Tehran University Medical Journal

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In this study, 1600 pregnant women who had referred to two prenatal clinics (Imam Khomeini and Mirza Kochek-Khan) were investigated. Ninety cases of asymptomatic bacteriuria were observed 77 of those cooperated with us until the end of our study. The subjects, who were within the 14-36 weeks of gestational age, were randomly divided into two groups: Group A received the medicine (Amoxicillin) in a single-dose (3gr.) and, group B received it within seven days (1gr. TDS). The rate of recovery (65% in group A and 56.8% in group B), based on chi-squared test, showed no significant difference (P=0.747%). According to the results of this study, we can conclude that single-dose treatment has the same value as a seven-day treatment and the advantages such as decreased total dose, lower cost, and a better patient compliance.

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We studied the effect of the selective alha-2 adrenoceptor blocker idazoxan and precursor serotonin (5-HTP) on anxiety-related behavior in rats. The conflict drinking test, and evaluator plus-maze were used as model. Idazoxan (2 mg/kg) showed an anticonflict effect, having doses dependently increased the number of punished lickes. 5-HTP showed that anxiolytic-like effect in both models. This drug reversed action and produced anxiogenic-like effect at high doses. In contrast, arecholine which is a cholinergic muscarinic agonist drug, produced anxiogenic-like behavior. At 2 mg/kg increased number of entrance (OE) and using time (OT) in open arms in montgomery's test. Anxiolytic-like effect of this drug was less than of chlordizepoxide. These results showed that increase release of noradrenaline in synaptic nerve terminals of neurons produced anxiety-related behavior. While high release of serotonin in this area reduced behaviors disorder in rats.

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Background: Tumor necrosis factor alpha (TNF-) is a major mediator of inflammatory responses and also plays a role in Febrile non-hemolytic reactions (FNHRs) after platelet concentrates (PCs) injection. It is thought contaminating WBCs are the source of these cytokine so inactivating or decreasing of these WBCs will be effective to decline of the cytokines. Due to difference results between different methods for TNF measurement, in this study we compared Immunoassay and Bioassay methods to determine TNF- in supernatants of PCs.
Materials and Methods: TNF- was measured by ELISA (Immunoassay) and by the L929 cytotoxicity Bioassay in supernatant of random donor PCs (RD-PC) prepared by platelet rich plasma (PRP). These platelet concentrates were divided in 4 groups: 1- unfiltered , non-irradiated RD-PCs (N=13) 2- unfiltered and -irradiated RD-PCs (N=16) 3- filtered , non-irradiated RD-PCs (N=14) 4- filtered and -irradiated RD-PCs (N=11)
Results: Our results showed: • TNF-  was increased (by ELISA) in unfiltered non-irradiated units during storage but not in -irradiated and filtered RD-PCs in day 3. Compared to unfiltered PCs in filtered units, pre-storage filtration and irradiation prevented a rise in the TNF-  in day 3 of storage. • There was no correlation between ELISA and the cytotoxicity L929 bioassay .
Conclusion: It has been previously reported that different quantitative results can be obtained when TNF alpha is measured in biological fluids by Bioassay and Immunoassay. This is thought to be related to the presence of antigenic forms of TNF alpha that cannot be detected by bioassay, such as complexes with soluble receptors (sTNF-R) or TNF alpha monomers.

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Background and Aim: Sudden Sensorineural Hearing Loss (SSNHL) is an emergency situation, and is one of the most controversial subjects in domain of otolaryngology. In this article, we have analyzed some Epidemiologic Characteristics, clinical features, audiological Characteristics, and other findings in routine serological tests and MRI of 48 cases with SSNHL ,who came or were referred to us in the past 2 years. Study design: Cross sectional.

Materials and Methods: In 48 patients with chief complaint of SSNHL, from June 2003 to Feb. 2005, who were admitted in clinic of otolaryngology- in Kashani Hospital -Isfahan- Iran, physical examination and history taking, audiological evaluation, MRI,and serological tests were performed in a similar way , and data were analyzed by SPSS software.

Results: From 48 cases(M:28 ,F:20) with mean age of 40.9(+/-15.9) years, left ear was involved in 26 cases (54.1%) ,and right ear in 19 cases (39.5%) ,and in 3 cases (6.3%),both sides were involved. The severity of hearing loss was “subjectively” HIGH in 78% of patients, and the mean threshold of hearing had been calculated as 69 dB. The most common pattern in pure tone audiometry curves ,was ‘flat pattern’(75%) ,and then ,’down sloping pattern’(16%).The most adjunctive clinical symptom was “tinnitus”(in 78.7%), and 40% of patients had “true vertigo”. 44.4% of our patients had some evidences of upper respiratory tract infections (URIs) during recent 2 weeks. Positive family history, smoking, alcohol intake ,oral contraceptive and ototoxic drugs consumption were uncommon. 24% of cases (11 of 39) had increased ESR, and 100% of 39 patients had negative VDRL. Diabetes mellitus was the most common underlying disease (in 6 cases).From 20 patients ,who were succeeded to perform brain and ear MRI, 2 cases had tumor in internal auditory canal and cerebellopontine angle.

Conclusion: SSNHL has some limitations in being studied histopathologically or in the form of clinical trials, and in nearly all of its aspects there are some mysteries to be cleared. Our ‘Iranian’ patients demonstrated some special characteristics.

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Background: Sudden sensorinueural hearing loss (SSNHL) is a baffling condition for patients, and its etiology, audiologic characteristics, prognostic factors, and treatment are still controversial.
Methods: In this prospective study, we performed pure tone audiometry (PTA), impedance acoustics (IA), auditory brainstem responses (ABR), otoacoustic emissions (OAE), and transiently evoked otoacoustic emissions (TEOAE) before beginning treatment for 53 patients with SSNHL. We then entered each patient, randomly and alternately, in one of two treatment groups: oral steroids + acyclovir vs. intravenous urographin.
Results: In 22 (41.5%) of the 53 patients (22 female, 31 male), we found negative or no signal to noise ratio and overall correlation in TEOAE. Furthermore, 26 cases (49%) had positive overall correlations less than 50%, and five cases (4.4%) had overall correlations >50%. Although 15 cases (28.3%) responded well, 20 cases (37.7%) showed only a partial response, and 18 cases (33.9%) had poor or no response to our treatment. The mean value for overall correlation in the three subgroups of patients (no response, partial response, and complete response) was -3.5% (±1/16%), + 11% (±1.99%), and +36.6% (±3.07%) respectively (P = 0.01). From 52 cases, 20 had no reproducible wave in ABR (38.5%), three cases had abnormal ABR with normal OAE, all of which responded completely to treatments. Thirteen cases had abnormal ABR and OAE, none of which responded to treatment, and six cases had normal ABR with abnormal OAE, which often responded to treatment.
Conclusions: ABR and OAE may be useful in the diagnosis of SSNHL and determining the site of such lesions as ischemia or neuropathy. The overall correlation (and S/N ratio) in TEOAE is a valuable prognostic factor in SSNHL.

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Background: Total spinal anesthesia is a complication of lumbar epidural anesthesia following undiagnosed subarachnoid or subdural injection of local anesthetic. Although many achondroplastic dwarfs have a normal spine, catheter insertion may be more problematic with a narrow epidural space making a subarachnoid tap more probable.  Other malformations associated with achondroplasia, such as prolapsed intervertebral discs, reduced interpedicular distance, shortened pedicles, and osteophyte formation, combined with a narrow epidural space may make identification of the space difficult and increases the risk of dural puncture. Furthermore, subarachnoid tap or dural puncture may be hard to recognize if a free flow of CSF is difficult to achieve due spinal stenosis. Yet, for those who meet the criteria, epidural regional anesthesia is frequently preferred over other forms, which often have more or more dangerous side effects in this type of patient.

Case report: A 22-year-old achondroplastic male dwarf patient was scheduled for pelvic mass resection and was considered a candidate for continuous epidural anesthesia. The anesthesia became complicated by total spinal anesthesia, which was reversed following supportive management for about two hours.

Conclusion: There is significant debate over the composition and volume of the test dose, especially for patients with achondroplasia. We nevertheless recommend repeated test-doses during the accomplishment of epidural anesthesia to exclude unintended intravascular, intrathecal or subdural injection, keeping in mind that a test dose of local anesthetic does not completely prevent complications.

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Background: post operative pain is an essential problem. Epidural infusion of two different doses of bupivacaine in pain management of post orthopedic surgeries was studied.

Methods: In this double blinded randomized clinical trial we studied two groups of 42 patients undergone knee surgery. Based on block randomization, patients received two different concentration of bupivacaine (0.1% or 0.125%) in combination with fentanyl (1.7µg/ml). The beginning infusion rate was 5ml/h. Pain scores were documented by a blinded researcher 6, 12, 18, 24 and 48 hours after completion of surgery according to VAS tool. Patient satisfaction, complications and treatment failure (when increased volume of epidural infusion or other analgesics were required) were evaluated.

Results: In higher bupivacaine dose group, post operative pain scores were not significantly lower in different hours and during the follow up (both p values less than 0.001). After 48 hours, patients satisfaction were more in the higher bupivacaine group. There were no significant differences in complications. Treatment failure was more significant in lower bupivacaine dose (33.3% versus 11.9%, p=0.03).

Conclusion: continuous epidural infusion of both bupivacaine and fentanyl provide acceptable post operative pain control in orthopedic patients. Although higher concentrations of bupivacaine during first hours are more effective, lower concentrations are as effective as the higher one, during subsequent hours.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Successful brachial plexus blocks rely on proper techniques of nerve localization, needle placement, and local anesthetic injection. Standard approaches used today (elicitation of paresthesia or nerve-stimulated muscle contraction), unfortunately, are all "blind" techniques resulting in procedure-related pain and complications. Ultrasound guidance for brachial plexus blocks can potentially improve success and complication rates. This study presents the ultrasound-guided brachial plexus blocks for the first time in Iran in adults and pediatrics.
Methods: In this study ultrasound-guided brachial plexus blocks in 30 patients (25 adults & 5 pediatrics) scheduled for an elective upper extremity surgery, are introduced. Ultrasound imaging was used to identify the brachial plexus before the block, guide the block needle to reach target nerves, and visualize the pattern of local anesthetic spread. Needle position was further confirmed by nerve stimulation before injection. Besides basic variables, block approach, block time, postoperative analgesia duration (VAS<3 was considered as target pain control) opioid consumption during surgery, patient satisfaction and block related complications were reported.
Results: Mean adult age was 35.5±15 and in pediatric group was 5.2±4. Frequency of interscalene, supraclavicular, axillary approaches to brachial plexus in adults was 5, 7, 13 respectively. In pediatrics, only supraclavicular approach was accomplished. Mean postoperative analgesia time in adults was 8.5±4 and in pediatrics was 10.8±2. No block related complication were observed and no supplementary, were needed.

Conclusions: Real-time ultrasound imaging during brachial plexus blocks can facilitate nerve localization and needle placement and examine the pattern and extend of local anesthetic spread.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: Bispectral index (BIS index) shows the depth of anesthesia. The effects of drugs on BIS and amnesia are different. This study was performed to evaluate the association between two different sedative regimens on BIS and amnesia.
Methods: In this clinical trial, 60 patients who needed elective orthopedic surgery under regional anesthesia with intravenous sedation were elected. Patients divided in two equal groups based on sedation protocol by block randomization method: midazolam plus fentanyl group (MF group) or propofol group (P group). Dose of sedative drugs were adjusted according to clinical findings of sedation. Depth of sedation in all patients, preserved in four based on modified Ramsey Sedation Score. Patients questioned about spontaneous recall after full awakening in recovery room. Recall of any event during operation considered as failed amnesia. Correlation of BIS index with recall was measured in two different groups separately.
Results: The frequency of recall was 2 (6.7%) in P group and 10 (33.3%) in MF group (p=0.01). The mean± SD of BIS in P group was 76±5 (68-91) and in MF group was 93.4±5 (77-98) (p<0.001). The difference of BIS in patients without amnesia (p=0.019) and with amnesia (p<0.001) in two groups were significant, respectively. No delay in recovery was observed.
Conclusion: Although the Modified Ramsey Sedation Score and clinical sedation indices were the same, but BIS in patients varied in a wide range. Hypnotic drug was a main determinant of BIS score and amnesia.

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Background: Staphylococcus aureus is a major foodborne pathogen throughout the world. Enterotoxins and toxic shock syndrome toxin-1 are important virulence factors and as pyrogenic toxin superantigens have profound effects on the ir host. Thus circulation of TSST1 producing S.aureus among people and food chain is a worrying issue. The present paper was conducted to study Prevalence of tst, entC, entA and entA/C genes in staphylococcus aureus strains isolated from different foods.
Methods: Over 1040 food samples have been analyzed differentially according to Iran national standard (number= 1194) for S.aureus identification. After DNA extraction, PCR reactions were carried out by reference strain as positive control, adequate primers.

Results: At present study, prevalence of foodstuffs contaminated by S.aureus isolates was about 9.5% (100 strains). Of 25% of isolates producing entC, 28% (seven strains) had tst gene at the same time and of 8% of isolates producing entA, 12.5% (one strain) were positive for tst genes simultaneously. Altogether of 9% isolates producing combination of entC and entA, 44.4% (four strains) were also producer of tst gene.

Conclusion: Prevalence of TSST1 producing strains in combination with enterotoxin genes is considerable especially with entC and A plus C. On the other hand, circulation of these isolates in humans, animals, foods and environment has hazardous effect for general public health.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Vulvovaginal candidiasis is a fungal disease with itching, and vaginal thick white discharge. Most of non-albicans species have less sensitivity to azoles. So, definition of candida species which lead to vulvovaginal candidiasis is very important to perfect usage of drugs. In the present study 191 Candida isolates from 175 patients who admitted in Gynecology department of Mahdieh Hospital during the period 1385-1387 were identified by multiplex PCR.
Methods: One hundred seventy five vaginal swab specimens from patients were cultured on Sabouraud Dextrose Agar (SDA). The internal transcribed spacer 1 (ITS1) region between the 18S and 5.8S rRNA genes and a specific DNA fragment within the ITS2 region of Candida albicans were amplified and the multiplex PCR products were separated by electrophoresis in 2% agarose gel (200 mA, 140V), visualized by staining with ethidium bromide, and photographed.
Results: One hundred ninety one Candida isolates were identified in vaginal swab specimens from 175 patients. In 89.7% of cases, single candida species and in 10.3% cases, multiple candida species were isolated. C. albicans (65.1%), C. glabrata (13.1%), C. tropicalis (6.2%), C. krusei (4%), C. guilliermondii (0.6%), C. parapsilosis (0.6%), C. glabrata and C. albicans (5.7%), C. albicans and C. parapsilosis (1.1%), C. glabrata and C. tropicalis (0.6%), C. krusei and C. tropicalis (0.6%), C. albicans and C. tropicalis (0.6%), C. krusei and C. albicans (0.6%), C. glabrata and C. krusei (0.6%), and C. glabrata and C. krusei and C. albicans (0.6%) were the cause of disease.
Conclusion: Our findings suggest that, the common cause of both recurrent and non-recurrent vulvovaginal candidiasis was C. albicans, and then C. glabrata. Also the most common mixtures of Candida species were combination of them

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Background: In according to immunomodulatory effect of probiotics and effect of these bacteria on the effectiveness of immune responses, at the present work we proposed the evaluation of oral administration of L.acidophilus on the immune statues in BALB/c mice bearing breast cancer.
Methods: A total of 30 In-bred BALB/c mices aged from six to eight weeks weighting 25-30g were randomly enrolled in our study, in two groups each consist of 15 mices. The L.acidophilus ATCC4356 strain used in this study was inoculated in MRS broth and cultivated for a day at 37°^C under anaerobic conditions, collected by centrifugation and resuspend in Phosphate Buffer Saline (PBS). After preparation of proper amount of these suspensions it was orally administered to the mice with a gastric feeding, Control mices received an equal volume of PBS in duration of study.
Results: Results showed the increase in production of IFnγ (p<0.005), and decrease in production of Th2 cytokines such as IL4 (p=0.347) in the L.acidophilus administered mice in comparison to control group of mice. In addition the proliferation of immune cells in probiotic group was significantly higher than controls, and most importantly probiotic administered mice showed an increase in survival rate of this group compared to control mice (p<0.001).
Conclusion: Results of our study suggested that daily consumption of Lactobacillus acidophilus can regulate immune responses skewed Th1 balance that is needed against tumor, further studies is needed to investigate the other mechanisms of this effect.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Vulvovaginal candidiasis is a common mucosal infection among immunocompetent, healthy women, and is caused by opportunistic yeasts that belong to genus Candida. In this study, we isolated and identified the Candida species in the vagina of patients who admitted in Gynecology Department of Mahdieh Hospital in Tehran, Iran to evaluate the in vitro activities of fluconazole, miconazole, itraconazole and flucytosine against 191 clinical Candida isolates by the NCCLS microdilution method.
Methods: 191 Candida were isolated from vaginal secretions and identified with conventional mycological methods in the diagnosis of Candida species. The identity of all strains was confirmed genotypically by multiplex PCR. In vitro susceptibility testing of vaginal Candida isolates was performed by the NCCLS broth microdilution method. The results were read at 48 h.
Results: Most C. albicans isolates (>90%) were sensitive in vitro to the antifungal agents tested. Most C. glabrata isolates showed sensitivity to miconazole and then flucytosine while they were more resistant to Itraconazole and fluconazole. Many isolates of C. tropicalis were susceptible to miconazole and then fluconazole. They showed a little resistance to all antifungals tested and flucytosine-resistance was the most frequent in the C. tropicalis isolates. High susceptibility to miconazole was observed in isolates of C. krusei and their susceptibility to the rest of the antifungals tested was dose-dependent. fluconazole -resistance was the most frequent in the C. krusei isolates.
Conclusion: Most isolates tested were susceptible to miconazole. A trend toward increased resistance among C. glabrata and C. krusei strains to antifungals tested was noted. Our findings suggest that, miconazole should be the agent of choice for the treatment of resistant vaginal candidiasis.

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Background: Because bronchial hyper responsiveness (BHR) has been shown to be a risk factor for asthma and lung function decline, interest has focused on diagnosing BHR. The aim of our study was to measure the association between airway caliber relative to lung size expressed as the ratio between forced expiratory flow, mid expiratory phase, divided by forced vital capacity (FEF25-75/FVC) and BHR measured by methacholine challenge test (MCT) to obtain a cutoff for this ratio and positive MCT.
Methods: We carried out a cross- sectional study on general Iranian population in 376 subjects aged 7-73 years who were referred to Shariati hospital in Tehran, Iran in an outpatient setting. There were 190 male (50.5%) and 186 female (49.5%) subjects. They had chronic respiratory symptoms such as cough and dyspnea. The physical examination was normal. Baseline spirometry was normal or equivocal. MCT was done for all subjects over a two year period (2009- 2010). Positive MCT was defined by PC 20≤4mg/ml.
Results: The methacholine challenge test was positive in 191 (50.8%) and negative in 185 (49.2%) patients. The mean of FEF25-75/FVC in positive MCT was 0.86±0.27 Vs. 0.91±0.28 in the negative ones (p=0.070). The sensitivity and specificity of FEF25-75/FVC for prediction of MCT results were 57.1% and 60.2% based on cutoff point of 0.85 in all patients, and 87.5% and 70.7% based on cut off point of 1 in allergic patients, respectively.
Conclusion: The FEF25-75/FVC appears to be a useful predictive ratio in allergic patients but not in general population.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Hepatitis C virus (HCV) is essentially considered as hepatotropic, but virus sequences have also been found in other important extrahepatic sites, including peripheral blood mononuclear cells (PBMCs). This study was done to investigate the presence of mixed infection and the differences between hepatitis C virus genotypes in plasma, peripheral blood mononuclear cells, and liver biopsy specimens in patients with hepatitis C virus infection.
Methods : One hundred and fifty two patients with established chronic hepatitis C infection attending Firouzgar Hospital, affiliated to Tehran University of Medical Sciences, from September 2008 to April 2010 were enrolled in the present study. After collecting plasma, peripheral blood mononuclear cell, and liver biopsy specimens, RNA was extracted from the samples and hepatitis C virus genotyping was performed using INNO-LiPA^TM HCV II kit. The hepatitis C virus genotyping was confirmed by sequencing the RT-nested PCR product of 5'-UTR fragments.
Results : The mean age of the participants was 31.2±16.9 years. Multiple hepatitis C virus genotypes were detected in 4 (2.6%) out of 152 plasma samples, 10 (6.6%) out of 152 peripheral blood mononuclear cell samples, and 9 (18.8%) out of 48 liver biopsy specimens. Hepatitis C virus genotypes were different in the plasma, PBMC, and liver biopsy specimens of 21 (13.8%) patients.
Conclusion: The present study shows that a significant proportion of patients with chronic hepatitis C infection are infected by multiple hepatitis C virus genotypes which may not be detectable in their plasma specimens.

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Background: Bone Marrow Transplantations (BMT) are limited by low CD34+ cell counts in umbilical cord blood (UCB) and these cells need to be expanded for success in such procedures. To achieve this goal, ex vivo expansion of hematopoietic stem cells (HSCs) by enhancing their self-renewal activity on demineralized bone matrix (DBM) scaffold coated with mesenchymal progenitor cells (MPCs) and unrestricted somatic stem cells (USSCs) was recommended. TGF-b pathway is a key inhibitory factor for HSCs self-renewal. In this study ex vivo expansion and downregulation of TGF-b pathway were simultaneously performed.

Methods: USSC cells were isolated from UCB and then coated on DBM scaffold as a feeder layer. UCB CD34+ cells were isolated from UCB by magnetic activated cell sorting (MACS) method and were transfected by siRNA against TGFbR2 in two-dimensional (2D) and three-dimensional (3D) cultures by co-cultivation with USSC. TGFbR2 expression levels were evaluated by quantitative real-time PCR. Cell count and flow cytometry were performed and clonogenic activity was evaluated.

Results: Ex vivo expansion of CD34+ cells was significantly enhanced (41±0.7 folds) by TGFbR2 downregulation, especially in 2D than 3D cultures. Finally, 2D culture showed less TGFbR2 expression levels and higher increase in the percentage of CD34 markers by flow cytometry assay.

Conclusion: The 3D siRNA delivery system would be of lower efficiency in contrast to 2D settings where the cells have less freedom and are in more contact with the feeder layer.

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Background: The goal of this study was to evaluate, functional capacity of the knee in flexion and internal rotation after hamstring ligament harvest for Anterior Cruciate Ligament (ACL) reconstruction.
Methods: Fifty patients (male and 18-45 years old) with isolated ACL injury, randomly allocated in two equal groups (in one group, ACL reconstruction was performed with Tibialis Posterior allograft and in another group with quadruple hamstring ligament auto graft) and before and 6 months after surgery in both groups isokinetic flexion strength and isometric internal rotation strength of knee evaluated with Biodex System 4 dynamometer and rotational torque recorder, in order. Isokinetic flexion strength evaluated in sitting and prone position the later position was performed for deep flexion strength evaluation. Also subjective and objective assessment of all patients pre operatively and 6 months post operatively was documented with International Knee Documentation Committee (IKDC) questionnaire. In this study for first time, rotational torque strength of knee was recorded with new design measure, from isometric aspect and not isokinetic.
Results: Although significant improvements in IKDC scores, flexion and internal rotation capacity of the knee were observed in both groups, post operatively in respect to pre operatively there was no significant difference between 2 groups. (P<0.05 or more than 95% confidence Interval of the difference)
Conclusion: This study demonstrates that ACL reconstruction surgery, improves knee performance in flexion and internal rotation, regardless of hamstring tendon harvesting. Considering potential complications of allograft (for example: transfer of harmful diseases from donor to recipient), it is logical to use hamstring auto graft ligament for ACL reconstruction surgery. Because result of this study is not longstanding follow up and limited to male sex, for more worthfull conclusion, we suggest future study in both sex and with long duration of follow up.

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Background: Radiotherapy can cause DNA damage in normal cells, misrepaired or unrepaired double strand breaks in DNA lead to chromosomal breaks. As a result patient experience early and late effects in normal tissue during and after radiotherapy. Cytogenetic techniques can be used as a cancer predictive assay because there is an association between chromosome abnormalities and the risk of developing cancer. Also it can assess patient's complications during the therapy. The aim of the present study was evaluation of the cytogenetic alteration in peripheral blood lymphocytes of esophageal cancer patients treated with radiotherapy. Methods: The present study is an experimental and prospective research. It was done at radiotherapy department at Omid Center in Urmia from January to December 2012. Blood samples were obtained from 15 esophageal cancer patients, before (0 Gy), during (21.6 Gy), and after radiotherapy treatment (43.2 Gy). Blood samples were cultured in RPMI-1640 complete medium containing 1% phytohaemagglutinin and incubated in a CO2 incubator. Cytochalasin-B was added to the cultures at a final concentration of 5 µg/ml. Finally, harvesting, slide making, and analysis were performed according to standard procedures. Results: This study consisted of 15 patients, including 7 men and 8 women from 55 to 84 years old (70.07±11.548). Results indicate that, in the middle of treatment the average frequency of micronuclei increased significantly compared with their concurrent pre-treatment samples (greater than four-fold). Also, an increase in chromosome damage (MN frequency) proportional increasing radiation doses at the end of treatment was observed (P=0.001). Conclusion: Increasing in the MN frequency in the second and third stages is due to radiation effects. Thus, the use of the MN technique for assessing of the side effects in patients during the therapy is very helpful. Moreover, MN assay can be used as a predictive assay for detecting individuals (patient or healthy) with intrinsic radiosensitivity.

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Growing and developing are influenced by genetic, social and environmental factors and it's most important and initial phase step is formed of the early life of the fetus and infant. According to the world health organization, the incidence of preterm birth and low birth weight are increasing in most countries that most of it related to developing countries. Low birth weight (LBW) and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems that can affect growing and developing so that it can threaten public health. Advances in medical technology in recent decades at intensive care unit, increased survival of premature infants and high-risk specialist care is needed, but failed, to reduce the complications of premature birth but it couldn’t reduce complications of preterm birth. There is also an increased recognition of the potential disconnect between perinatal outcomes and long-term outcomes. The administration of oxygen and postnatal steroids are prime examples of interventions that may have immediate positive effects but negative long-term effects. Many premature babies will be encounter with mobility problems, cognitive, neurosensory impairments, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances in the future. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Without a doubt, one of the tragedies of the world is people with physical or mental damage caused by premature birth, many of these disorders are not early diagnosed and the prediction of long term complications of infants discharged from the NICU is difficult. Although nourodevelopmental follow-up of these babies is a necessary part of the neonatal assessment but there is no standard process for it. The present review article aims to introduce the care process and tools that is used for following-up these babies, also introduces the application of screening tools for neuro-developmental care.

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Background: In this study were focused on corneal cells changes in keratoconus disease, as there are differences between results of other studies that were done on keratokonic eyes. And the chief purpose was a comparison between keratoconus and normal population based corneal endothelium (in cell density, pleomorphism and polymegethism of cells). Methods: This study is an observational study and is a case-control type. This study was done in Farabi Ophthalmology Hospital, Tehran, from September 2013 to February 2014. In this study, 26 mild (corneal power is lower than 48 diopter) and moderate (corneal power is between 48 to 54 diopter) keratoconic eyes (case group) with no history of contact lenses wear or eye surgeries were compared with 25 normal eyes (control group) that corneal power based topographic images is lower than 47.2 diopter. This comparison were done based specular microscopy images which were taken by Noncontact (Topcan Sp-2000 P) specular microscope in 5 corneal regions (central, superior, inferior, nasal, temporal). Then the information related to the cell density, Coefficient of Variation (CV) of polymegethism and pleomorphism of cells were analyzed by SPSS software, version 21 (SPSS, Inc., Chicago, IL, USA). Results: Superior corneal region has the largest amount of endothelial cell density in case and control groups (P<0.001). But the effects of keratoconus on the cell density was not significant (P=0.96). And also CV of polymegethism in two groups (case and control groups), was similar (P=0.828). Pleomorphism was seen in 7 eyes of 26 eyes in case group (26.9%) and 6 eyes of 25 eyes in control group (24%). Conclusion: Keratoconus does not have any considerable effect on cell density, polymegethism and pleomorphism, in mild and moderate stages and corneal opacity risk caused by intraocular surgeries (such as: Cataract or Glaucoma surgeries) and some diseases (such as diabetes and uveitis) is similar in keratoconic and normal eyes.