Journal of Gorgan University of Medical Sciences

Effect of oral ZnCl2 on glucose, Insulin, lipoproteins and liver enzymes in male Rats

Shahraki MR

Background and Objective: Zinc is an essential ion for living and inter the body from different sources. Since Zn⁺⁺ interfere on many cellular process such as biological function such as calcium chanalls, this study was designed to investigate the effect of oral ZnCl₂ on glucose, Insulin, lipoproteins and liver enzymes in male Rats.

Materials and Methods: This experimental study was performed on 48 of Wistar-Albino male Rats randomly allocated into three exprimental and one control groups. Exprimental groups received 50 mg/l, 100 mg/l and 200 mg/l ZnCl₂ in drinking water daily for four weeks but the control group received tap water. After four weeks, animals were anesthetized, sacrificed and blood samples were collected. Glucose, insulin, lipoproteins, aspartat amino transferase (AST) and alanine amino transferase (ALT) were measured. Data were analyzed by SPSS-11, ANOVA and Tukey-tests.

Results: The mean±SD of Cholesterol in group D (85.7±3.2), HDL in groups B, C, D (66.1±2.7, 67±2.18, 68.83±2.69 mg/dl) and LDL in groups B, C, D (2.8±0.9, 14.6±6.3, 13.4±2.8 mg/dl) respectively were significantly decreased compared with Cholesterol (125.5±4.9 mg/dl), HDL (80.5±3 mg/dl) and LDL (30.3±3.2 mg/dl) in group A. Mean±SD of glucose, insulin, triglyceride and liver enzymes did not show any differences among the groups.

Conclusion: This study showed that ZnCl₂ added on drinking water reduce serum lipoproteins in male Rats.

Effect of potassium benzoate on BALB/c mice placenta: a histopathological study

Shahsavan M

Background and Objective: The food additives, like sodium and potassium benzoate are used in many food products and drugs to prevent the growth of yeast and molds. There is no report about the histopathological effect of potassium benzoate. Placenta, has a critical role in embryonic development therefore this study was set up to evaluate the effects of potassium benzoate on placenta of BALB/c mice.

Materials and Methods: 45 BALB/c female mice were allocated into two experimental (1, 2) and one control groups. Experimental groups received daily intraperitoneal injection of 280 and 560 mg/kg/body weight of potassium benzoate and control group received normal saline. All injections were done during 10 days before mating and 5^th to 16^th of gestational days (GD). In GD 18 all placenta were removed via cesarean section. Macroscopic studies for morphological abnormalities were done and after measuring of placental weight and diameter, for microscopic studies the specimens were fixed and tissue passage were done. Tissue sections were stained with hematoxylin-eosin and histopathological changes were studied. Weight, diameter and percentage of agenesis of placenta in all groups were gathered. Data analyzed with using
SPSS-11.5, ANOVA and Tukey tests.

Results: The mean weight and diameter of the placenta in both experimental groups 1 and 2 were significantly decreased compared to control group. Also atrophy of placenta in the experimental groups was increased significantly compared to the control group (P<0.05). Comparison of weight and diameter between groups 1 and 2 was not significant. Percentage of placenta agenesis in the experimental groups was increased significantly compared to the control group (P<0.05). Massive hemorrhage in labyrinth zone, fetal and maternal zones were seen in both experimental groups.

Conclusion: This study showed that exposure of potassium benzoate during mice pregnancy cause morphological and histopathological changes of placenta, including decrease of weight and diameter, agenesis, hemorrhage and tissue disorders.

Effect of aquatic extract of Cannabis sativa leaves on degeneration of alpha motoneurons in spinal cord after sciatic nerve compression in Rats

Javadmoosavi BZ (MSc)

Background and Objective: Neurons are injured under physical, chemical and pathological conditions. The effects of injuries in peripheral nervous system returns as retrograde to the cell body of neurons in central nervous system and causes brain and spinal degeneration. This study was done to evaluate the effect of aquatic extract of Cannabis sativa leaves on degeneration of alpha motoneurons in spinal cord after sciatic nerve compression in Rats.

Materials and Methods: This experimental study was carried out on thirty two male Wistar rats, weighing 300-350 grams. Animals were divided into four groups each consisting eight members A: control, B: compression, C: compression + treatment with 25 mg/kg aquatic extract, D: compression + treatment with 50 mg/kg aquatic extract. In order to induce compression in B, C and D, after cutting the right thigh muscle, Sciatic nerve of thigh was exposed to compression for 60 seconds using locker pincers. The first extract injection was done intraperitoneally immediately after compression and the second intera peritoneal injection was done 7 days later. 28 days after compression, the Lumbar spinal cord were dissected, fixed and stained with toluidine blue. The density of alpha motoneurons was measured using dissector and stereological methods. Data was analyzed with using Minitab-13 software, ANOVA and Tukey tests.

Results: Neuronal density was 611.5±34.2 and 1633.4±30.7 in compression and control groups respectively (P<0.001). There was a meaningful statistical increase in neuronal density of group C (1278.6±28.1) in comparing compression group (P<0.001). The neuronal density in group (D) (1549.8±87.7), significantly increased in comparison with group (B) (P<0.001).

Conclusion: This study showed that aquatic extract of Cannabis sativa leaves increases the density of alpha motoneurons in spinal cord after sciatic nerve compression in Rats. The increase in neuronal density is relevant to the amount of extract used.

Effect of adjustable wrist hand splint on upper limb spasticity in post stroke patients

Tutunchi E

Background and Objective: Spasticity is common problem in stroke patients. Spasticity couse dysfunction and restricted activity. The most of patients have hand dysfunction due to stroke. This study was done to determine the effect of adjustable wrist hand splint on upper limb spasticity in post stroke patients.

Materials and Methods: This randomized clinical trial study was carried out on 15 patients with stroke referred to rehabilitation centers in Tehran-Iran during 2009. Patients randomly were divided into interventional (4 female, 3 men) and control (5 female, 3 men) groups. Common occupational therapy practice was carried out for 4 weeks for both groups equally. In treatment group intervention was based on the use of adjustable wrist hand splint moreover common occupational therapy practice. Upper limb spasticity pre and post intervention based on the Modified Ashworth Scale was evaluated. Data were analyzed by SPPS-17 software, pair-t-test and independent t-test.

Results: Mean age of patients in interventional and control groups were 61.37±4.10 and 58.85±5.01 years respectively. After 4 weeks of treatment, the mean of spasticity was not significant between interventional and control groups, but internal analysis of spasticity were significant in interventional and control groups (P<0.05).

Conclusion: This study showed that the adjustable wrist hand splint is not useful in reduction of upper limb spasticity in post stroke patients.

Effect of educational program based on PRECED model on quality of life in patients with typeII diabetes

Borhani M

Background and Objective: The Problems caused by diabetes have direct and indirect impacts on quality of life of diabetic patients. By increasing of these problems quality of life of patients will decrease. This study was done to assess the effect of the educational program based on PRECEED (predisposing reinforcing enabeling causes educational diagnosis evaluation) model in promoting quality of life of patients with typeII diabetes.

Materials and Methods: This pre- and post-intervention quasi-experimental study was conducted on 78 patients with type 2 diabetes referred to diabetes clinic in Minoodasht located in Golestan province of Northern Iran. The educational program based on PRCEDE Model and patients educational needs was designed. The data were collected using two questionnaires. life-quality WHOQOL- BREF questionnaire and PRCEDE Model-based educational questionnaire. The subjects were followed for one month after intervention to identify the role of educational intervention on patients. The data was analyzed by using SPSS-16 and Paired t-test.

Results: After the intervention, the mean score of quality of life increased from 80.39±11.35 to 81.35±8.31. No significant difference was existed in the total score of quality of life after intervention but there were significant differences in the physical health (P<0.05), self-evaluation of quality of life of patients (P<0.01) and self-assessment of health of patients after educational intervention.

Conclusion: This study showed that the educational program based on PRECEDE model was effective in improving quality of life of patients with regard to physical health and self-assessment of their health status.

The degree of agreement of quantiferon TB gold test and tuberculin skin test in nurses

Vaziri S

Background and Objective: Tuberculin skin test (TST) is the standard method for diagnosis of latent tuberculous infection. Positive results of TST (significant induration) may be seen in persons with latent M.tuberculosis infection and negative results of this test may be seen in patients with active tuberculosis. After performing TST false positive reactions may be seen with nontuberculous mycobacterial infections or false negative results may be encountered in anergic patients with tuberculosis disease. Quantiferon TB Gold test (QFT) is a new diagnostic test which assays the amount of released interferon gamma from peripheral blood lymphocytes in response to M.tuberculosis antigens. The purpose of this study was to determine the degree TST and QFT correlation.

Materials and Methods: This descriptive study carried out on 72 nurses of two internal medicine and infectious diseases wards of Imam Reza and Imam Khomeini hospitals in Kermanshah located in West of Iran, during 2009. 58 of nurses were vaccinated with BCG vaccine and none of them had any immune compromising condition. TST was performed by intradermal injection of 0.1 ml of standard tuberculin test (5 TU) and QFT was performed 48 hours then after using peripheral whole blood. The amount of released interferon gamma from lymphocytes in response to antigens were measured by ELISA method.

Results: Three of nurses excluded and this study was done on 69 nurses. Overall the degree of agreement of TST and QFT was 63.7% (P=0.69 and Kappa=0.139). The degree of discordance between these tests in PPD negative but QFT positive persons was 15.94% and in PPD positive but QFT negative persons was 20.3%. The sensitivity and specificity of QFT was 41.67% and 75.56% respectively. The degree of agreement of TST and QFT in vaccinated and unvaccinated nurses was 63.8% (Kappa=0.143) and 66.67% (Kappa=0.54) respectively.

Conclusion: There was no significant difference between QFT and TST in diagnosing latent tuberculous infection.

Homocysteine and high sensitivity C –reactive protein in patients with systemic lupus erythematosus, and their relation with diseases activity and cardiovascular risk factors

Sedighy S

Background and Objective: Systemic lupus erythematosus (SLE) is an inflammatory multi-system disease with an unknown origin. In patients with lupus disease cardiovascular events is an important cause of mortality and morbidity. This study carried out to measurement of high sensitivity C –reactive protein (HsCRP) and homocysteine in patients with SLE and their relation with diseases activity and cardiovascular risk factors.

Materials and Methods: This case control study carried out on 60 patients (55 females and 5 males) with lupus disease which referred to Clinical Research Center of Rheumatology, Mashhad, Iran and 30 controls (26 females and 4 males) during 2007-08. Information of subjects were gathered using SLEDAI questionare. HsCRP and homocysteine of subjects were measured. The level of low density lipoprotein (LDL), Triglycerid, hypertension and Body mass index (BMI) was assessed. Systemic lupus erythematosus activity was assessed by using SLEDAI so that if the score was higher than 10, lupus was called as active disease.

Results: Mean age was 28.8±10.3 and 33.8±9.13 years in SLE and control groups respectively. The mean of HsCRP in SLE patients were 3±2.42 mg/dl versus in controls were 1.58±2.1. The serum level of homocysteine were 12.3±1.93 µmol/L and 24±8.13 µmol/L in SLE patients and controls (P<0.001). Mean disease activity was 15.37. There was no any associtation between homocysteine and HsCRP and disease activity. LDL, Triglycerid, hypertension had significant association with homocystein (P<0.05). BMI and Triglycerid had significant association with HsCRP (P<0.05).

Conclusion: This study showed that there is no linear significant corrolation between homocysteine, HsCRP and disease activity, but there is significant corrolation between increase of homocysteine and HsCRP and cardiovascular risk factors.

NK, T and B lymphocyte populations in infertile women

Saadati N

Background and Objective: Many different factors and problems can cause infertility. This study carried out to compare NK, T and B lymphocyte populations in peripheral blood of fertile and infertile women.

Materials and Methods: In this case - control study 30 infertile women and 15 non pregnant women participated. The non pregnant women had a history of at least two alive children as a control group. The monoclonal antibodies and flowcytometry were used for evaluation of T cell subpopulations (CD3, CD4, CD8), B cells (CD22) and NK cells (CD56) in fertile and infertile women.

Results: NK cells (CD56) significantly increased in infertile women compared with control groups (P=0.009) and T lymphocytes CD3, CD4 significantly reduced in infertile women compared with fertile women (P=0.013, P=0.004, respectively). CD4/CD8 ratio reduced in infertile women compared with fertile women (P=0.05). There was no difference in B cells and CD8 T cells in infertile women compared with controls.

Conclusion: This study showed that NK cells increase and CD4 T lymphocytes reduce in infertile women. Our results suggest the immunological alterations may be related to infertility.

Determination of parasite species of cutaneous leishmaniasis using Nested PCR in Damghan – Iran, during 2008

Rassi Y

Background and Objective: Cutaneous leishmaniases with two forms of rural and urban is the endemic diseases and as a health problem in our country. Identification of parasite species and type of disease is very important for treatment of disease as well as for planning of control program. The microscopic observations by Giemsa-stained smears is the most common laboratory test for the diagnosis of cutaneous leishmaniasis, but the determination of parasite species is impossible and utilization of other ways such as biochemical and molecular methods is required. This study was carried out to determine the parasite species caused cutaneous Leishmaniasis by Nested PCR in Damghan, Iran.

Materials and Methods: This descriptive study was performed on 67 patients with dermal lesions that referred to Damghan health center laboratory in Iran during 2008. The patient's information were recorded in questionnaire. DNA of Giemsa-stained slides from patients was extracted and evaluated by specific primers of kinetoplast DNA using Nested PCR.

Results: Leishmania parasites were observed in 57 patients under light microscope. The 10 patients were infected by other dermal diseases. The PCR result showed the parasite presence in lesions of 57 patients is Leismania major. 54% of patients were male and 46% were female. 72% of the patients were lived in rural areas. 50.9% of disease was observed in over 25 years old patients. Hands were the most common region of ulcer (44.7%). 48% of the patients had one ulcer and the other patients had two or more ulcers. High prevalence (31.6%) of disease was observed in October.

Conclusion: This study showed that zoonotic cutaneous leishmaniasis to be prevalent in this area and Nested PCR method is a sensitive and accurate to leishmania species characterization.

Prevalence of IL18 -607A/C polymorphism in patients with visceral leishmaniasis

Bazmani A

protozoan of Leishmania genus and in Iran by Leishmania infantum. The protective immune response against VL is cellular immunity through Th1 CD4+, which dominant chemokiens are IL12, IFN- γ and IL18 and lead to Th1 response. Single nucleotide polymorphism (SNP) on IL-18 gene and its relation to IL18 levels in blood and IL18 function have been studied in many inflammatory diseases such as Behcect’s disease and tuberculosis. According to the important role of IL-18 in immunity against visceral leishmaniasis, this study was conducted to demonstrate the prevalence of genotypes on -607A/C in promoter region of IL-18 gene.

Materials and Methods: This descriptive and cross-sectional study was done on 91 pateints with confirmed VL, 105 healthy sero-negative controls and 78 seropositive controls during 1999-2009. Salting out method was used to extract DNA and ARMS-PCR was used to determine the genotype of -607A/C allele of individuals. Statistical analysis of genotypes was performed using Chi-Square test.

Results: According to the results, -607C/C was the dominant genotype among the groups (35.8%). Distribution of genotypes among groups had not any significant difference. The lowest genotype among healthy sero-positive and patients were -607A/C and -607A/A, respectively. Statistical analysis of distribution of genotypes, did not reveal any significant difference among groups.

Conclusion: The dominant genotypes of VL patients, healthy sero-negatives and healthy sero-positives were -607C/C (38.5%), -607A/C (37.1%) and -607C/C (35.9%) respectively.

Evaluation of the diaphragmatic myopathy onset time among mechanically ventilated patients

Ghaffary MR

Background and Objective: Critical illness diaphragmatic neuromyopathy are significant causes of weakness, morbidity and prolong mechanical ventilation among critically ill patients under mechanical ventilation. It is important determine the true initial time of neuromyopathic changes associated with critically ventilated patients. Based on new electrodiagnostic studies, electrophysiological studies of diaphragm and phrenic nerve, as an important muscle and nerve in ventilation, compared with other evaluating methods, have specific importance. This study was done to evaluate of the diaphragmatic myopathy onset time among mechanically ventilated patients using electrophysiological method.

Materials and Methods: This descripvtive study was performed on 56 mechanically ventilated patients in intensive care unit without primary neuromuscular disease in Tabriz Imam Khomeini hospital in West of Iran between 2004-06 years. Electromyography (EMG) and nerve conduction velocity test were performed in the 4^th and then in 4 days intervals.

Results: In 56 patients EMG and NCV performed at 4 and 8 days after mechanical ventilation, none of them had any evidence in favor of diaphragmatic myopathy. During the course of study, EMG were done on 24 patients in 12^th days , that in three of them (12.5%), mild myopathy were reported. From 18 patients, considered in 16^th days, only five (31.25%) of them showed mild myopathy. From 10 (100%) reminder patients, in 20^th day, all of them had mild to moderate myopathy.

Conclusion: According to these results, minimum duration of the diaphragmatic weakness onset time in mechanically ventilated patients with diverse causes in general critical care ward were 12 days and increased with prolonged time of mechanical ventilation.

Determination of contamination with Clostridium botulinum in two species of processed and non prosecced fish

Imani Fooladi AA

Background and Objective: The Clostridium botulinum is one of the most important causative of food poisoning. Spores of Clostridium botulinum spread out in the soil, the sea sediments, the marine environments and the marine animals. In recent years use of the marine food products like as fish and cultured fish are elevated. The aim of this study was done to compare between processing and non processing fish infected by predominant type of Clostridium botulinum.

Materials and Methods: This descriptive study was done on the 146 samples of fish in two species of processed and non prosecced that collected from Gilan province in Iran during 2008. These samples included the Liza auratus Fish (45 processed fish and 28 non processed fish) and the Salmo Trutta caspius Fish (34 processing fish and 39 non processing fish). The samples examined according to the APHA2000 and FDA2003 protocols. Data Analyzed with SPSS-13 and Chi-Square test.

Results: 16 (11%) of samples (13% of the processed fish and 7.5% of non processed fish) were confirmed that infected by Clostridium botulinum. Also the dominant type of exotoxin was Type E. The Type E exotoxin was determined from 11 of the samples (6 processed fish and 5 non processed fish).

Conclusion: This study showed that fish are infected by Clostridium botulinum special the type E. also use of fish in bad preparation (half cooking and add material in its stomach) may cause the food poisoning.

Pregnancy complications among hospital operating room personnel in Fars province - Iran

Amini A

Background and Objective: Anesthetic agents effect on pregnancy in operating room personnel is a challenge in anesthesiology. This study was carried out to determined pregnancy complications among hospital operating room personals in Fars province – Iran.

Materials and Methods: In this case-control study, 122 women working in operating rooms of governmental Fars province hospitals during their pregnancies with different jobs considered as case group. 122 women working in internal and pediatric wards considered as control group. The history of pregnancy complications including infertility, abortion, preterm labor, fetal death, neonatal death and low birth weight obtained using questionnaire. Data were analyzed using SPSS-15 software and Chi-Square test.

Results: The incidence of abortion was 19.8% and 16% in case and control group respectively, this difference was not statistically significant. Infertility was significantly higher (8.2% versus 2.5%) in case group than control group (P<0.05). No significant differences in incidence of preterm labor, fetal death, neonatal death and low birth weight were seen between two groups.

Conclusion: This study showed that the incidence of pregnancy complications is similar between women working in operating room and those working in other hospital wards but the prevalence of infertility is higher in operating room personnel than those of other wards.

Comparison of Nomadic and non-Nomadic Lifestyles in Transmission of Visceral Leishaniasis

Maleki Ravasan N

Background and Objective: Epidemiology of Visceral Leishmaniasis is affected by combination quality and interaction of Parasite-Vector-Host and environmental conditions. So, disease cycle related and eco-social factors and environmental risk factors co-analyzing, help to understanding these interactions, prognosis and orientation in disease control and treatment. This study was done to determine the role of nomadic and non-nomadic lifestyle in transmission of Kala-Azar in the Northwest of Iran.

Materials and Methods: In this case-control study, firstly the prevalence of Kala-Azar among people living in selected villages were determined by both serological test (Direct Agglutination Test: DAT) and immunological test (Montenegro Skin Test: MST) in the Northwest of Iran, on the way of Shahsavan tribe travelling in summer/winter quarters villages. Then DAT was conducted on the dogs presenting in those villages during 2006. One year later Seroconversion rate was calculated through collection of the individual’s negative sera and re-analyzing them via DAT. Finally, occurrence of Visceral Leishmaniasis in relation with various involving factors like dog density/abundance and nomadic and non-nomadic lifestyle using Chi-Square test were determined.

Results: Both MST and DAT were significantly higher in the nomadic lifestyle than in the non-nomadic lifestyle (P<0.05). Three values of prevalence (5.5%), seropositivity (2.7%) and seroconversion (2.5%) were higher in nomads than non-nomads. The GIS studies and electronically prepared maps showed that the endemicity and the infection rate are higher in nomads than non-nomads. There were a negative correlation between general distribution of Visceral Leishmaniasis in relation with environmental conditions altitude, mean temperature and rainfall.

Conclusion: This study indicated that Nomadic lifestyle can play as a risk factor in transmission of Visceral Leishmaniasis due to nomads/dog contacting, their entering in the wild cycle of disease and travelling.

Relationship between women’s quality of life and type of delivery

Saberi F

Background and Objective: Controversies results in quality of life associated with the type of delivery have been reported. This study was performed to determine the relationship between Women’s Quality of life and type of delivery.

Materials and Methods: This descriptive analytical study was conducted on 300 women that referring to health center in kashan city during 2007-08. The women were divided in two groups according to the type of delivery whether it was cesarean section or vaginal delivery. Special life quality questionnaire, 2 and 4 months after delivery was completed by women. Scores of aspects in 2 and 4 months after delivery were determined and compared between two groups. Data was analyzed by SPSS-16 software, Chi-Square, independent t- test, pair t test and Mann- U Whitey test.

Results: Findings showed no differences in aspects of quality of life between cesarean section and normal delivery groups except in “Mother's satisfaction toward delivery” that results showed higher score 2 months (p=0.03) and 4 months (p=0.018) after normal delivery. Scores of this aspect in 2 months after normal delivery and cesarean section was (4.40±1.11, 3.76±1.16) and in 4 months after normal delivery and cesarean section was (4.13±1.40, 3.82±1.22) respectively.

Conclusion: This study showed there was not significant difference in women quality of life between cesarean section and normal delivery 2 and 4 monthes after delivery.

Coronary arteries angiography findings of subjects referring to Kosar angiography center in Golestan province, Iran (2008-09)

Hosseini SA

Background and Objective: Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran.

Materials and Methods: In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index (BMI), cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests.

Results: In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects (58.8% males, 41.2% females). Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure (47.7%) has been found in left anterior descending artery.

Conclusion: Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders.

Mucocutaneons manifestation in end stage renal disease patients under hemodialysis in 5th Azar hospital in Gorgan, Iran (2009)

Tajbakhsh R

Background and Objective: Mucocutaneons manifestations are common in hemodialysis patients.The aim of this study was evaluate the prcvalence of cutaneous and mucosal manifestations in end stage renal disease (ESRD) patients who are on the maintenance hemodialysis.

Materials and Methods: This cross sectional study was performed on 100 (51 males, 49 females) hemodialysis patients in 5 Azar hospital in Gorgan, North of Iran during 2009. Patients selected on randomly based an all of them completely examined by a deramatologist for any changes in skin, hair, nail and mucous membrane. If necessary biopsy perform and refer to a pathologist. Data analysed with SPSS-13, mann-whitney, t-test, Chi-Square and Fisher tests.

Results: The average age was 49±12.3 years. The most common causes of ESRD was dibetes mellitus. The most common skin lesion was xerosis (78.3%), after that pruritis (39.1%) lentigo (34.8%) skin discoloration (32.6%) leukonychia (32%) thining of nail bed (24%) were common lesions. Lentigo was more common in female than male 42.85% vs 21.50% (p=0.042). Xerosis (p<0.01), scaling (p=0.042), lentigo (p<0.01), folliculitis (p<0.01), idio pathic guttate hypopigmentation (p<0.01) leukonychia (p<0.01) and half and half nail (p<0.01) have meaningful correlation with age. There was also meaningful correlation between dialyis duration and skin discoloration (p<0.031) and leukonychia (p<0.041). Clubhing and ca-p product also have meaningful correlation (p<0.027). Pruritis (p<0.048) and skin fungal infection (p<0.047) (tinea versi color) also have meaningful correlation with serum ferritin level.

Conclusion: Mucocutaneous manifestation were common in end stage renal disease patients.

Frequency of ABO and Rh blood groups in patients with acute leukemia

Sadeghian MH

Background and Objective: There are some reports about probable association between acute leukemia and special blood groups. Frequency of ABO and RH blood group is different in each population. This study was done to determine frequency of ABO and Rh blood groups in patient with acute leukemia and healthy population.

Materials and Methods: This case - control study was done on 214 patients (132 males, 82 females) that suffering from acute leukemia as case group and 117026 individuals healthy population who were voluntary blood donors as controls in Mashhad, Iran during 2001-07. Age, sex, ABO blood group and RH blood group were collected from hospital files for each cases. Furthermore the results of ABO and RH blood groups of controls were collected. Data were analyzed with Chi-Square, fisher test and Odd’s ratio.

Results: The frequency of A, B, AB, O and RH blood groups in cases were 23.8%, 32.8%, 7.0%, 36.4% and 90.7%, respectively. The frequency of A, B, AB, O and RH blood groups in controls were 29.8%, 27.4%, 8.9%, 33.9% and 88.3%, respectively. Odds Ratio test didn’t show association of ABO and RH blood groups with acute leukemia. Odds Ratio test showed association of B blood group with acute leukemia in females (OR=0.571, 95%CI: 0.358-.0908, P=0.021).

Conclusion: This study showed although there was not any association between ABO and RH blood groups and acute leukemia but probably females with B blood group are more susciptible toward acute lymphoblastic leukemia.

Tissue trans-glutaminase antibody in Inflammatory Bowel Disease in Golestan province, Northern Iran (2005-08)

Besharat S

Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

Concomitant pleural tuberculosis and aspiration pneumonia due to epiphrenic diverticula: a case report

Godazandeh Gh

Aspiration pneumonia is a critical disease and can result from a various causes. Epiphrenic diverticula is a rare disorder, which can cause aspiration of food material contained in it. Mediastinal tuberculosis can also cause traction diverticula at mid-esophagus, which usually are asymptomatic and induce no complication. In this article we describe a case, suffering of all these three disorders and after seven years of surgery and medical treatment any symptom was not found in the patient.

Letter to Editor

Shokraneh F

no english absract