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Background and purpose: The cooperation of men is the basis of success in Family hygiene programs and family planning which are very important, in traditional community, particularly among tribe men. Âim of this study is to determine the attitude of tribemen towards family planning which is based on behavioural intention madel(BÏM) in tribal areas in Birjand.
Materials and methods: This is cross- sectional study done on 400 tribemen selected through multistages sampling data were recorded in questionnair designed for the variabls of BÏM which consisted the items such as, attitude towards family planning, subjective norms, intention, behaviour, knowledge. The data were collected by taking interview, and analyzed statistically.
Results: Mean age of the individual under study was 41. 26± 9. 84, and mean family member was 6.24 ± 2.5 attitude mean score of tribemen was 5. 74 out of 19. mean Score of knowledge was 4.14 from 18. These findings indicate poor knowledge and attitudes of tribemen towards family planning and prevention methods. 42.5% of the subjects under study still had desire of having more children, 2.5% of them intented self prevention without contraceptive. and 5% of them utilized male relatrd methods The most common method of prevention was using contraceptive pills in the area(71.5%)
Çonclusion: This study confirms the relationship between intention, attitude and knowledge. Besides, effective factors on subjective norms were assessed. Therefore it could be concluded Behavioural intention model (BÏM) has very extensive application in family planning particularly in traditional cultures. Therefore it is suggested that in order to study fertility behaviour in tribe and rural areas the above model be applied.

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Background and purpose: Çonsidering the role of mite in causing severe allergic reactions in sensitive individuals, particularly women, a study was done to determine the effects of mites in residents of sari township in 1999-2000
Materials and methods: This was a desciptive study done on the residens in sari. Sampling was done randomly in 80 residential places. Samples were collected from mattresses, pillows and carpets by vacume cleaner collected material was kept in a plastic bag and sent to the laboratory. 200 mgs of dust particles were placed in a petridish and observed under minocular considering the anti light property of mites, they remained under the layer of dust and were picked up by an entomology needle and kept in 70% alcohol. Lighting of sample, neutraliztion and finally assembling were done in hoyer solution for identification after mounting. Âll the data about the mites were recorded in a questionnair and analyzed statistically.
Results : Ïn this study, 3400 mites were hunted and 5 species could be identified as follows: D. Pteronyssinus, D. farinae, Glycyphagus domesticus, Ë. moynei and Çheylatus malayensis. Çonsidering the identified species, it was cleared that, 30 houses(37.5%) were infected by one or more species of mites, also it was noticed that, 15% of houses had more than 300 mites.
Çonclusion: The result of this study showed that contamination rate of house with mites contaning dust was 37.5%. Çonsidering the fact that Ë. mayei, D. pteronyssinus and D. farinae play an important role in severe allergies, and 15% of these houses had the density of more than 300 mites, this could have a complete correlation with symptoms of bronchial asthma.

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Background and purpose: Despite the rapid development of assisted reproduction techniques (ÂRT) in recent years, implantation rates after replacement of embryos into the uterine cavity remains low. Ân important approach to improve embryo quaility and implantation rates has been the use of coculture systems. Hence this study was undertaken to evaluate the influence of cumulus cells monolayer in follicular fluid on mouse early embryo development in vitro. Ône cell embryos were obtained from Swiss white mouse after superovulation with HMG and hÇG. Çumulus cells were prepared from mouse egg-cumulus mass after a short exposure to medium containing hyaluronidase. These cells were seprated from red blood cells using a percoll gradient. Follicular fluid was collected from patients undergoing an ÏVF program during oocyte pick-up. Granulosa cells monolayer were prepared in Follicular fluid (FÇ) and Ham’s F10 medum (HÇ). Mouse one-cell embryos were cultured in FÇ, HÇ, Ham’s F10 (HF) and follicular fluid (FF) for 120 hours. Ônly 10% of embryos passed the 2-cell growth block in HF. Howerer, the proportion of 2-cell block passed emboryos were 21%, 27% and 69% in FF, HÇ and FÇ respectively which are significantly different from HF (P<0.05). The differences between FÇ and two other treatment were also significant (P<0.001). Ïn FÇ, 35% of 4-cell embryos continued to grow to blastocyst stage whereas only 8.9% and 7.7 % of 4-cell embryos in HÇ and FF reached this stage and no embryos developed to blastocyst in HF. The blastocyst rate in FÇ was significantly higher (P<0.001). Ït can be concluded that follicular fluid and cumulus cells in monolayer form may synergistally improved early embryo culture conditions compared with all other treatments.

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Âspergilloma can be defined as a conglomeration of intertwined aspergillos hyphea matted together with fibrin, mucus and cellular debris within pulmonary cavity or ecstatic bronchus (usually cavitary tuberculosis). Âlthough most patients are asymptomatic, hemoptysis is a common symptom of pulmonary aspergilloma and results in fetal asphyxiation. Most often there is one or two aspergilloma in lung, but we are reporting a 46 year old non smoker diabetic man admitted with hemoptysis ÇXR and lung ÇT showed three cavitary lesions, each containing mass separated from the cavity wall and air space (air crescent sign). Ïn this patient aspergilloma occurs in cavities of an old tuberculosis. Diagnosis was by finding the organism in sputum smear and a positive serology for aspergillus specific antibody. Definitive treatment for aspergilloma is surgical resection, but this case was not operable, thus angiography and bronchial arthery embolization (BÂË) was done for source of hemoptysis and oral itraconazole 200mg BÏD was administered. Three pulmonary aspergilloma was not reported from Ïran to date and this case is rare.

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Background and purpose : Respirators (respiratory protective equipments) are widely used, but many of their health impacts, especially cardiovascular effects, have not been determined. The aim of this study was to determine the impact of using respirators on heart rate, systolic and diastolic blood pressure.
Materials and methods : This interventional study was undertaken on 40 healthy 20-30 years old young men. Their heart rate, systolic and diastolic blood pressure at rest and at the end of 5 minutes 7kcal/min exertion with ergometer were measured. Âfter 15 minutes rest, this process was repeated, while the person was breathing via respirators. The data were analyzed using SPSS, descriptive statistics and paired t-test.
Results : Üsing respirator during heavy work increased the mean value of heart rate to 8.5 beat/min, systolic and diastolic blood pressure 7.4 and 4.9 mmHg respectively.
Çonclusion : This study showed that respirator imposes additional load on cardiovascular system. Âlthough these increases may seem inconsiderable, these mild increases of heart rate and blood pressure can be threatening in workers with hypertension, coronary artery disease and many other cardiovascular disorders

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Background and purpose : bata thlassemia is the most common monogenic disorders in Iran. The gene frequency varies the country. Sistan and Baluchistan province, located in the southeast of iran with more than 1200 affected individuals, represents one of the regions where thalassemia id not only an important public health problem but also a socioeconomic problem. As a matter of fact high frequency of ß- thalassemia gene inter- family marriages, evasion of couples to carry out pre- marriage blood test, avoidance of counseling before wedding and eagerness for more children in spite of having ß - thalassemia kids collectively prompted us to eatablish prenatal diagnostic center in khordad 1381(May 2002) in this province.
Materials and methods : 140 minor thalassemia couples were referred to our center from May 2002 to Feb. 2004. After admission of the couples to the center their demographic data were collected. 10 ml of blood sample was then collected from couples added with anti- coaqulant(0.5 M EDTA). DNA was subsequently extracted before being amplified by Refractory Mutation System(ARMS) techniques vs the common primers of B- gene mutations in Iran. Within the 10 to 12th weeks of pregnancy, chorionic villi samples were taken and subjected onto two techniques namely direct and indirect. We afterwards evaluated the inheritance of mutation in the fetus from any of his/ her parents.
Results : We carried out preliminary diagnosis for 56 couples, as well as first round and further step of prenatal diagnostic procedures for another 84 couples(n= 140). 79. 3% of the total number resided in cities, whereas 87.9% were born in Sistan and Baluchistan province. Out of which 30% and 70% had sistany and Baluchi ethnicity respectively. Furthermore, 60.7% had at least one affected child, while 85.7% had consanguineous marriages. Out of the totalnumber, 57.9% were from Sunni minority. 88.05% of the couples demonstrated one of the common mutations identified in Iran. The latter figure also indicted that IVS 1-5 was the most common mutation in this region as 77.9% of the sufferers carried the gene. Futher investigations on 84 couples by chorionic vili DNA analysis showed that, 21.4% of their fetuses had major thalassemia.
Conclusion : High rate of homogeneity in mutations observed in this region has been caused by frequent inter- family marriages. Considering the population of Shiites and Sonis(40% & 60% respectively) both sects of religions with the same percentage stated above has made use of PND services in our center. It is worthy of mention that it is for the first the sonnies are willing to use prenatal diagnosis services. The establishment of this center in Zahedan has been one of the effective polices in prevention of thalassemia.

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Background and purpose: Ambulatory medicine is one of the most important parts of medical education. Due to its profound relation with professional future of physicians, ambulatory medicine is especially under attention and many studies have been performed to survey its quality and to design some ways to promote it. There is obvious deficiency in our evidence about ambulatory medicine. The aim of this study was to survey the quality of teaching of the ambulatory medicine from the viewpoint of the faculty members and students of medical faculty of Mazandaran.
Materials and Methods: This was a descriptive and cross-sectional study. The study's population consisted of students, residents and clinical faculty members who were included by simple sampling. Data collection was performed by a questionnaire with 22 questions about demographic and educational variables as well as respondents’ opinions about environmental conditions, independent activities, instructors’ supervision, and social training in the ambulatory clinics. The validity of the questionnaire was controlled by content validity with expertise consultation, and its reliability was controlled by test-retest(r=0.85). Data were analyzed using spss13 software.
Results: Response rate was 79%, the mean age of 36 faculties was 43.6+- 8.7 years and 32% of them were female. The mean age of 146 students was 25+-3.6 years and 61% were female. The attitude of the majority of the students (88.3%) towards the quality of ambulatory teaching was negative, but majority of faculties (66.7%) had positive attitudes. There was no significant difference among teaching departments. Attitude of junior trainees was even worse. Attitude of faculty members and students was similar towards inappropriate physical environment of ambulatory clinics, but it was significantly different from independent activities of trainees in clinics (p=0.000) relational drugs prescription (p=0.000) management (p=0.004), and supervision of faculty members (p=0.000).
Conclusion: The overall attitudes towards the current condition of ambulatory teaching (especially trainees) were negative because of the impossibility of independent activities for trainees, low supervision of faculties, absence of teaching for rational drug prescription, differential diagnosis and management.

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Background and purpose: Anal fissure is a chronic condition characterized by painful defecation and rectal bleeding. The aim of this study was to compare the injection of botulinum toxin (BT), versus with surgical lateral internal sphincterotomy (LIS).
Materials and Methods: In this clinical trial, 40 patients enrolled with chronic idiopathic anal fissure (CIAF) and were divided into 2 groups (20 BT group and 20 LIS group). Both groups were compared according to complications and healing process during one week, following, 2 and 4 months after interventions.
Results: There were no statistical significant differences between 2 groups as a viewpoint of duration of disease, pain and other symptoms at the beginning of the study. The rate of healing in the LIS group was greater than the BT group within the first month (16/0), and second month (16/7) (p<0.05), however, there were no significant differences between the two groups in the 4th month (17/11) of the study (p>0.05). In comparison with the BT group, the severity of pain in the LIS group decreased significantly. There were no significant differences between the two groups regarding complications.
Conclusion: Healing in the BT group was approximately similar to the LIS yet it appears to occur slower than LIS. Therefore, according to the results of the study, injection of the BT is recommended within the first step of CIAF treatment. To obtain the maximum healing effects of BT, a minimum period of 4 months is needed.

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Background and Purpose:Coronary artery Stenting is known to improve the outcome for ischemic heart disease. Many clinical studies have been performed to determine the long-term outcome of coronary Stenting and most of them were based on first-generation bare-metal Stents. The aim of this study is to evaluate long-term (24 6.4 month) results of second-generation bare metal stent.
Materials and Methods:From August 2004 to September 2006, one hundred and twenty eight (128) consecutive patients with significant coronary artery stenosis underwent elective angioplasty and stent implantation, using second generation bare metal stent (BMS). Clinical outcome were analyzed after (246.4) months. The Primary end point was based on the incidence of MACE (MI, Death, and Repeat Revascularization).
Results:One hundred and forty four (144) bare metal stents were implanted in 134 Vessels. The Mean age was 57 10.4 years, 72% of patients were male and 35.2% were diabetic with 98.4% in- patient hospitalization success rate. Thirteen (10.3%) patients had MACE during the follow-up period (4MI, 3CABG, 2 Deaths and 4R-PCI). Independent Predictor of MACE was Unstable Angina, Prior PCI, Prior CABG, stent diameter and post PCI plavix dose.
Conclusion:Our study demonstrated second generation bare metal stent, is superior to the first generation one with a greater survival rate and lower incidence of MACE.

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ackground and Purpose: For the past years, tubes have been inserted into the stomach via the nose (nasogastric Tube: NGT) for the purpose of evacuating gas and liquid routinely, and for the prevention of nausea, and vomiting. However, there are no evidences regarding its efficacy. The aim of this study was to evaluate the post abdominal surgery complications either NGT inserted or not.
Materials and Methods:In this clinical trial comparative study, 100 consecutive patients who underwent abdominal surgery (elective or urgency) were included in the study. They were divided in two groups: one was inserted NGT before anesthesia and remained until after initiation of bowel movement (control) and another without an incubated (case).
Results:Post surgery complications was similar in both groups (P>0.05): nausea (26% vs. 18%), vomiting (4% vs. 6%), fever (10% vs. 6%), bowel movement time (22.8 ± 10.84 vs. 21.84 ± 9.21), pulmonary complications (2% in both), wound infection (4% in both), duration of stay in hospital (2.58 ± 1.62 vs. 2.47 ± 1.6 days) in controls and cases respectively. Only sore throat was significantly more frequent in control group (74% vs. 16%).
Conclusion:These results suggest that routine and prophylactic insertion of NGT is not necessary, cannot reduce complications and also leads to patients' discomfort. Therefore, it must be saved in some specific indications.

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Background and Purpose: An important factor involved in infertility is reactive oxygen species (ROS). ROS can damage sperm DNA, and involve lipid per-oxidation. ROS elevation is under the influence of leukocyte activation. The objective of this study was to evaluate the level of ROS as well as leukocyte, in normozoospermic (NO) and ologoasthenoteratozoospermic (OAT) ejaculates.
Materials and Methods: The study population consisted of 75 individuals who were referred to the Research and Clinical Center, regarding infertility in Yazd, for semen analysis. Fifty (50) out of Seventy-Five (75) men were NO, and the remaining was OAT. ROS was measured with laminator, while leukocyte concentration was analyzed with the ENDTZ test
Results: The results showed that ROS levels in OAT was significantly higher compared with NO (1253.49±200.95 vs. 75.64±149.52 P=0.00). Furthermore, men with OAT were divided into 2 groups, with sperm morphology and motility >5% and <5%. In group >5%, ROS level was significantly higher than the group with <5% (3627.55±407.79 vs. 81.29±100.48 P=0.007). In addition, leukocyte concentration in NO was 0.07±0.22x106 while it was 0.12±0.20x106 in OAT samples P=0.35).
Conclusion: The results indicate although ROS is present in normal seminal samples, it is significantly higher in OAT. This shows the vital role of antioxidants, which may improve the sperm quality. Further clinical studies will pinpoint the antioxidant capacity in improving the seminal contents.

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Background and purpose: The development of pre-implantation mammalian embryos in vitro is compromised, compared with those grown in vivo. Selecting embryos with a high implantation potential is one of the most important challenges in the field of assisted reproductive technology. The aim of this study was to postulate morphometrical characteristics of good quality embryos, with comparisons between in vivo and in vitro produced mouse embryos.
Materials and methods: Embryos was obtained from NMRI female mice after super ovulation. In vivo developed 2-, 4- and 8-cell embryos morulla and full blastocyst were isolated from mice on 18, 36, 52, 60, 72 and 96 hours after hCG administration respectively. Ham, s F10 medium was used for in vitro culture of embryos. External and internal diameter of embryos, zona thickness and number of cells in full blastocysts were evaluated and compared between in vivo and in vitro groups.
Results: External and internal diameter and zone thickness in oocyte and zygotes were 99.9µm, 75.4µm and 4.9µm respectively. These values did not change prior to the blastocyst stage in both in vivo and in vitro groups but in full blastocyst stage, the diameter of embryos significantly increased and zone thickness decreased compared to prior stages in both groups (P<0.01). The diameter of full blastocysts of in vivo group (116.5 µm) were significantly larger than those of in vitro group (104.3 µm, P<0.05). Moreover, the full blastocysts of in vivo group had significantly more blastomeres (49), compared to in vitro group (43, P<0.05). Additionally, cultured embryos reached full blastocyst at 110 hours after hCG administration, while in vivo condition the time frame was 96 hours.
Conclusion: Based on the above results, embryo size and zona thickness can not predict embryo quality prior to blastocyst stage, however, in this stage larger embryos and those that have more blastomere may show greater viability.

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Background and purpose: Literature review indicates that antibiotic resistance of bacteria may be associated with the resistance to host natural immunity. In the previous study we found that: all meningococcal isolates of meningitis cases are less sensitive to typical anti-meningococcal antibiotics. In present study, the association of the above characters was analyzed in an ex-vivo “case-control” study.
Materials and methods: A randomized controlled trial compared effect two dietary treatments (low glycemic index & low fat) in 46 adults, ages 18-55 years old, BMI >27,who proceed to motahary clinic in shiraz, Iran. Body weight, BMI, WHR (waist/hip ratio), fast and post-prandial Plasma lipid profile (Triacylglycerol, total Cholesterol, LDL-C, HDL-C concentration) level of obese women measured at the beginning and at the end 6 weeks.
Results: The resistance of both groups against selected sera were similar in the ratio 1:2- by SIC and SBC methods. The growth of “test” and “control” groups in the pooled sera were stopped at the ratios 1:512 and 1:1024 respectively. In SBA the population of “test” and “control” groups decreased in parallel to each other. However, the invasive (test) meningococcal strains established slower reduction in WBA.
Conclusion: Studies on the correlation between antibiotic resistance of bacteria and the resistance to the natural immunity have ended with different results. According to our experience, it seems that for ex- vivo investigation of natural immunity against meningococci the WBA is more reliable.

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Background and purpose: Preliminary studies have been established to examine the cardiotonic effect of Citrus bigaradia extract, by implenenting various mechanisms. The functional protective role of this plant against supraventricular tachyarrhythmia remains to be determined.The present study is designed to assess the role of hydroalcoholic extract of Citrus bigaradia by modifing the electrophysiological properties of atrioventricular node, during simulated experimental atrial fibrillation in rabbits and also, to determine the role of adrenoceptores regarding effects of Citrus bigaradia on the AV node.
Materials and methods: In this present study, Newsland male rabbits(1.5-2 kg) was used. Programmed stimulation protocols (Recovery, Wenckbach, Atrial fibrilation and Zone of concealment) were applied in two groups (N=23) to assess electrophysiological properties of isolated rabbit AV node. In the first group (N=10), different concentrations of hydroalcoholic extract of Citrus bigaradia were added to thyrods to detect nodal concealed conduction. In the second group (N=13), the effects of extracts (54-108 mg/L) were analysied in the presence of β-adereceptor blocker(Nadolol 2 µm). AF protocol was simulated by high-rate atrial pacing with random coupling intervals (range 75-125 ms). All data have been shown as Mean±SE.
Results: Citrus bigaradia, had biphasic concentration-effect pattern, such as in low and intermediate concentrations (0.8-3.2 mg/L), shortened nodal functional refractory period and Wenckebach. We observed a non-significant decrease in the average H-H intervals and numbers of concealed beats in all concentrations of Citrus bigaradia. Zone of concealment was shortened by this plant. Nadolol (2 µm) prevented the whole effects of Citrus bigaradia on the nodal conduction time, refractoriness and concealed conduction.
Conclusion: The above results indicate the potential pro-arrhythmic effects of Citrus bigaradia in worsing supraventricular tachyarrhythmia. The effects of plant to decrease the AV-nodal refractory period and concealment zone may be considered the major mechanism of this plant.At least some parts of effects of Citrus is mediated through β-adrenoceptores.

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Background and purpose: Noise is one of the most harmful factors in the environment. It is also one of the harsh phenomenons in this century that people are exposed to. Exposure to noise higher than threshold limit value could cause some physical and mental disorders. High traffic flow due to recent increase in number of vehicles causes higher noise pollution. There are few studies regarding the evaluation of noise pollution in the environment in some Iranian cities. Thus, it is necessary to measure sound pressure level and other related parameters for noise pollution control. Identification of the effective factors on noise pollution is the best approach for promotion of individual, as well as, public health and safety. The aim of this study is to evaluate the noise level in the city of Sari.
Materials and methods: There exist various methods for calculating the equivalent noise level regarding to noise measurement period. The most ordinary method is DL (day average sound level), that takes 15 hours of sampling (7 am- 10 pm), based on regulations that was approved by the National Environmental Protection Association in year 2003. This method was used for evaluation of noise level in this study. In the first stage, sampling locations were selected, followed by measuring sound levels at the height of one’s hearing zone (1.6 m above the ground surface). A calibrated sound level meter (Model Cell-490, Casella CEL, England) was used for all measurements. The SPSS software V.15 was used to perform T-test analysis.
Results: The results showed that the mean (SD) DL was 75.52± (4.41) dB. The minimum and maximum sound pressure levels during the sampling period were 47 dB and 121.5 dB respectively. Due to the measurement of various circumstances, some times, and also, sampling locations, measure sound pressure level was high.
Conclusion: The mean sound level during the daytime period was higher than the national standard levels. Therefore, environmental noise control is the best approach for the prevention of noise related to adverse health effects.

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Background and purpose:Cancer is the second most common cause of death in developed countries and third in less developed countries. The incidence of the different histological types of cancer varies greatly between various populations and is attributed to occupational, social, cultural, racial, and geographic influences. The objective of this study was to determine and register all cases of cancer among population of Mazandaran province, during the year of 2006.
Materials and methods:Characteristics of all registered malignancies were obtained from records in histopathology and radiology clinical, hospitals and deaths certificated in Mazandaran using the International Classification of Disease (ICD), with data being analyzed using ASR, Excel and spss soft ware.
Results:A total of 2.399 patients with cancers were found during this study. These, 1.321(55.06%) were males and 1.078 (44.94%) females. Age standardized rate (ASR) for all cancers in males and females were 112.91/100000 and 104.59/100000 Respectively. The most common malignancies among females were breast (23.38%), skin (11.78%), colon and rectum cancers (10.30%). In men, stomach (42.41%), skin (15.59%) and esophagus (9.08%) were the most common cancers respectively. Infiltrating duct carcinoma, was the most common histopathological types of tumors (69.35%) in breast cancer. The most common morphology in stomach cancer was adenocarcinoma, (54.67%).
Conclusion: Distribution of malignant disorders in our population is different from other regions. Therefore, it appears necessary to have a valid health policy for prevention. Consequently, it is necessary to have a valid health policy for prevention and control of this problem.

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Background and purpose:We evaluated outcome of transplantation in donors MRAs that underwent multiple anastomosis in recipient, according to graft function, survey of graft and recipient, hypertension before and after transplantation, and surgical complications, comparable with single renal artery and MRA that was converted to a single artery before transplantation.
Materials and methods:In this case series study, from March 2003 to March 2009 in our kidney transplantation center, 7 renal grafts with MRAs underwent multiple anastomosis between renal arteries and recipient internal and external iliac and inferior epigasteric arteries. Single renal artery and multiple renal arteries that were converted to a single artery before transplantation, were excluded.
Results:Excellent perfusion was observed in renal graft after removal of vascular clamps in all cases. Convenient diuresis with average of 13444 cc in first day after transplantation was instituted. Post transplantation hypertension did not occur. All of recipients had a normal serum creatinin level with mean range 1.3 mg%. We observed perinephric collections in 2 recipients. One of collections was lymphocele and second one reported degenerated hematoma. Both collections were treated with aspiration. Isotopic scan and grafts ultrasonography indicated good survey and function of allografts.
Conclusion:We observed graft function, graft and recipient survival, intra and post operative complication, preoperative and post transplantation hypertension in our procedure similar to renal transplantation with single renal artery and MRA that was converted to single artery, because total ischemic time (TIT) was decreased in our option. We believe our procedure is a good alternative for bench surgery in MRA.

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Background and purpose: The incidence of tuberculosis (TB) in Iran is about 13 in 100000 people and this rate in Golestan and Sistan & Balouchestan Provinces is the highest. Due to the proximity of Golestan to Mazandaran, this epidemiological survey has been done to identify the high risk locations by using of disease mapping of tuberculosis incidence rate.
Materials and methods: This observational longitudinal survey was performed on the cases occurred between 1999 and 2008. The characteristics of the total cases of 2,444 were taken from tuberculosis admission book. The epidemiological and demographical variables including age, gender, year, location, and others characteristics were analyzed using descriptive and inferential statistics methods by statistical package of SAS and SPSS.
Results: From 2,444 patients, 1,283 (52.5%) were male and 47.5% were female. 61 percent were city dwellers, 39 percent were from rural areas and 96.4 % were Iranians. The highest incidence rate of TB was seen in Behshahr with rate of 19.39 and the lowest rate in Joybar with the rate of 6.45.
Conclusion: The prevalence of TB cases in Mazandaran is lower than other provinces such as Guilan and Golestan. In addition, late diagnosis of TB in Mazandaran was higher than other provinces such as Khorasan Razavi and Kordestan. The delay in TB diagnosis in Iran is longer than other in countries such as the UK and Nepal. The results of this study can provide useful information for health care services providers and policy makers to mange the disease by implementing appropriate and timely interventions.

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Background and purpose: The CD4 lymphocyte count is the strongest index indicating the severity of immunodeficiency, prediction of incidence, diagnosis, and making a decision to start anti retroviral treatment and follow up of therapeutic response. This study was conducted to establish the clinical syndrome resulting in admission of patients with HIV infection based on the CD4 count.
Materials and methods: This cross-sectional descriptive study was performed on 71 HIV patients admitted at least for onece to Imam Khomeini Hospital, Tehran during 2008 and 2009. HIV infection was confirmed by positive ELISA and Western blot. The obtained data were analyzed using SPSS software, version 16.
Results: From a total of 71 patients, 8.5% were female and 91.5% were male. The mean age of the subjects was 35 ± 8.1 years. 74.6% were addicted and 38% had a prison history. The average CD4 count was 202.9 ± 20.09 /ML. 21.1% of the patients received anti-retroviral medication. 49.3% of HIV patients had hepatitis C and 18.6% had hepatitis B simultaneously. Patient with PCP, toxoplasma and TB had the least CD4 count, with an average of 75.85, 94.66 and 143.95 /ML respectively. Patients with empyema, esophagititis and abscess of femur had the highest CD4 average count of 698, 536 and 349.5 ML, respectively. There was a significant correlation between pneumonia and CD4<200/ML (P=0.001) and also, between prison history and TB (P<0.001), and between TB and CD4<200/ML (P=0.012).
Conclusion: The prevalence of Pneumocystic pneumonia, Toxoplasmosis and TB syndrome may be higher in patients with CD4<200/ML and the incidence of pulmonary TB were greater in patients eith prison history.

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Background and purpose: Medication errors today are discussed as one of the main concerns of the health care systems and are used as an indicator for determining the level of patients safety in hospitals. This study was conducted with the purpose of evaluating medical errors among intensive care nurses. Materials and methods: In this descriptive study the research population composed of nurses working in intensive care units of Imam Khomeini Hospital Complex, Tehran, 2011. 64 nurses were randomly selected and asked to answer to a researcher made questionnaire. The data was analyzed by SPSS version 16 using descriptive and inferential statistics. Results: 73.43%, 42.55% and 57.45% of nurses reported the occurrence, verge of occurrence and not occurrence of medical errors, respectively. The most common type of medication errors were infusion rate and doses of drugs due the drug’s abbreviated names and existence of similarities among drug's names. The most important causes of medication errors were lack of pharmacological information. Conclusion: Since the risk of medication errors among nurses is high, therefore, retaining courses on pharmacological information, modification of educational curriculum, encouraging nurses to report medical errors and also encouraging hospital managers to give positive response to errors are suggested.