmental health personnel and standardization for preparation and handling techniques are required by Health and Veterinary organizations

[Study on validity of farsi version of irritable bowel syndrome quality of life questionnaire [IBS-QOL-34]]

This study aimed to evaluate psychometric characteristics [diagnostic validity and reliability] of quality of life questionnaire in irritable bowel syndrome [IBS-QOL] which is a popular inter-cultural measure. According to ROME II criteria 126 patients were included by the caring physician in Alzahra and Noor hospital clinics in Isfahan, Iran. Results: Eight scales of the questionnaire and total quality of life measure showed good internal reliability [Cronbach alpha=0.93 for the whole questionnaire, 0.88 for dysphoria, 0.67 for activities interference, 0.72 for body image, 0.57 for health worry, 0.57 for food abstinence, 0.71 for social reaction, 0.76 for sexual worry, 0.62 for interpersonal relations]. The validity was measured against another quality of life questionnaire [IBS-QOL-36] and a significant correlation was found [r=0.61. p<0.01]. To evaluate diagnostic accuracy 40 patients were compared with 40 healthy subjects. Except for body image scale other parts of questionnaire and the global quality of life were significantly different between these two groups [p<0.05]. Generally, Farsi version of IBS-QOL questionnaire was found to be a valid and reliable mean to study patients with irritable bowel syndrome

[Contributions of dysfunctional attitude scale and general health subscales to prediction and odds ratio of depression]

Dysfunctional attitude may be predispose factor for depression, but there are few investigations for that. The aim of this study was to determine contributions of dysfunctional attitude and general health index based on GHQ-28 to depression. In this description and analytical study, a total of 65 patients with major depression and dythymic disorder from Noor and Navab-Safavi psychiatry clinics and 65 healthy individuals with age and sex, and education matched were randomly selected. Dysfunctional attitude scale and general health questionnaire were filled in by two groups. Data were analyzed using linear and logistic regression and correlation methods. Logistic regression analysis on categorized scores of DAS- 26 as high and low risk revealed that odds ration for high risk group was 6.89 fold than low risk one [OR=6.82, Cl/95, 2.9-16.06]. Two point serial correlation between DAS-26 and psychiatrist diagnosis was 0.44. Also, major depression and dysthymic disorder was significantly predicted by general health subscales [P<0.001]. Dysfunctional attitude may be a predisposing risk factor of depression. Predict depression support and Beck's cognitive diathesis stress theory of depression that dysfunctional attitude [26 options] can be used for determination of depression in this group

[Pathologic assessment of Meckel's diverticulum specimens; a ten year study]

Meckel's diverticulum is one of the most common congenital anomalies of gastrointestinal tract. Our aim was to study pathologic features of surgical specimens of the diverticulum and to assess the type of lining mucosa, presence of Helicobacter pylori and inflammatory changes. We studied patients' medical records and pathology files of the years 1994 through 2004, of the patients who underwent surgery with the diagnosis of Meckel's diverticulum in Children's Medical Center, Tehran. Pathologic features such as length and lining of the diverticulum and other variables such as age, gender and clinical signs were studied. We found 45 specimens in this period [80% male 20% female]. The mean age was 3.8 years [25 days to 11 years] and most of the patients were between 2 to 4 years old [33.6%]. Most common clinical symptoms were abdominal pain [17] and hematochesis [4]; 20 patients had combined symptoms such as abdominal pain and melena. Only 9 patients with lower gastrointestinal bleeding had Technetium scan and all of them were positive. Associated findings during surgery included appendicitis and invagination. Twenty diverticulae were inflamed in pathologic report, 8 with gangrene and 5 with perforation. Pathologic examination of specimens revealed a mean diameter of 2 cm [range: 0.4-4.5] and a mean length of 3.8 cm [range: 1-10]. Lining was of intestinal type in 27 [60%], gastric in 10 [22.2%] and combined in 8 specimens [17.8%]. 11 specimens from 18 that were lined by gastric type of mucosa showed no Helicobacter pylori in Giemsa stain [2 had mucosal necrosis]. Clinical findings of Meckel's diverticulum in our study were rather the same as in literature. The most efficient way of diagnosis was Technetium scan. Pathologic examination of specimens revealed that most diverticulae were lined by intestinal type of mucosa. None of those with gastric type of mucosa showed Helicobacter Pylori infection

[ role of ultrasonography guided transthoracic needle biopsy in diagnosis of peripheral pulmonary mass]

Transthoracic needle biopsy [TNB] is a well established method for obtaining pathologic diagnosis in the lung masses that is performed after a previous negative bronchoscopy. The goal of this study was evaluation of the safety and accuracy of ultrasonography guided TNB in diagnosis of peripheral lung masses. This descriptive study was done from 2005 to 2006 in Ghaem Hospital. 30 patients with peripheral lung mass, greater than 3[cm] in diameter and within 5[cm] from the chest wall, underwent ultrasonography guided TTNB. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. Male to female ratio was about 1:2, and mean age was 61.2 years. 60% lesions were located in the right side. Adequate biopsy specimens were obtained in all patients; but TNB was diagnostic in 86.6%, 13.3% patients underwent thoracotomy for definitive diagnosis. Pathological diagnoses were malignant in 83.3%, with SCC and ACC being the most common, and benign in 16.6%, the most common of which was tuberculosis. Complications were observed in 13.3%, including pneumothorax in 6.6%, and hemoptysis in 6.6%; mortality was not observed. According to this study, TNB with ultrasonography guide due to appropriate diagnostic accuracy and low complication rate with low cost and good availability is recommended for diagnosis of peripheral lung mass

[Characterization of leishmania parasites isolated from kala- azar patients in kohgiloyeh and boyerahmad, using semi-nested PCR]

Visceral leishmaniasis [VL] is a disease commonly known as Kala-azar caused by protozoan parasites of the genus Leishmania including L. donovani, L. infantum and L. chagasi. VL is sporadic in manyareas of Iran and is endemic in a few provinces such as Fars, Azarbayjan, Bushehr, Ardabil and Qom. VL has been reported from some areas of Kohgiloyeh and Boyerahmad and this study aimed to characterize the causative agent of VL in this region. Bone marrow sample was obtained from 6 VL patients from children department in Imam Sajad hospital in Yasuj. DNA was extracted from the obtained samples and was checked by semi-nested PCR to determine the species of the parasite. To do that, a segment of minicircle kinetoplast DNA was amplified, using LINR4 and LIN17 primers. Products of PCR were evaluated by electrophoresis, using 1.5% agarose and stained with ethidium bromide. Parasitologically examination of bone marrow smears demonstrated amastigotes form of the parasite in the samples. For mass cultivation, isolated parasites were cultured in diphasic NNN followed by RPMI 1640 media. All the samples produced a 720 bp band in PCR assay. The isolates were compared with referent strains and it was revealed that all the isolates were L. infantum. Findings of this study demonstrated that the causative agent of VL in Kohgiloyeh and Boyerahmad was L. infantum. Further study is needed to explore other aspects of VL in this region

[Congenital intestinal malrotation as the serious cause of neonatal intestinal obstruction]

Congenital intestinal malrotation as an abnormal embryonic intestinal rotation and fixation leads to various clinical presentations of high complete or incomplete intestinal obstruction, especially midgut volvulus and extensive intestinal loss that may cause short bowel syndrome or death of the patient. we conducted this study to assay clinical presentations, surgical findings, mode of management and outcome of neonates with intestinal malrotation. We studied retrospectively data of 25 neonates with intestinal malrotation in 3 hospitals of the Tehran University of Medical Sciences [1985-2003]. Patients consisted of 17 males and 8 females. 5 [24%] patients had extensive intestinal gangrene that resulted in short bowel syndrome in 2 patients. 7 [20%] patients died, 5 of them due to intestinal volvolus and 2 other due to associated anomalies and sepsis. Most common clinical signs and symptoms were vomitus [96%], bilious vomiting [80%], constipation [24%],], coliky abdominal pain [23%]. Abdominal distention was observed only in patients with volvolus [38%]. Obstipation [31%] and rectorragia were seen only in patients with volvolus and intestinal gangrene. 28% of neonates had associated anomalies. Malrotion was suggested by abdominal X-ray in 3 out of 12 [25%], barium enema in 9 out of 11 [81.8%], and gastrointestinal follow through in 3 out of 4 [75%] examinations. 3 patients were surgically managed according to only one abdominal X-ray. Ladd procedure was performed in all patients and other necessary corrective operations for associated anomalies included intestinal resection with anastomisis in 5 and intestinal resection with entrostomy in 2 cases. To prevent extensive intestinal loss due to intestinal volvolus in neonates with abrupt bilious vomiting, malrotation must be excluded, and if a volvulus is suspected, emergency laparotomy should be undertaken