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Background and Objective: Ferula gummosa Boiss. (Barije.) contain medical and antimicrobial properties. This study was done to determine the effect of aqueous and alcoholic extracts of roots of Ferula gummosa Boiss. on the growth of Pseudomonas aeruginosa. Materials and Methods: In this laboratory study, the plant was dried in dark place and aqueous, alcoholic extracts of Barije's root, powder were prepared using Soxhlet method. The efficacy of 0.1 dilution of different values of extracts of Ferula gummosa Boiss. on the strain of Pseudomonas aeruginosa (PTCC 1430) were evaluated by disk diffusion, Agar-well diffusion, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. Results: Pseudomonas aeruginosa was completely resistant to the aqueous extract, and the MIC for the methanol and ethanol extracts was 1.25×10⁴ μg/ml and 6.25×10³ μg/ml, respectively. Conclusion: Methanolic and ethanolic extracts of Ferula gummosa Boiss. have antimicrobial activity against Pseudomonas aeruginosa in in-vitro model.

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Background and Objective: Indiscriminate use of antibiotics is one of the major health problems worldwide. Rapidly increasing incidence of antibiotic-resistant microbes warns healthcare authorities in the country to use drugs, reasonably. This study was carried out to assess the pattern of antibiotic usage in Razi teaching hospital in Ahvaz, southwest of Iran. Methods: This descriptive –analytical study was conducted on 17668 hospitalized patients in Razi teaching hospital Ahvaz, southwest of Iran during 2012. Proper or inappropriate antibiotic usage was judged based on existing national guidelines or guidelines referenced in textbooks. Results: 3119 of patients were received antibiotics which 20.4% of patients were being treated unnecessarily. 2482 (79.6%) of patients had indications for antibiotic therapy. Out of 2482 patients with indications for antibiotic therapy, 51.9%, 18.1 % and 6.5 % of patients were received incorrect antibiotic regiment, inadequate dose and unsuitable duration of therapy, respectively. The highest rate of unnecessary, inappropriate, incorrect duration and dosage of antibiotics were observed in internal, scorpion wards and the lowest was in infectious diseases and obstetrics wards (P<0.05). Conclusion: The pattern of antibiotic usage in Razi teaching hospital in Ahvaz was inappropriate. Unnecessary prescription, inappropriate antibiotic spectrum, inadequate dose and duration of antibiotics were inappropriate treatment strategy.

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Background and Objective: Cardiovascular autonomic neuropathy (CAN) is the most common and important type of diabetic autonomic neuropathy. Silent myocardial infarction, respiratory failure and increased mortality are the outcomes of CAN. This study was carried out to screen the cardiovascular autonomic neuropathy in non- insulin dependent diabetics patients. Method: This descriptive - analytic study was carried on 70 (22 males, 48 females) non- insulin dependent diabetics’ patients. Resting heart rate, heart rate variability, orthostatic changes in heart rate, blood pressure and corrected QT interval were recorded for each subject. The final findings were categorized as follow: 0=normal, 1=borderline and 2=CAN positive. Results: 10 (14.3%) of patients were normal, 35 (50%) of patients were borderline and 25 (35.7%) of patients were considered cardiovascular autonomic neuropathy positive. There was significant differences between duration of diabetes and three CAN scores (P<0.05). The systolic blood pressure alterations showed the maximum correlation with CAN scores (r=0.509). Conclusion: In our study, the rate of cardiovascular autonomic neuropathy was higher than other reports. The most important risk factor for cardiovascular autonomic neuropathy was more than 10 years history of diabetes mellitus.

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Background and Objective: Neural stem cells can difrentiate to mature neural cells. Neural stem cells can migrate and repair the damage neural tissue. This study was done to determine the effect of hydro-ethanolic extract of Chamaemelum nobile on cell prolifration and apoptosis of rat hipocample neural stem cells in the oxitative stress condition. Methods: In this experimental study, neural stem cells were isolated from hippocampus of neonatal rat brain. Isolated neural stem cells were treated at 200, 400, 600, 800 and 1000 µg/ml of hydro-ethanolic extract of Chamaemelum nobile for 48h. Cells proliferation rate were evaluated by MTT assay. Anti-apoptotic property of hydro-ethanolic extract of Chamaemelum nobile evaluated using TUNEL assay method. Results: Proliferation of neural stem cells were significantly increased in Chamaemelum nobile extract group in comparision with control (P<0.05). The rate of apoptotic cells were significantly reduced in Chamaemelum nobile extract group compared to control (P<0.05). Conclusion: The hydrethanolic extract of Chamaemelum nobile increases proliferation rate and reduces apoptosis of neural stem cells in the oxitative stress condition.

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Background and Objective: The incidence rate of elderly misbehavior increased in the past two decades. This study was conducted to determine the prevalence of elderly misbehavior in northern Iran. Method: This descriptive - analytic study was done on 247 more than 60 years old (137 males, 110 females) in north of Iran during 2012. In order to determine misbehavior, an elderly questionnaire was filled for each subject. Results: The mean age of subjects was 68.8±7.08 years. The prevalence of lack of attention, care, financial, authentic was 34.8%, 33.6%, 29.1% and 22.3%, respectively. The prevalence of psychological, physical, isolation and financial misbehavior were 26.7%, 26.7%, 2.6% and 21.9%, respectively. There was a significant relationship between income and marital status with misbehavior maner (P<0.05). Conclusion: Elderly misbehavior particularly lack of attention and care are more perevlant in northern Iran.

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Background and Objective: Nasal obstruction is a common complaint leading to septoplasty as one of the most common surgical procedures in otorhinolaryngology. This study was done to determine the relationship between patients' satisfaction following septoplasty with rhinomanometry perior and after surgery. Methods: This descriptive – analytic study was done on forty-one patients, candidated for septoplasty, from Oct 2012 to Sep 2013. Rhinomanometry were tested perior and 6 months after surgery. At the time of rhinomanometry after surgery, common clinical symtomps and patient's quality of life and their satisfaction from operation were recorded by using GBI questionnaire. Results: Nasal obstruction and congestion, trouble sleeping, insufficient breath during physical activity and difficulty breathing through the nose were significantly reduced after surgery (P<0.05). In overall, patients' satisfaction after septoplasty was 90.24%. Rhinomanometry was not predictive factor for satisfaction after surgery. Conclusion: Six month follow-up after surgery showed high patients satisfaction (90.24%) following nasal septoplasty, but this was not related to rhinomanometry test results.

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Background and Objective: Modification of life style, nutrional regiment and insulin therapy is used for improvement of pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). This study was done to evaluate the effect of the dietary approaches to stop hypertension (DASH) eating plan on pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods: In this clinical trial study, 52 women with GDM were randomly divided into DASH and control groups for 4 weeks. The control diet contained 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The DASH was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg/day sodium. The numbers of women whom commenced insulin therapy after dietary intervention, the mode of delivery and prevalence of polyhydramnios were assessed. The length, weight and head circumference of infants were measured during the first 24 h after birth. Results: 46.2% of women in the DASH group needed to have a cesarean section, this rate for the control group was 80.8% (P<0.05). The percentage of those who needed to commence insulin therapy after intervention was 23% for DASH group vs 73% for controls (P<0.05). Infants born to mothers on the DASH group had significantly lower body weight (3222.7 vs 3818.8 g, P<0.05), head circumference (34.2 vs 35.1 cm, P<0.05) and ponderal index (2.50 vs 2.87 kg/m3, P<0.05) compared to those born to mothers on the control diet. Conclusion: Consumption of dietary approaches to stop hypertension for 4 weeks among pregnant women with GDM resulted in improved pregnancy outcomes.

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Background and Objective: Oxidative stress plays a major role in the structural and functional changes of the myocardium due to diabetes. This study was done to determine the effect of swimming training and arbutin supplement on cardiac antioxidant enzymes and oxidative stress in diabetic rats. Methods: In this experimental study, 42 male Wistar rats were randomly allocated into 6 groups including control, diabetes, Arbutin, diabetes+Arbutin, diabetes+exercise and diabetes+ exercise + Arbutin (combined). Diabetes induced using alloxan (90 mg/kg/bw, intraperitoneally). Arbutin (50 mg/kg/bw, ip) was administered for 5 days a week. The exercise consisted of swimming training at 5 min to 36 min per day, 5 days a week for 6 weeks. Renal Malondialdehyde, catalase level and superoxide dismutase (SOD) activity were evaluated in animals. Results: Diabetes significantly increased cardiac Malondialdehyde level and decreased cardiac SOD activity and catalase level (P<0.05). Six weeks of supplementation with Arbutin, swimming training and combined intervention significantly increased catalas level and superoxide dismutase activity compared to the diabetes group(P<0.05). Malondialdehyde level significantly reduced in combined and exercise groups in comparison with diabetic group (P<0.05). Conclusion: Regular training (swimming) and Antioxidant supplement (Arbutin) protect the cardiac tissue against diabetes-induced oxidative stress through their antioxidants capacity and the combination of the two interventions have synergic effect.

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Background and Objective: With respect to the antioxidant role of melatonin and retinoic acid, it seems to be effective both in the maturation and embryonic development. This study was done to investigate the effect of combination of melatonin and All-Trans retinoic acid (RA) on maturation, fertilization and embryonic development of immature mouse oocytes. Methods: In this experimental study, cumulus - oocyte complex (COCs) were recovered from 4-6 week old female mice NMRI and were divided into 6 maturation medium groups including control, sham, experiment 1(melatonin 100 nM, 1 and 2 µM), experiment 2 (retinoic acid 1, 2, 4, 6 µM), experiment 3 (melatonin 2 µM+RA 4 µM), experiment 4 (Mel 100nM + retinoic acid 4µM). The maturation rate was recorded after 24 hours of culture in a humidified atmosphere of 5% CO2 at 37°C. The matured oocytes were fertilized with sperm. Fertilization and embryonic development rates to the blastocyst stage were recorded. Results: Maturation rate in the control and sham groups were 50.6% and 49.4%, respectively. Maturation rate were 54.3%, 54.8%, 59.9% in melatonin group with concentrations of 100 nM, 1 and 2 µM, respectively. Maturation rate were 51.6%, 51%, 59% and 49.6% in t-RA group with concentrations of 1, 2, 4, 6 μM. Maturation rate were 60.4% and 54.2% in the experiment 3 and 4 groups, respectively. The maturation rates in the melatonin 2 µM, retinoic acid 4 µM and experiment 3 significantly increased in compare to control (P<0.05). The embryonic development rate in the melatonin with 100nM concentration and 4 µM of retinoic acid increased significantly compared to controls (P<0.05). Although, embryonic development rate in experiment 3 was higher than control, but lower in compare to melatonin 100 nM and the retinoic acid 4 µM. The embryonic development rate in experiment 4 significantly increased in compare to control (P<0.05). Conclusion: Combination of melatonin and All-Trans retinoic acid in medium culture increase maturation rate and improved embryonic development in dose dependent manner.

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Background and Objective: Overweight and obesity are increasing in the last three decades indicates the strong influence of environmental factors. Fats are the most important sources of human food which is considered as one of the reason for obesity. Among the components of the diet, poly unsaturated fatty acids (PUFA) are resulting in obesity. This study was done to evaluate the effect of diets containing poly unsaturated fatty acid on body weight and colon macroscopic properties in rabbit. Methods: In this experimental study, 24 female rabbits were allocated into three experimental groups including short, medium and long term and control groups (three subgroups). Animals in experimental groups were received diet containing corn oil for one month (short term), two months (medium term) and three months (long term). Animals at the end of the first, second and third months, were weighed and dissected and taken biopsy from colon. The macroscopic properties of the samples including shape and arrangement of Haustration were evaluated. Results: Over weight was not in the long – term consumption of corn oil in comparison with controls, but Haustra organization in different parts of the colon were disappeard in experimental animals. Conclusion: The diet containing poly unsaturated fatty acid causes macroscopic alteration in rabbit colon.

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Background and Objective: Sodium Arsenite is an environmental pollutant which can generate free radicals causing tissue damage. This study was done to evaluate the effect of Green Tea (GTE), as a strong antioxidant, on kidney tissue in mice treated with Sodium Arsenite. Methods: In this experimental study 24 adult male NMRI mice were randomly allocated into four groups including: control, GTE (100mg/kg/day), Sodium Arsenite (5mg/kg/day) and Sodium Arsenite + GTE, for 34 days, orally. Animals were scarified and left kidney was taken out, fixed, sectioned, processed and stained using Heidenhain'azan method. Using stereological technique the total volume of kidney, volume of cortex, medulla, proximal and distal tubule, renal corpuscle, gelomerelus, tuft and capillary, membrane and space of Bowman's capsule and length of proximal and distal tubule were determined. Creatinine, BUN and MDA serum samples were measured. Results: The mean of total volume of cortex, proximal tubule, distal tubule, renal corpuscle and gelomerolus, taft, Bowman's capsule space, size of epithelium and lumen of proximal and distal tubule were significantly reduced in Sodium Arsenite group compared to control (P<0.05). These parameters were significantly increased in the Sodium Arsenite + GTE group in comparison with Sodium Arsenite group (P<0.05). The creatinine, Blood urea nitrogen (BUN) and MDA were significantly increased in the Sodium Arsenite group in compared to the control group (P<0.05). These parameters were significantly reduced in the Sodium Arsenite + GTE group in comparison with Sodium Arsenite group (P<0.05). Conclusion: Green tea has a protective role in Sodium Arsenite induced nephrotoxicity.

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Background and Objective: Attention deficit hyperactive disorder (ADHD) is commnest psychological disorders in children. This study was done to evaluate the effectiveness of rhythmic games on social skills of children with ADHD.

Methods: In this quasi -experimental study with pretest, post test and follow up with control group, 30 boys student with ADHD were non-randomly divided into the two groups. Conners rating scale and social skills checklist were used.

Results: Social skills significantly increased in ADHD students and this effectiveness continued in follow up stage (P<0.05).

Conclusion: Play therapy is effective on social skills of children with ADHD.

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Case presentation: A 20 month-old hypotonic boy with a history of preterm labor at 32 weeks of gestational age, secondary generalized seizures in infancy, hypothyroidism (T4: 2, TSH: 14); motor and speech developmental delay, mild  ataxia and renal failure (chronic kidney disease: CKD) was presented to the clinic of Taleghani pediatric hospital in Gorgan, Northern Iran during 2015. In further evaluation, the patient did not have fix and follow occularly and the head of the left optic nerve was atrophic and congenitally malformed although it seemed the visual prognosis for the right eye was even good with just a slightly pale nerve. The renal ultrasonography showed an increase of general echo which was suggestive for congenital or parenchymal abnormalities. Dialysis was ordered but the patient's family declined. The Image of the infant brain in axial cut using MRI 1.5 Tesla marked molar tooth sign (MTS). The schematic view is also given. Conservative treatment including Scholl, anti-convulsant solution, (30 cc daily), ferrous sulfate (20 drops), calcium tablets carbonate (2 per day) and phenobarbital (5 mg/kg/bw divided in two parts) was administered for the patient.

Diagnosis: Classic Joubert syndrome subtype: CORS (11q12.2 TMEM216)

Joubert syndrome is a rare autosomal recessive disorder affecting the cerebellum and characterized by abnormal respiratory pattern and eye movements, hypotonia, ataxia, developmental retardation with neuropathological defects of cerebellum and brainstem comprising inherited hypoplasia or aplasia of vermis. This clinical entity is possibly under-reported with a prevalence of less than 1 per 100,000. This syndrome is prototype of congenital vermian hypoplasia. Treatment for Joubert syndrome is symptomatic and supportive. Infant stimulation and physical, occupational, speech and hearing therapy may benefit some patients. Infants with abnormal breathing patterns must be monitored.

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Background and Objective: The growing evidence suggest on the association between dietary patterns and obesity. This study was done to determine the relation between pattern of nutrient intake and obesity in Isfahanian adults.

Methods: In this descriptive - analytical study, dietary data were collected using a semi-quantitative food frequency questionnaire in 8,691 subjects aged 18-55 years. Complete data of 6,724 and 5,203 adults were available for general and abdominal obesity, respectively. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis was applied to derive major nutrient patterns.

Results: Three major nutrient patterns were identified: 1) pattern high in fatty acids, cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus, and pantothenic acid; 2) high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and 3) high in glucose, fructose, sucrose, vitamin C, potassium, dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model (95% CI: 0.20-0.76, OR: 0.39, P<0.05). After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men (95% CI: 1.04-3.04, OR: 1.77, P<0.05), but it was not in women (95% CI: 0.74-1.88, OR: 1.18, P>0.05).

Conclusion: Nutrient patterns were significantly associated with general, but not abdominal obesity in the male Iranians participating in SEPAHAN study.

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Background and Objective: Ducrosia anethifolia (Dc.) is a medicinal odor plant contains CNS effective compounds which has been used in Iranian traditional medicine. This study was done to determine the effect of Ducrosia anethifolia (Dc.) Boiss essential oil on spatial learning and memory in adult male rats.

Methods: In this experimental study, 35 wistar adult male rats were randomly allocated into the five groups (n=7) including: control, sham (injected vehicle) and Ducrosia anethifolia (Dc.) Boiss essential oil groups 0.125, 0.25 and 0.5ml/kg/bw, intraperitonally during four days. Morris water maze test was used to assess learning and memory.

Results: Ducrosia anethifolia (Dc.) Boiss essential oil (0.5 ml/kg/bw) was significantly increased escape latency in the second and third (P<0.05) as well as forth (P<0.05) days of acquisition test in compare to control group. In addition latency to find the hidden platform was significantly decreased with 0.25 essential oil in all days except first day (P<0.05) and in essential oil- treated rats at 0.125 ml/kg/bw in the second and third days (P<0.05) in compare to the control group.  Time spent and distance travelled in target zone were significantly increased in Ducrosia anethifolia (Dc.) Boiss essential oil -treated rats (0.5ml/kg/bw) in compare to control group (P<0.05).

Conclusion: Intraperental administration of the Ducrosia anethifolia (Dc.) Boiss essential oil at doses of 0.5 and 0.25 ml/kg/bw during four days can improves spatial learning and memory in adult male rats.

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Background and Objective: Hydroalcholic extract of Peppermint is traditionally used for gastrointestinal disorders. This study was done to evaluate the effect of Peppermint extract on the mice colon motor activity following immobilization stress.

Methods: In this experimental study, 30 male Albino mice were randomly allocated into the three groups; including control, stress and stress + Peppermint oil groups (n=10). The second group as a stress group exposed to immobilization stress for four hours during three days. Third group as stress plus Peppermint oil group was exposed to stress in addition to administration of 27 mg/kg/bw Peppermint oil intraperitoneally prior to stress. After three days, intestinal and peristaltic activity was recorded using pressure transducer from in vitro segments of colon (4-5 cm in length. Also, fecal weight, food intake and body weight was measured for each mouse for in vivo condition.

Results: The mean±SD of fecal weight after three times stress immobilization was 1.36±0.71, 1.06±0.6 and 0.47±0.39 gr in control, stress and Stress + Peppermint oil groups, respectively (P<0.05). The mean±SD of internal luminal pressure after three times stress immobilization was 4.47±1.15, 3.48±1.25 and 0.77±0.37 mm/hg in control, Stress and stress + Peppermint oil groups, respectively (P<0.05).

Conclusion: Peppermint oil is a strong inhibitor for colon motor activity following immobilization stress.

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Background and Objective: Extended-Spectrum Beta Lactamase enzymes (ESBLs) are the most important factor for antimicrobial resistance in Enterobacteriaceae The resistance to beta-lactam antibiotics is the main problem in the bacterial infections therapy. This study was done to determine the prevalence of Extended-Spectrum Beta Lactamase enzymes in clinical isolates of Enterobacteriaceae family.

Methods: In this descriptive study, 240 isolates of Enterobacteriaceae family were collected from clinical specimens obtained in Shohada, Rahimi and Madani hospitals in Khorramabad city, Iran. Antibiotic susceptibility of isolates was performed by disk diffusion method. ESBLs production in all isolates was determined using the combination disk method.

Results: Bacteria strains isolated in this study were Escherichia coli (76%), Klebsiella pneumonia (16.2%), Citrobacter (5.4%), Enterobacter spp. (0.83%) and Proteus (1.6%). The results of antimicrobial susceptibility of isolates showed that the highest rate of antibiotic resistance was toward Ampicillin (88%) and Cefotaxime (43%) and the lowest rate was observed to Amikacin (2.5%). According to the results of the phenotypic tests, 141(59%) isolates out of 240 Enterobacteriaceae were beta-lactamase producers.

Conclusion: ESBL producer isolates and antibiotic resistant due to of Enterobacteriaceae isolated from clinical samples from hospitals are high prevalence in Khorramabad city, Iran.

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Background and Objective: Medicinal drug interactions are one of the problems caused by irrational drug prescription. It eigher change the therapeutic effect or cause drug toxicity. This study was performed to determine the prevalence of medicinal drug interactions in medicinal prescriptions in Golestan province, north of Iran.

Methods: In this descriptive study, 1100000 medicinal prescriptions under contract with the Golestan province health insurance organization were assessed for drug interactions during 20 March-
20 September 2012.

Results: Drug interactions frequency was 6262 (0.66%). 35.5%, 63.1% and 1.4% of prescriptions were severe, moderate and mild interactions, respectively. The most common severe, moderate and mild drug interactions related to Atorvastatin-Gemfibrozil (13.67%), Ceftriaxone- Gentamicin (9.05%) and Lithium Carbonate-Haloperidol (2.56%).

Conclusion: In view of moderate and severe medicinal drug interactions in physicians' prescriptions, health system should plan a comprehensive program to improve awareness and effective monitoring to reduce medicinal drug interactions.

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Background and Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiologic data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms and gastro-esophageal reflux disease (GERD) in a large group of Iranian adults.

Methods: This descriptive -analytic study was conducted on 3363 Iranian adults (19-70 yr), whom were working in 50 health centers across Isfahan province in Iran during 2012. We used easy non-random sampling to select participants. The “healthy lifestyle score” for each participant was calculated by summing up the binary score given for five lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. A validated Persian version of ROME III questionnaire was used, to assess functional gastrointestinal disorders.

Results: The prevalence of FD and GERD among study participants was 14.5 and 23.6%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (95% CI: 0.05-0.92, OR: 0.21, P=0.03) and GERD (95% CI: 0.09-0.69, OR: 0.26, P=0.01), respectively, compared with those with the lowest score. They were also less likely to have early satiation (95% CI: 0.11-0.73, OR: 0.28, P=0.001), postprandial fullness (95% CI: 0.09-0.50, OR: 0.22, P<0.001) and epigastric pain (95% CI: 0.21-0.92, OR: 0.44, P=0.03). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits and non-smoking were separately associated with FGIDs (P<0.05).

Conclusion: This study showed that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults. Individual lifestyle-related factors were also associated with these conditions.

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Background and Objective: A high percentage of patients with multiple traumas sustained at least from an orthopedic problem. One of the high frequent lesions was femoral shaft fracture. The aim of this study was to determine the amount of bleeding and the need for blood transfusion in femoral shaft fractures and risk factors.

Methods: This descriptive, retrospective study was done on 84 patients with femoral shaft fractures whom were operated in Imam Khomeini Hospital in, Sari, in northern Iran during 2012-15. Age, sex, comorbidities, type of fracture, hospitalization period, pre and post-operative hemoglobin and blood unit's loss were recorded for each patient.

Results: In 43 patients (51.19%) plate and in 41 patients (48.80%) intramedullary naling were used for treatment of fractures.13 (15.47%), 33 (39.28%) and 37(44.04%) of patients were received one, two and three blood units, respectively. There was no significant relationship between energy intensity and age. There was significant relationship between the intensity and the type of fracture (P<0.05). A significant correlation existed between blood unit transfusion with sex, fracture type, hemoglobin before surgery and fracture energy intensity (P<0.05).

Conclusion: Based on the results of this study, it is recommended for hip fracture at least 3 units of blood should be reserved.