effect of one session endurance running [5000 m] on the level of serum electrolytes

Background: The purpose this study was the effect of one session endurance running [5000 m] on the level of serum electrolytes

Materials and methods: In this quasi-experimental, 14 male runners participated in the test, voluntarily. After warm-up, subjects ran distances of 5,000 meters in 23 minutes and participated in the second blood sampling. Photometer and spectrophotometer video device to determine blood electrolytes were used

Results: 5,000-meter run at Tehran's climate caused significant change in serum sodium [p=0/039, t=2/30].Serum calcium levels also rose significantly in the amount of 7/1 percent [p=0/005, t=- 3/37]

Conclusion: the 5000-meter run, Increases in sodium and calcium in the blood serum and Reduces the amount of potassium

[Evaluation of the role of hyperbilirubinemia in the diagnosis of complicated appendicitis]

Early and precise diagnosis of complicated appendicitis [gangrene, perforation, …] and proper surgical measures are necessary to prevent mortality and morbidity. The aim of this study was to investigate the diagnostic value of serum bilirubin level as a preoperative laboratory marker in the diagnosis of complicated appendicitis. We evaluated 295 patients with primary diagnosis of acute appendicitis in Shahid Rajaee Hospital in Qazvin City. Demographic information, pain duration and other clinical findings such as fever and history of liver disease and the findings of physical examination were recorded in a predefined questionnaire. Then CBC diff. and serum total bilirubin of the patients were checked and macroscopic findings of appendix in the operating room and final pathologic diagnosis were also entered on the questionnaire. Appendicitis was more frequent in the patients between 15 and 20 years of age [42.7% of the patients]. The mean age of patients was 30.35 years old, 60% were male and 40% female. Leukocytosis and shift to the left were detected in 98.5% of the patients with complicated appendicitis and 85.6% of the cases without any complications which showed a significant difference [P<0.001]. The serum bilirubin level was significantly higher in the patients with complicated appendicitis [P<0.01]. This study showed that patients with clinical symptoms of appendicitis and hyperbilirubinemia were more likely to develop complications in comparison to the patients with normal bilirubin level. Therefore, measurement of serum bilirubin level together with WBC count can be helpful for assessment and diagnosis of complicated appendicitis

Efficacy of microwave and infrared radiation in the treatment of the skin lesions caused by leishmania major in an animal model

Cutaneous leishmaniasis caused by L. major is an important public health problem in endemic areas. The aim of this study was to explore the therapeutic effect of microwave and or infrared radiation in the treatment of lesion induced in BALB/c mice by L. major inoculation. The footpad lesion was induced in BALB/c mice by inoculation of L. major promastigotes subcutaneously. The lesion was treated with 600 watts power, 2.450 GHz frequency and/or infrared device with 150 watts and a wave length of 890 nanometres. The size of the lesion was recorded by footpad swelling measurement ever 10 days. The lesion growth was significantly hampered in treated mice compared with the untreated control group [P<0.05]. Infrared radiation was more effective than microwave in inhibiting ulcer enlargement. Infrared radiation and microwave significantly hampered L. major lesion growth in BALB/c mice. This therapeutic effect was more in infrared radiation treated mice than microwave treated mice

[Prevalence of Staphylococcus aureus resistant to methicillin in traditional cheese and cream: a study in city of Tabriz, Iran]

In recent years isolation of antibiotic resistant Staphylococcus aureus, especially methicillin resistant Staphylococcus aureus in food and food-producing animals has become more frequent. The aim of this study was to determine the prevalence of MRSAin traditional white cheese and butter presented in Tabriz by culture and PCR techniques, as well as the determination of their antibiotical susceptibility. In the present study, 250 traditional white cheese and butter samples were collected from different producers across Tabriz. Evaluation for contamination by coagulase positive Staphylococcus aureus was done using the Culturing method. The isolates were subjected to the PCR technique according to the Nuc gene in order to confirm Staphylococcus aureusand methicillin resistance to the gene [mecA] and the antibiotic resistance trend of the isolates were studied by the Disc Diffusion Agar method. The culture of the samples indicated that 26 cheese and 24 butter samples were contaminated by Coagulase Positive Staphylococcus aureus. Nineteen cheese samples and 11 butter samples were confirmed to be Staphulococcus aureus based on PCR using the Nuc primer gene. From a total number of 30 isolates containing the nuc gene, 11 had the resistant mec-Agene. In overall, from the evaluated samples 100% of the isolates demonstrated simultaneous resistance to more than 3 antibiotics. It can be stated that there was a considerable amount of Staphylococcus aureus which was resistant to a variety of antibiotics, most importantly methicillin resistant. Staphylococcus aureus in the evaluated samples

[Effect of relaxing incisions for post penetrating keratoplasty astigmatism on graft curvature]

To evaluate changes in graft steepness after graft refractive surgery [GRS] and to discover influential factors and a coefficient to predict the amount of postoperative shift. Keratoconic patients with history of penetrating keratoplasty [PKP] who underwent GRS due to high post-PKP astigmatism were included. Changes in mean keratometry after GRS were evaluated to find possible influential factors such as age, graft anatomical features, number of incisions, use of compression sutures, and total arc length on achieved vector astigmatic correction. There was a significant increase in average keratometry by 0.86 +/- 1.07 D postoperatively [P<0.001]. Mean keratometric coupling ratio [CR] and coupling constant [CC] were 0.62 +/- 1.09 and -0.34 +/- 0.70, respectively. A significant association was found between preoperative spherical equivalent keratometry and keratometric CR, and between achieved correction in vector keratometric astigmatism and keratometric CC. Additionally, age had a significant negative association with keratometric CR and CC. A significant increase in graft steepening occurred after GRS. For every diopter reduction in vector keratometric astigmatism, a mean of 0.34 D increase in graft curvature is expected postoperatively

[Chemical eye burns]

Chemical injuries of the cornea are ophthalmic emergencies. These injuries often result in significant ocular morbidity and generally strike young adults in the prime years of life. Classification schemes enable the ophthalmologist to determine the severity of injury and the prognosis for the injured eye. Immediate management consists of copious irrigation following exposure. Effective management in the intermediate and late phases requires an understanding of the cellular events that occur during each phase. Appropriate medical and surgical care helps ensure the best outcomes for these potentially blinding injuries. With appropriate management, it is possible to restore vision to all but the most severely burned eyes. While our current understanding of these injuries allows us to save many of these eyes, more work is needed to improve the prognosis of grade IV injuries. Ongoing animal and human research is investigating the use of novel topical agents to reduce angiogenesis, inhibit inflammation, promote repair, and reduce the risk of corneal melting. Efforts at preventing ocular chemical burns are equally important and deserve emphasis

[Success rate in basic medical sciences national exam among graduates and students applying for transfer to Iran]

In recent years, many Iranians have made educational travel to countries to study in the field of medical sciences. Considering the different educational systems and lack of comprehensive exams in some countries, the present study was attempted. To determine the success rate in basic medical sciences national exam of graduates and students applying for transfer to Iran. In this descriptive study 2621 students from Ukraine, Armenia, Azerbaijan, Russia, Romania, Belarus, Tajikistan, Kazakhstan, and Philippine, who participated in the medical basic sciences national exam during 1998 to 2008, were evaluated and the success rate calculated. The highest and lowest success rates for countries with more than 100 participants were 48.6% and 27.4% for Armenia and Romania, respectively. Regarding the countries with less than 100 participants, the highest and lowest success rates were 55.6% for Belarus and 8% for Kazakhstan. Based on the field of study, the lowest success rate was associated with pharmacy [15.8%] and the highest with dentistry [38.9%]. The success rates obtained for students from different countries evaluated were much lower than those for domestic students. The reason for this difference is likely due to inappropriate style of national exam with the training methods used for these students or the students' poor educational performance to successfully pass the national medical exam

National strategies of ophthalmic education in Iran

Academic medicine is in a state of dramatic transformation. For this reason strategic thinking is the most essential part of educational planning. The main purpose of the present study was developing the strategic educational planning of Ophthalmology in Iran from 2007 to 2010. A qualitative investigation using focus group discussion has been implemented successfully tor developing educational planning. Six to twelve representatives of key stakeholders in the ophthalmic education of Iran participated to this study. Strengths, weaknesses, opportunities and threats of ophthalmology education in Iran were analyzed. Strategic goals in education, research, and health service providing domains were being developed. Educational goals were defined as training of human resources in accordance with the community needs at the level of general practitioner, specialist, and fellowships in ophthalmology. Research goals of the program were defined as scientific interdepartmental and international communications, in order to promote the level of education, research, and treatment in the country. Also, in the field of health services according to the community needs, providing services by the means of advanced and cost effective methods were defined as strategic objectives. Based on this strategic plan in the last three years ophthalmic education in Iran shall be many changes in educational, research and health care provision for social accountability

validity of transvaginal sonography in the measurement of endometrial thickness

Transvaginal ultrasonography is a non invasive procedure for endometrial thickness evaluation in abnormal uterine bleeding. This technique is helpful for selecting patients for diagnostic tests. This study was designed to determine the validity of transvaginal sonography in the measurement of endometrial thickness. A total of 71 women who were admitted for abdominal hysterectomy due to different causes in Kosar Hospital [2008-2009] were enrolled in the study. The main exclusion criteria was inability to measure endometrial thickness via transvaginal sonography. Endometrial thickness measurements were done prior to surgery. Histopathologic measurement of the fresh specimen was carried out immediately after surgery. Data were analyzed using T-test and kappa index. No ultrasound measurement was possible in 15% [11] of the patients. No statistically significant difference was observed in endometrial thickness between the two procedures. Taking into account 5 mm as a cut- off point, in 70% [42] of the patients, endometrial thickness was < 5 mm in both procedures. In 30% [18] of the patients, endometrial thickness in sonography was >5 mm, 11 cases of which were confirmed by histopathologic measurement. The remaining 7 cases were falsely reported as thick endometrium by sonography. The overall accuracy of sonography was about 83/3%, which was more efficient for samples with thin endometrium [89/8% vs. 72/8%].Despite a concordance between transvaginal sonography and histopathology results for endometrial thickness evaluation, the former is faced with limitation as a single diagnostic test

Changing indications and surgical techniques for corneal transplantation between 2004 and 2009 at a tertiary referral center

The aim of this study is to report the indications, techniques, and clinical outcomes of corneal transplantation and investigate any changing trends in surgical techniques over a 6 year period. Records of patients who had undergone any kind of corneal transplantation at Labbafinejad Medical Center, Tehran, Iran, from January 2004 to December 2009 were reviewed to determine the indications and types of corneal transplantation. Postoperative best-corrected visual acuity, refractive error, graft clarity, and complications were reported. During this period, 1859 eyes of 1624 patients with a mean age of 41.3 +/- 21.3 years underwent corneal transplantation. The most common indication was keratoconus [38.4%] followed by aphakic/pseudophakic bullous keratopathy [11.7%], previous failed grafts [10.6%], infectious corneal ulcers [10.1%], non-herpetic corneal scars [7.6%], trachoma keratopathy [4.7%], stromal corneal dystrophies [4.6%], post-herpetic corneal scar [3.7%], Fuchs' endothelial dystrophy [0.8%], and congenital hereditary endothelial dystrophy [0.4%]. Techniques of corneal transplantation included penetrating keratoplasty [PKP; 70.9%], deep anterior lamellar keratoplasty [DALK; 20.1%], conventional lamellar keratoplasty [LKP; 4.4%], and Descemet's stripping automated endothelial keratoplasty [DSAEK; 2.3%]. Over the study period, there was a significant increase in the relative frequency of infectious corneal ulcers, failed grafts, and trachoma keratopathy. Additionally, a significant reduction was observed in PKP and LKP procedures, and volume of DALK and DSAEK increased significantly. At final follow-up, 69.0% of grafts were clear in the PKP group. This figure was 82.6%, 82.7%, and 97.6% in the DALK, LKP, and DSAEK groups, respectively. Keratoconus was the most common indication and PKP was the most prevalent technique used for corneal transplantation. However, significant changes in the indications and surgical techniques were observed from 2004 to 2009

[Letrozole induction of ovulation in infertile women with clomiphene citrate resistance]

Background: Aromatase inhibitors have been recently advocated as an inexpensive, effective, and low risk treatment in clomiphene citrate [CC]-resistant patients

Objective: To evaluate the efficacy of letrozole in induction of ovulation in CC- resistant patients

Methods: This prospective clinical trial was carried out on 30 patients admitted to a private infertility clinic in Qazvin during 2009. Thirty patients with polycystic ovary syndrome [PCOS] and unexplained infertility who were resistant to CC entered the study. Inclusion criteria included age between 18-39, infertility more than 2 years, normal TSH, prolactin, spermogram, and FSH in the beginning of follicular phase and the exclusion criteria were history of pelvic surgery, presence of adhisions and every infertility factors except unovulation. After a washout period of 2 months, letrozole was given orally in doses of 2.5-7.5 mg on days 5-9 of the menstrual cycle. Dose increase was performed if there was no dominant follicle at lower dose. Follicular assessment was carried out by vaginal sonography on day 16 followed by administration of hCG if follicle >/= 18mm was detected. Ovulation and pregnancy rate and the endometrial thickness on day of hCG administration were measured. Data were analyzed using chi-square test, paired t-test, and the Fischer's exact test

Findings: Following administration of letrozole in three doses of 2.5, 5, and 7.5 mg, 3 [10%], 12 [40%], and 5 [16.7%] patients had follicle >/= 18mm, respectively. The overall ovulation rate was %66.6. Among these patients, 16 [80%] had one dominant follicle and 4 [20%] with 2 but no twin pregnancy was present. Pregnancy took place in 5 patients [16.7%]. Endometrial thickness was 11.5, 11.5 and 11.4 in doses of 2.5, 5 and 7.5 mg of letrozole, respectively

Conclusion: The findings of the present study showed that the induction of ovulation with letrozole in CC-failure is associated with ovulation and pregnancy in a significant number of patients. Regarding the low risk of multiple pregnancy and hyperstimulation syndrome, letrozole could be the first line treatment in CC- failure

[Association between bacterial vaginosis and preterm delivery and birth weight in infants]

Background: Preterm birth and low birth weight are important causes of mortality in infants

Objective: This study aimed to determine the relationship between bacterial vaginosis, low birth weight, and PROM

Methods: This analytical study was performed on vaginal discharge of 751 pregnant women within the weeks 23-26 of gestation in Qazvin health centers during 2008-2009. Cluster sampling was the method used in our study. Samples were analyzed according to Nugent criteria and the data evaluated with chi-square test

Findings: Results showed that 734 [97.7%] of specimens were negative for bacterial vaginosis and 17 [2.3%] cases positive. Migration of a number of study population made it impossible to check the delivery status. Of 697 patients with negative bacterial vaginosis, 72 [10.3%] had PROM while in other group there were four cases [23.5%] with PROM however, the difference was found to be insignificant, statistically

Conclusion: Based on results found through this study, No significant difference was found between bacterial vaginosis, preterm delivery, and LBW

[Effect of education and social support on quality of life among elderly living in nursing homes [2010]]

Background: Aging is an inevitable phenomenon that the human societies are facing with. Health and life style of elderly in nursing homes are challenging thus, achieving appropriate measures to improve the quality of life seems to be necessary

Objective: The purpose of this study was to assess the effect of education and social support on quality of life among elderly living in nursing homes in Qazvin, Iran

Methods: This was an interventional study performed on all old people [37] who were living in nursing homes in Qazvin, Iran. Quality of life was assessed before and 1 month after intervention using SF36 questionnaire. Intervention included education, monthly physical exam, city tours, visiting places of public worship, field trip to recreation sites, and weekly visits. Data were analyzed using paired t-test

Findings: Of total 37 participants [female=17 [45.9%]; male=20 [54.1%]] with an average age of 66 years, 86% and 62.2% were illiterate and married, respectively. The average score for quality of life were increased in all areas following intervention [P<0.005]

Conclusion: Based on the results, it seems necessary to plan and arrange suitable programs to improve the quality of life in elderly living in nursing homes

Epidemiological aspects of visceral leishmaniasis in Baft district, Kerman province, southeast of Iran

Visceral leishmaniasis [kala-azar] is an endemic disease in some areas of Iran. A cross-sectional study was conducted for sero-epidemiological survey of visceral leishmaniasis [VL] in Baft district from Kerman Province, southeast of Iran. Blood samples were collected from children up to 12 years old and 10% of adult population from Baft villages with a multi-stage randomized cluster sampling. In addition, blood samples were collected from 30 domestic dogs from the same areas. All the collected blood samples were tested by direct agglutination test [DAT] for the detection of anti-Leishmania antibodies in both human and dog using the cut-off value of >/= 1:3200 and >/= 1:320, respectively. Parasitological, molecular, and pathological were performed on infected dogs. Chi-square and Fisher exact tests were used to compare sero-prevalence values. From 1476 collected human serum samples, 23 [1.55%] showed anti-Leishmania antibodies at titers of 1:800 and 1:1600 whereas 14 [0.95%] showed anti-Leishmania infantum antibodies at titers of >/= 1:3200. No statistically significant difference was found between male [1.18%] and female [0.69%] sero-prevalence [P=0.330]. Children of 5-8 years showed the highest sero-prevalence rate [3.22%]. Seven out of 30 domestic dogs [23%] showed anti-Leishmania antibodies at titers >/= 1:320. Leishmania infantum was identified in five infected dogs by nested -PCR assay. It seems that visceral leishmaniasis is being endemic in southern villages of Baft district, southeast of Iran

[Comparison of fasting glucose and oral glucose tolerance tests in diagnosis of diabetes mellitus in liver cirrhosis]

Diabetes mellitus [DM] and glucose intolerance are commonly associated with liver cirrhosis and considered as important prognostic factors in liver cirrhosis. To determine the more sensisitive test for diagnosis of diabetes mellitus in liver cirrhosis. A total of 92 patients with liver cirrhosis were enrolled in a descriptive-analytic study. The levels of FBS and blood sugar two hours after ingestion of 75gr glucose [OGTT] were measured. FBS and 2-hPG concentrations were analysed for all subjects. Chi-square test and Fisher's exact test were used to analyse the data and p values <0.05 were considered as significant. A total of 92 cirrhotic cases with mean age of 54.1 +/- 14.1 years were enrolled in this study of which 51 cases were males [55.4%] and 41 females [44.6%]. Using FBS measurement test, DM was diagnosed in 14 subjects [15.2%], impaired fasting glucose [IFG] in 16 subjects [17.4%], and normal fasting glucose in 62 subjects [67.4%]. However, when OGTT was employed, DM found to be present in 36 subjects [39.1%] impaired glucose tolerance [IGT] in 26 subjects [28.3%], and normal glucose tolerance [NGT] in 30 subjects [32.6%]. Comparison of FBS and OGTT [as gold standard test] showed that there was a significant difference between two tests [p<0.001]. The sensitivity of FBS test to diagnose DM was 46.7% with a specificity of 96.7%. The P.P.V and NPV were 96.7% and 46.7%, respectively. The FBS cut off was estimated at 83.50 mg/dl. The determination of FBS level seems to be insufficient in detecting DM in patients with liver cirrhosis. Thus, in addition to FBS measurement, the OGTT, as a routine test for cirrhosis, is recommended

[Prevalence and causes of blindness and visual impairment in varamin district]

To estimate the magnitude and causes of visual impairment [VI] in subjects aged >/= 50 years in Varamin district in 2009 using the proposed method by the World Health Organization [WHO]. This cross sectional population based survey was performed in Varamin targeting people over the age of 50 years using the proportional probabilities to size and cluster compact segment sampling method. Blindness was defind by WHO definition as best corrected visual acuity [VA] in the better eye less than 3/60. Severe visual impairment [SVI] and visual impairment [VI] were defined as 3/60

[Keratic precipitate morphology in various uveitic entities: a confocal scan study]

To characterize keratic precipitate [KP] morphology in different forms of uveitis. One hundred and twenty nine eyes of 93 patients with different forms of uveitis underwent confocal scan and the morphology of KPs were determined. Differences in KP morphologies among different uveitic groups were evaluated. Age ranged from 14 to 67 years [mean: 32.5 +/- 11.2] and 58 cases [62.36%] were female, 38.7% had bilateral uveitis. Almost all types of uveitis disclosed predominantly stippled and globular KPs. Dendritiform KPs were more common in infectious uveitis [P=0.053] and smooth-rounded KPs were significantly more common in non-infectious uveitis [P<0.001]. Dendritiform KPs were observed more commonly in nongranulomatous uveitis than granulomatous ones [P=0.005]. Smooth-rounded KPs were more common in chronic uveitis than acute forms [P<0.001]. The predominant morphology of KPs in Fuchs heterochromic iridocyclitis [FHIC] were dendritiform [80.0%] and infiltrating [78.0%]. The most commonly observed morphology of KPs in intermediate uveitis were dendritiform [56.3%] and smooth-rounded [56.3%]. Cruciform KPs were more frequently seen in cases with FHIC [60.0%]. Morphologic features in bilateral cases were similar. KP morphologies are diverse in different forms of uveitis. Some forms of KPs are less specific such as globular and stippled which exist in almost all types of uveitis. Confocal scan can play a potential role in differentiating infectious from noninfectious uveitis and granulomatous from nongranulomatous uveitis

[Bilateral nocardia keratitis following photorefractive keratectomy]

To report the clinical, confocal scan, and histopathologic features of bilateral Nocardia keratitis following photorefractive keratectomy [PRK]. A 23-year-old girl underwent simultaneous bilateral PRK for myopia. On the third postoperative day, dense central infiltrates mainly involving the anterior stroma were noticed in both eyes. Clinical and confocal scan features were consistent with a diagnosis of Nocardia keratitis and topical amikacin eye drops 2% were started. Empirical antibiotic therapy was converted into specific therapy after confirming the definite diagnosis by clinical features and confocal scan. Due to poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination confirmed the initial diagnosis. Familiarity with the clinical and confocal scan features of Nocardia keratitis facilitates early diagnosis, proper management and hence a rapid clinical response

[Indications for corneal transplantation at labbafinejad medical center]

To investigate indications and methods of surgery in corneal transplantation in Labbafinejad medical center from 2007 to 2009. Records of 1083 patients who had undergone corneal transplantation from 2007 to 2009 were reviewed. Age, sex and indication and type of surgery were evaluated. Patients included 709 [65.5%] male and 374 [34.5%] female subjects with mean age of 43.2 +/- 10.2 year [range, 17 days to 33 years] keratoconus [36.7%] was the most common indication followed by cataract extraction with or without IOL insertion [12.8%]; corneal ulcers due to bacterial, fungal and acanthamoba infections [11.7%]; non herpetic scar and opacities [7.4%]; trachoma keratopathy [5.6%]; corneal dystrophy [4.6%] and mustard gas keratopathy [4%]. The most common type of surgery was penetrating keratoplasty [56.2%] followed by deep anterior lamellar keratoplasty [24.5], tectonic grafts [9.4%], lamellar keratoplasty [3.4%], endothelial graft [3.5%] and keratolimbal allograft without penetrating keratoplasty [3.1%]. During this 3 years period, keratoconus was still the most common indication for corneal transplantation but rate of regraft is increasing in comparison with previous reports. Corneal edema following cataract surgery with or without intraocular lens implantation was the second most common indication. Rate of endothelial grafts and keratolimbal alografts have increased since our previous reports

[Comparison of cornel graft biomechanical properties following penetrating keratoplasty and deep anterior lamellar keratoplasty using the ocular response analyzer]

To compare corneal hysteresis and resistance factor after penetrating keratoplasty [PK] and deep anterior lamellar keratoplasty [DALK] using Anwar's big-bubble technique using the ocular response analyzer. Forty-five PK eyes and 23 DALK eyes with keratoconus were compared in terms of corneal hysteresis [CH], corneal resistance factor [CRF], Goldmann-correlated intraocular pressure [IOPg] and cornea-compensated IOP [IOPcc]. Mean age was 29.8 +/- 6.1 years in the PK group and 27.2 +/- 6.5 years in the DALK group [P=0.11]; patients were followed for 31.4 +/- 19.0 and 29.2 +/- 17.3 months after corneal transplantation, respectively [P=0.27]. There was no significant difference between the study groups in terms of recipient [P=0.21] and donor [P=0.57] trephine size or BSCVA [P=0.77]. Mean CH was 10.09 +/- 2.5 mmHg in the PK group and 9.64 +/- 2.1 mmHg in the DALK group [P=0.36]; mean CRF was 10.13 +/- 2.2 and 9.36 +/- 2.1 mmHg, respectively [P=0.17]. No significant difference was found between the study groups in terms of IOPg [P=0.25] and IOPcc [P=0.80]. PK and DALK techniques provide comparable graft biomechanics in keratoconic eyes