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Background and Objective: From 1942 when Griffith & Johnson suggested that muscle relaxants are safe drugs for better laryngoscopy & intubation and good for skeletal muscle relaxation during surgery, many of muscle relaxants discovered with different effect, side effect and potency. Some of the muscle relaxants properties include rapid onset, short-acting, fast recovery, stability of hemodynamic, lock of histamine release and etc. Hemodynamic stability is one of the important properties of this drug. In this research we wanted to see effect of Rocuronium, which is an intermediate muscle relaxant on systolic, diastolic BP and HR of patients who is candidate for elective surgery. Patients and Methods: This research is an experimental study. We wanted to see the effects of Rocuronium that is an intermediate muscle relaxant on mean avierial pressure and heart rate of the patient who is coming to the hospital of Iran medical university hospitals for elective orthopedic surgery. The sample size calculated 30 patients. We choose our patients with simple randomized method. All of them were ASA1 and in the age of 20 to 50 years old. The patients didn’t receive any pre-medication until coming to operating room. In the OR they received 7 cc/kg ringer solution and then 70 µg/kg thalamonal was administered intravenously. 5 minute latter their BP and PR was checked, which considered baseline measurement. Induction of anesthesia was with Thiopental 5 mg/kg and Rocuronium 0.9 mg/kg. After 60 sec patients were intubated with direct laryngoscopy. The maintenance of anesthesia for first 10 minutes was with O2 50% and N2O 50% and for continue of anesthesia MR and Opioid depend on need. Results: We analyzed our data with paired to T-test and green house test. Systolic and diastolic blood pressure and heart rate changes was 5% lowest than baseline hemodynamic parameter. Conclusion: With attention to previous studies and observation of hemodynamic changes with muscle relaxants which uses in Iran, this drug (Rocuronium) have good effect on stability of hemodynamic parameters. Beside other properties of Rocuronium include: Rapid onset, lack of histamine release, intermediate acting and etc. We can said this drug is a good and safe muscle relaxant for use during anesthesia and surgery.

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Background & Objective: Acne Rosacea is a recurrent chronic and inflammatory skin disease. According to the prevalence of Acne Rosacea, importance of determining its etiology and controversies about the role of Demodex mites in expression of the disease, this study has been done on patients who has been referred to Booali and Loghman hospitals during 1370-80. Materials & Methods: This research was a case-control study. The case group has been Acne Rosacea patients according to the pathologic report and there has been 2 control groups: One, who has had discoid lupus erythematosus (DLE) and the other one, those who has been affected by actinic Lichen Planus (ALP). The groups have been matched for their age and sex. Pathologic specimens being provided by skin biopsy technique, have been studied for the determining the presence and density of Demodex mites, the results has been recorded on special information sheets and their role in expression of Acne Rosacea and its odds ratio have determined. Results: This study has been done on 225 patients, 75 in case group (Acne Rosacea) and 75 in patients in each of the control groups (DLE and ALP). There was no statistical difference in the age and sex of patients in these groups. 16% of the control group and 38% of case group had Demodex mites (P<0.05) and the presence of this parasite has increased the chance pf expressing Acne Rosacea by 3.3 times. The mean count of Demodex mites in DLE and ALP groups has been 0.66 and 0.2 respectively, whereas, in case group, it was 1.4 (P<0.05). Conclusion: We concluded that the presence and density of Demodex mites increases the chance of expression of Acne Rosacea. Further studies for determining the effect of treating these mites in Acne Rosacea is recommended.

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Background & Objective: Pityriasis rosea is an acute inflammatory dermatosis with an unknown cause. Although it is a self limitted disorder and has no chronic side effects (nevertheless it will take between 3-6 weeks) but it may continue for two months. In order to shorten pityriasis rosea course and remove itching and skin lesions, it is advisable to cure the disease with an appropriate drug. Based on the above, the present study was performed to investigate efficacy of Erythromycin in comparison with placebo and improve this disease period. Materials & Methods: A randomized double blind clinical trail was carried out on typical pityriasis rosea patients who had referred to 5th Azar clinic Gorgan-Iran during December 2004-May 2005. 46 patients were selected and randomly divided into two groups (23 patients in each one). Since it was a double blind study, treatment for two weeks was prescribed then the cure rate was measured during second, fourth and sixth week. In case group, Erythromycin 1gr/day was prescribed and continued for two weeks. In the other group only placebo was prescribed. Statistical analysis: Pearson chi-square analysis with 2- sided p value was applied to compare the distribution of pityriasis rosea between patients by using Sspss-11.5 software Regard to the kind of study and qualitative attribute, we used comparison between ratios in order to analyze them. Meaningful level for these tests was α=0.05. Results: Even though we gained good results in case group during second, fourth and sixth week after treatment, but there was no significant difference between these two groups at α=0.05. Conclusion: This investigation shows that Erythromycin has little effect on pityriasis rosea period. Therefore we suggest complementary study with larger samples in future.

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Granuloma faciale is an uncommon cutaneous lesion characterized by asymptomatic skin nodules and plaques without any systemic presentation. The lesions mainly seen in middle aged males. We report an uncommon presentation (multiple cutaneous lesions) in trunk,upper arm and face)of a 32 years old male.

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Background and Objective: Maternal position during the second stage of labor can be considered to be an intervention in the natural course of labor. This study aimed to establish the effect of sitting versus lithotomic position on duration of second stage of labor, preneal truma and neonatal outcome.

Materials and Methods: This clinical trial study was done on 110 term nuliparuse women with normal conducte of labor in second stage, which divided randomly in sitting position, (n=55) and lithotomic position (n=55) in teaching hospital in Yazd, Iran during 2005-06. Duration of second stage, Perinea trauma and first 5 minutes APGAR evaluated and compared in two groups. Data analyzed by SPSS-11.5 with T student and Chi square tests. P<0.05 was significant.

Results: Duration of second stage of labor was 34 and 42 minutes in sitting and lithotomic position respectively (P<0.05). Perinea damage was seen in 15 (27.3%) and 24 (43.6%) women of sitting and lithotomic position respectively (P<0.05). No significant difference existed between the groups in neonatal first 5 minutes APGAR.

Conclusion: This study showed that sitting position reduce second stage duration and perinea trauma versus lithotomic position.

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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.

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Background and Objective: Due to the increase of incidence of extrapulmonary tuberculosis in Iran, This study was conducted to determine the epidemiological pattern of extrapulmonary tuberculosis in the Mazandaran province, northern Iran. Methods: This descriptive-analytic study was carried out on medical record of 3313 tuberculosis patients in Mazandaran province, northern Iran during 2001-11. Age, gender, affected year, area and affected organ were gathered for each patient. Results: 843 (25.4%) of subjects were diagnosed with extrapulmonary tuberculosis. The incidence of extrapulmonary tuberculosis increased by 4% for every unit increase in incidence year (P<0.05). The mean age of patients with extrapulmonary tuberculosis was significantly less than patients with pulmonary tuberculosis (42.8±20.6 years vs. 48.7±21.2, P<0.05). Extrapulmonary tuberculosis was significantly higher in women (P<0.05). The chance of extrapulmonary tuberculosis in women was 1.7 times of men. Lymph node (33%) was the most common affected organ followed by pleura (18.9%) and bone (17.7%). Conclusion: The trend of incidence of extrapulmonary tuberculosis was ascending during 2001 to 2011. The most affected organ in extra pulmonary tuberculosis was lymph nodes.

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Background and Objective: There are controversial reports about the effect of training on serum level of visfatin and TNF-α Cytokine .This study was done to evaluate the effect of 8 weeks of aerobic training on serum level of visfatin and TNF-α in non-athletic young women. Methods: In this quasi-experimental study, thirty non-athletic healthy women were non-randomly based on the weight, height, BMI index and body fat percentage divided into two control and training groups. In the training group 8 weeks of aerobic exercise on a stationary bicycle 3 times a week was performed. Serum level of visfatin and TNF-α was measured using ELISA method, prior and at the end of 8th week of training while the subjects were fasted for 12-14 hours. Results: At the end of 8 weeks of aerobic exercise, serum level of visfatin and TNF-α significantly reduced in the training group in comparison with controls (P<0.05). Conclusion: Eight weeks of aerobic training reduces visfatin and TNF-α serum level in non-athletic healthy women.

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Background and Objective: Low birth weight (LBW) is one of the most important problems in the world. Many morbidity are more prevalent in LBW included in attention deficit and hyper activity disorder (ADHD). This study was done to find the Relation between low birth weight with attention deficit and hyper activity disorder in children. Methods: This historical cohort study was done on 226 rural children in Yazd province, central area of Iran. ADHD symptoms were evaluated in LBW and NBW using DSM-IV criteria. Results: Frequency of ADHD was 22.8% in LBW and 12.5% in NBW (P<0.05). The mean of family members was 4.7±0.6 and 4.2±0.8 in child with ADHD versus child without ADHD (P<0.05). Odd's ratio for ADHD was 3.1 in patient with more than one sister or brother (95% CI: 1.2-7.9, P<0.001), and 5.7 in patients with positive familial history (95% CI: 2.6-12.4, P<0.001). Conclusion: Relationship between ADHD and LBW was statistically significant. Positive familial history for ADHD and over-crowded family were social factors related with ADHD. LBW is one of the risk factors for ADHD and can be considered in children health program ADHD was frequent in child with low birth weight than child with normal birth weight.

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Background and Objective: Vitiligo is one of the most frequent skin disorders with a prevalence of 1-2% in different populations. Although many theories have been suggested for its pathogenesis, but the most popular hypotheses is the role of autoimmunity in Vitiligo. This study was done to evaluate the thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo.

Methods: This case-control study was carried out on 45 patients with Vitiligo and 45 age- and sex-matched healthy individuals as control group. Age, gender, duration of the disease and type of Vitiligo were collected through a standard questionnaire. Thyroid autoantibodies including thyroglobulin antibody, anti- thyroglobulin and thyroid peroxidase antibody, and anti-TPO thyroid hormones Tetraiodothyronine (T4), Triiodothyronine (T3) and thyroid stimulating hormone (TSH) in Vitiligo patients and healthy volunteers were measeared.

Results: Serum level of T4 was significantly reduced in Vitiligo patient compared to controls (P<0.05). Serum level of T4 in 20% of Vitiligo patient and 2.2% of control cases was less the normal level. Anti-TPO in 14 (31.1%) of Vitiligo patient and 6 (13.3%) of controls were higher than normal range (<60 IU/m) (P<0.05). Serum level of anti- thyroglobulin was significantly higher in those with Vitiligo in compared to controls (P<0.05).

Conclusion: This study showed that the thyroid dysfunction particularly hypothyroidism and anti-TPO is more common in Vitiligo patients.

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Background and Objective: Iran remains a major stronghold for glanders in the Middle East. In Iran, the non-indigenous Burkholderia mallei Razi 325 strain is used in manufacturing of the mallein, required for malleination of animals. Multi Locus Variable number tandem repeat analysis is currently the standard globally accepted genotyping system for Burkholderia mallei. This study was done to survey the genomic structure of Burkholderia mallei Razi 325, the strain used for industrial production of Mallein.

Methods: In this descriptive study, a MLVA genotyping system with 4 previously-characterized loci VNTR140, VNTR1367, VNTR2065, VNTR2971 along with two new loci of VNTR24, VNTR41 was used.

Results: Optimization of PCRs resulted in a single protocol that enabled simultaneous amplification of all the six loci. Sequencing of PCR products revealed there were 2, 3, 12, 6, 1 and 2 copies of the unit repeat hold in the genome of the Burkholderia mallei Razi 325 strain. This observation was extended to include the already-whole genome sequenced Chinese Burkholderia mallei ATCC 23344 and Burkholderia mallei BMQ and also Burkholderia mallei SAVP1 strains.

Conclusion: The Burkholderia mallei Razi 325 strain is distinguishable from the other three strains through MLVA genotyping method.

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Background and Objective: Gum diseases and dental caries are the most prevalent diseases in societies with different cultures particularly among pregnant women. This study was done to evaluate the oral health status of pregnant women in Gonbad Kavous, northern Iran.

Methods: This descriptive - analytical study was conducted on 400 pregnant women aged 20 to 40 years old in Gonbad Kavous, northern Iran during 2010-11. Demographic and oral examination information was recorded in a chick list. The obtained data were evaluated by DMFT index (Decay, Missing, and Filling Teeth) and OHI-S index (Oral Hygiene Index-Simplified).

Results: The average of DMFT index was 3.29±6.21. There was a significant difference between the place of birth and place of residence of pregnant women with DMFT index (P<0.05). The average of OHI-S index in pregnant women was moderate (0.88±1.36). There was a significant difference between the location of residence and the level of education of pregnant women with OHI-S index (P<0.05). The most important factor to increase DMFT index was the high average of decayed teeth among pregnant women. Regarding the method and duration of observing oral hygiene, the most correct answers were related to method of cleaning teeth (toothbrush and toothpaste) and the least ones were related to the duration of cleaning (3-5 minutes).

Conclusion: DMFT index was high in pregnant women in northern Iran.

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Background and Objective: Coronavirus disease 2019 (COVID-19) can lead to organ failure by the occurrence of mechanisms such as increased thrombosis and, subsequently, increased lactate dehydrogenase (LDH). This study was conducted to determine LDH serum levels in COVID-19 patients and the factors affecting their mortality.
Methods: This descriptive-analytical study was conducted on 212 patients (57 males and 155 females) with COVID-19 with a mean age of 49.19±10.6 referring to Imam Ali Hospital in Chabahar, Iran during 2021. After obtaining patients’ informed consent and demographic information, the heparinized peripheral blood sample was taken from them. The LHD levels were determined using an autoanalyzer.
Results: Twenty-nine (13.67%) patients died. The mean LDH serum level of 29 deceased patients (708.420±96.25 U/L) was not statistically significant compared to survivors (640.360±96.80 U/L in 183). The comparison between the surviving and deceased groups showed that 25% of the deceased patients were hospitalized in the intensive care unit (ICU), and 90.90% of the survivors were hospitalized in the internal ward (P<0.05). All the deceased and 85.85% of the survivors were 40 years old and above, and this difference was not statistically significant. Furthermore, 24.56% of the deceased were male, 90.32% of the survivors were female (P<0.05), 22.72% of the deceased had a university education, and 88.69% of the survivors had a diploma or under-diploma education (P<0.05), and 71.42% of the deceased patients had thin, and 91.37% of the survivors were overweight (P<0.05).
Conclusion: There was no difference in the LDH serum levels of the COVID-19 survivors and deceased. The age of 40 years and above, lean and morbidly obese body mass indices, male gender, and the need for hospitalization in the ICU were determined as risk factors.