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Meningitis is one of the urgent medical ceases, and in spit of tramendous efforts. There is a high prevalency in various part of the world, still has got a high mortality. Rapid diagnosis is one of the best way to control the disease, and the basis for the present study is to find out the rate of occurrence of meningitis in suspicious cases. During nine-month study (Sep 1999-June 2000), 100 children with suspicious sings of meningitis referring to Taleghani children hospital were taken under medical surveillance, and LP has been carried out by the pediatrician. The samples were transferred to the laboratory and various tests has been done on the samples. On the ground of clinical and paraclinical findings 15 meningitis patients (7 bacterial, and 8 viral were diagnosed). The most abundant isolated bacteria from the CSF was Pneumococci (42.8%) and the most significant clinical finding was fever, vomiting, stiffness of neck. In all bacterial meningitis the CSF’s appearance was deeply turbid, and the average WBC in CSF was about 3200, the rate of PMN was 92%, these results had significant meaning with comparison to the viral and non-meningitis sample (P<0.001). CFS’s protein level was much more higher in bacterial meningitis, than other cases (P<0.001), and this can be used as diagnostic tool, but in spit of reduction in CSF glucose concentration, and CSF/blood glucose ratio (48% in bacterial, 70% viral, and 74% in non-meningitis), these ratios didn’t have significant meaning (P<0.4). The results of this research indicate the clinical manifestation such as fever, convulsion, vomiting turbidity of CSF, WBC count more than 500, and positive CRP, could help effectively in the diagnosis of bacterial meningitis.

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Background and Objective: Internal derangement of knee (IDK) is a common problem following knee trauma. Magnetic resonance imaging (MRI) extensively is used to diagnose the ligamentous and meniscal injuries, but the use of ultrasonography remains controversial. Previous studies showed different results about the usefulness of sonography (IDK). This study was done to determine diagnostic accuracy of ultrasonography in comparison with magnetic resonance imaging in patients with knee trauma. Materials and Methods: This descriptive study was done on internal knee disorders of 73 patients with knee trauma who referred to MRI center of Imam Khomeini hospital in Sari, Iran during 2009-10. Three radiologists independently reported the ultrasonography and MRI of the patients. Results: The study population comprised of 61 (83.6%) men and 12 (16.4%) women, 91.9% of patients were less than 40 years old. The joint pain was the most common complaint (89%). The sensitivity, specificity, positive and negative predictive value of ultrasonography for the lateral meniscus was 100%, 97.14%, 60%, 100%, for the medial meniscus were 61.90%, 94.23% ,81.25%, 85.96%, for the anterior cruciate ligament (ACL) was 65%, 100%, 100%, 70.21% and for the medial collateral ligament (MCL) was 100%, 94.28, %42.86 and 100%. Conclusion: This study showed that the high specificity of ultrasonography as a noninvasive and inexpensive method to exclude the ACL and meniscal lesion. Ultrasonography can reasonably be applied for screening of internal derangement of knee in the absence of MRI, especially in urgent conditions. In clinical setting of highly suspicious of ACL and meniscal tear, MRI is preferred due to low sensitivity of sonography.

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Background and Objective: Uropathogenic strains of Escherichia coli (UPEC) are the most common cause of urinary tract infections. UPEC strains possess an arsenal of virulence factors including fimH, iucD, iroN and hlyA which increase their ability to cause urinary tract infections. This study was done to determine the relationship between phylogenetic group and distribution of virulence genes of Escherichia coli isolated from patients with urinary tract infection. Methods: This descriptive - analytic study was performed on 100 isolates Escherichia coli which collected from patients with UTIs. DNA was extracted from all isolates by the boiling method and subsequently DNA was used to determine the presence of genes encoding virulence factors by Multiplex-PCR. In addition, determination of phylogenetic group, A, B1, B2 and D, was performed by determination of present or absent of of yjaA and chuA genes and DNA fragment TSPE4.C2 using Triple-PCR. Results: The frequency of virulence factors, fimH, iucD, iroN and hlyA were 95%, 69%, 29% and 32%, respectively. In all isolates, the frequency of phylogeny of groups A, B1, B2 and D were 17%, 6%, 55% and 22%, respectively. A significant correlation was found between the presence of virulence encoding genes and the B2 phylogenetic group (P<0.05). Conclusion: Virulence genes were common in phylogenetic group B2 isolates among all phylogenetic groups.

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Background and Objective: Hypertension is associated with changes in the structure and function of the vessels. This study was done to evaluate the effect of aerobic training with Garlic consumption on matrix metalloproteinase-3, 9 (MMP-3, MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in obese postmenopausal women with hypertension.
Methods: This double-blind clinical trial study was done on 36 obese postmenopausal women with hypertension. Participants were randomly divided into 4 groups including control group, Garlic consumption, aerobic training and training with Garlic consumption. Subjects in training groups participated in a progressive aerobic training for eight weeks, three sessions a week (55% to 65% of the reserved heart rate and for 30 to 55 min). Garlic and training with Garlic groups consumed 1000 mg of garlic supplement for eight weeks (after breakfast and dinner). Two days before and after the protocol, blood samples were taken in fasting state.
Results: The level of MMP-3 and MMP-9 were significantly decreased in Garlic, aerobic training and training with Garlic groups in compared to the control group (P<0.05). Also, the level of MMP-3 in the training with Garlic was significantly reduced in compared to the training and the Garlic groups (P<0.05). MMP-9 in the training with Garlic was significantly reduced in compared to the Garlic group (P<0.05). However, TIMP-1 level were significantly increased in the Garlic, training and training with Garlic in comparison with control group (P<0.05).
Conclusion: Aerobic training alone and in combination with Garlic affect on extracellular matrix thorough reduction of MMP-3, MMP-9 and increasing TIMP-1, improves systolic blood pressure in obese postmenopausal women with hypertension.

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Background and Objective: Aging and old age are associated with an increase in inflammatory cytokines. Due to their anti-inflammatory properties, constituents of spirulina may be able to reduce or even improve this process. This study was performed to determine the effects of endurance training and spirulina supplementation on the level of inflammatory cytokines in overweight men.
Methods: In this clinical trial, 40 overweight, middle-aged and elderly men were randomly selected and divided into 5 groups: control-normal, control-overweight, overweight + training, overweight + supplement, and overweight + training + supplement. The training program consisting of an hour of walking on a treadmill, stationary bike workout, and climbing stairs was performed at an intensity of 65% of the maximum heart rate, 3 sessions a week, for 8 weeks. Individuals in the supplement groups received a spirulina tablet (500 mg) twice daily in the morning and evening. Blood sampling was performed after 12 hours of fasting at baseline and 48 hours after the last training session. The level of inflammatory cytokines including transforming growth factor-beta (TGF-β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) was measured by enzyme-linked immunosorbent assay.
Results: The levels of TGF-β, IL-6, and TNF-α were higher in the control-overweight group than in the healthy control-normal group (P<0.05). Training and supplementation significantly reduced the inflammatory markers in overweight men (P<0.05). Moreover, the level of inflammatory markers was significantly lower in the training + supplement group compared with the training group and the supplement group (P<0.05).
Conclusion: Endurance training combined with spirulina supplementation can significantly reduce inflammatory factors in overweight individuals.
 

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Background and Objective: Any factor that disrupts the tear duct can cause epiphora, one of the most prevalent causes for patients to go to ophthalmology clinics. Nasolacrimal duct obstruction can be congenital or acquired. Dacryocystorhinostomy (DCR) surgery, which can be operated using external or endonasal approaches, is the standard treatment for nasolacrimal duct obstruction. This study was carried out to assess the success rate of endoscopic dacryocystorhinostomy surgery for patients with nasolacrimal duct obstruction.
Methods: This descriptive study was carried out on 38 patients (29 females and 9 males), aged over 18 with an average age of 43.07±13.83, suffering from epiphora referring to 5 Azar Hospital in Gorgan (Iran) between 2015 and 2018. The success rate of endoscopic dacryocystorhinostomy surgery for epiphora treatment was evaluated 6 months after the surgery. Furthermore, from the viewpoint of the complications of the surgery and the connection to the CT scan results, endoscopic dacryocystorhinostomy surgery was assessed.
Results: The surgery was successful for 36 patients (94.74%). The extent of the nasolacrimal duct obstruction of the right eye and the left eye was measured at 63.2% and 36.8%, respectively. Slight and heavy bleeding during the surgery was observed in 76.3% and 7.9% of the cases, respectively. Cerebrospinal fluid leakage and orbital injury during the surgery were not seen in the patients. According to the CT scan findings, deviation of the septum was seen in 76.3% of the patients, while septoplasty was operated on in 41.37% of the patients during the surgery. Moreover, half of the patients were suffering from chronic sinusitis for whom, the involved sinuses were opened and sinuses drainage was performed.
Conclusion: Endoscopic dacryocystorhinostomy surgery is an acceptable and successful method for treating epiphora, especially for patients with sinusitis or nasal septum deviation.