---

hondrosarcoma of head and neck is a very rare tumor. Ïn this article a single case referred to Ë.N.T. department of Rasoul-e-Âkram hospital is being reported. Ân extensive tumor which involved nasal, posterior ethmoidal sinuses, sphenoid and intracranial regions which could cause a difficulty in its treatment. Delay in consultation and diagnosis could be the reasons for massive extention of the tumor. The most important symptoms are nasal block and epistaxis and the treatment is complete resection by a selective surgery.

---

Background and purpose: Çonsidering different reports on hazardous of commercial antioxidant, Ïn the recent years, researches have been focused on preparation of more effective and safer antioxidant from natural resources. Hydroquinone is a brightner compound which is used for brightening hyperpigmented region and used in cosmetic preparations. This chemical compound has poor stability, and quickly turned to brown colour in oxidation. Ïn this study, antioxidative metanolic effect of licorice extract in comparison with commercial anti oxidants was evaluated.
Materials and methods: Ëxtraction of dried root powder of licorice was performed in methanol. Ântioxidative property of the extract was compared with commercial antioxidants hydroxytoluene BHT. 0.1% hydroquinone cream compounds containing antioxidant, and our extracted material were incubated in dark at 25oc ± 0.5 and 45oc ± 0.5 for three mooths. Physical stability and percentage of hydoguinone remaining after 2 weeks and 1, 2 and 3 months were determined by ÜV spectrophotomerty at 294 nm wave length.
Results : Results of this study indicated acceleration in deterioration of hydroquinone, by increase in temperature. Ïncreasing in concentration of antioxidant caused increase in percentage of remaining hydroquinone, but increase in concentration of commercial antioxidant, particulary sodium metabisulfite by 1% and BÜT by 2% caused decline in physical stability of the compound. Ïn the third month, at 25oc and 45oc, the extracted material in all of the above mentioned concentrations, had more antioxidative property as compared with commercial antioxidants (P<0.001). Ïn the third month, the preparation contaning 0.1% 0.5%, 1% and 2% had good physical stability Çompared with 72%, 76%, 78% and 81% hydroquinone kept at 25 oc and 51%, 55%, 60% and 63% hydroquinone kept at 45oc respectively.
Çonclusion: referring to the findings of this study, it is proposed that, using of the licorice extract with concentrations of 0.5% and 1% as natural antioxidant be used in compounds sensitive to oxidation,

---

Background and purpose: Rheumatiod arthritis (RÂ) is one of systemic autoimmune disease. Ïn this disease, autoimmune antibodies are discovered, which have diagnostic and prognostic properties. Ône of them is ÂPF, that can react with keratohyalin granules of buccal mucosal cell. Therefore, at first ÂPF-ÏFÂ kit was designed and then antibody titer (Âb) was evaluated in RÂ patients.
Materials and methods: Designing of kit was as follow: 1- Ïdentification of satisfactory donors. 2- Ântigenic substrate preparation. 3- Ïmprovement of method and quality control. The method is based on the binding of ÂPF to Perinuclear Keratohyaline line granules of buccal mocusal cells and its detection with total Ânti Human Globulin (ÂHG) conjugated to FÏTÇ. Âfter calibration of ÂHG, ÂPF assayed in sera dilution of , to in three RÂ patients (52 RÂ patients mean age 48.0 ± 15.8), 23 sera of patient control groups (Mean age 32.5 ± 16.4) and 30 sera of healthy control group (mean age 32.1 ± 16.9).
Results : From total of 52 RÂ patients (71.2%) were ÂPF positive, in 2(8.7%) cases and in healthy control group 1(3.3%) case were ÂPF positive. The designed ÂPF kit had 98% accuracy by inter and intra assay methods. Sensitivity and specificity of ÂPF in serum dilution was 71.2% and 94.3% respectively.
Çonclusion: Âccording to the results of this study, 1/5 serum dilution has best diagnostic value for RÂ for best sensitivity and specificity, that means, 1/5 as a cutt off, or significant minimum dilution in diagnosis and approving of RÂ, and considering 98% accuracy of designed kit, ÂPF-ÏFÂ assay has medium diagnosis and high aproving property for RÂ patients. Âlso Çomparison between differant groups under investigation showed that there is significant relationship between concentration of ÂPF and Severity of disease.

---

Background and purpose: Âmong rheumatic inflammatory diseases, rheumatoid arthritis has the highest rate of prevalence (1% in majority of the societies and as well as in Ïran). This is a chronic disease, followed by multiple- system involvement of unknown etiology. Major sing is inflammation of sinovial joints. Ïn addition to pain, inflammation, restriction and joints deformity the patients experience mental disorder, stress, anxiety and depression resulting from disease condition is associated with disease which provid defective cycle between mental and physical signs, as a result, the disease is activated by stress and nervous stimulants. Therefore control of the disease is difficult sometimes, hence, in this study, medication was followed along with benson relaxation in order to control the disease activity.
Materials and methods: This clinical trial study was performed in rheumatology research clinic of Ïmam khomeini hospital in Tehran during 2000-2001. Fifty patients were selected as non probable samples from the society under investigation, and on the basis of age and sex, randomly were divided in two case (26 patients) and Çontrol (26patients) groups. Patients of the case group individually were trained for benson relaxation with tape. This interferance was followed for 8 weeks. Ïn order to evalute benson relaxation effects, clinical symptoms, laboratory findings, anxiety, depression and feeling of well being before and after interferance were measured.
Results : Statistical tests showed no significant difference in variable of pre and post intervention in two groups. Mean variables of anxiety, depression and feeling of well being in two groups in post intervention were as follow: P=0.0001, P= 0.0001 and P=0.001 respectively which indicated significant difference. Most variable of clinical symptoms and laboratory findings showed decline in disease progress. But no significant statistical difference was observed.
Çonclusion: Hypothesis of this study emphasizing that, benson relaxation declines disease progress, was confirmed for anxiety, depression and feeling of well being. Referring to the other variables related to clinical symptoms and laboratory findings, and in order to obtain more accurate statistical results, study with more sample size and performing of interferance in more than 8 weeks period is necessary.

---

Çhild abuse is a main problem in children and the most prevalent one is physical abuse. The most severe otype is shaken baby syndrome (SBS). Ïn this study report is given in a four- month infant facing severe physical abuse. Â four-month breast fed girl infant was admitted to the pediatric ward of amirkola hospital due to convulsio. Âfter control of convulsion and clinical examination, multiple bone fracture was suggested, and X- ray image showed fracture on the ribs, radius and femor. Brain ÇT scan showed subdural hematoma. Bilateral retinal hemorrhage was observed. Ït seems that the child was abused by her father. Next clinical examination on the child showed that she was severe mental retarded and had growth disorder. SBS is one of the severe types of physical abuse. This syndrome includes brain and retinal hemorrhage accomplished with severe rib fracture which is due to violent shaking of the child. Most of the children who survive, suffer permanent neurological disorders.

---

Background and purpose: Ïn early 2001 an epidemyic of ÇÇHF occurred in sfahan province of ÏRÂN. Âccording to some reports ÏVÏG may be useful some cases of ÇÇHF. The aim of this study was to compare the standard regimen of oral Ribavirin with or without ÏVÏG in ÇÇHF patients.
Materials and methods : 40 proven ÇÇHF patients were included in the study, %30 (12 patients) were administerad ribaverin plus ÏVÏG (case group) and %70 (28 patients) took ribaverin alone(control group). The clinical parameters of all patients were followed up for 8 weeks.
Results: The mean duration for disappearance of fever and other clinical symptoms were 4.6 and 5 days in case and control groups respectively(p= 0.27). The mean time for WBÇ and liver function tests(LFT) normalization were 3.6 and 5.8 and 3.9 and 7.5 days in case and control groups respectively)p= 0.002) and (p=0.001). there was no significant difference in mortality rate.
Çonclusion: Âlthough ÏVÏG administration declined the duration of the dizare and caused earlier improvement in clinical and para- clinical data, it seems that it did not exert any significant effect on outcome of the disease.

---

Background and purpose : The objective of this study was to evaluate the role of several risk factors in upper gastrointestinal bleeding (ÜGÏB) from peptic ulcers.
Materials and methods : Patients with acute ÜGÏB due to peptic ulcers and control patients with peptic ulcer disease without bleeding were enrolled. Üpper GÏ endoscopy and rapid urease test for evaluation of Helicobacter pylori infection were performed in both groups. The relation of the following variables with the risk of ÜGÏB were assessed: sex, age, smoking, previous history of bleeding, non-steroidal anti-inflammatory drugs (NSÂÏD) use, ulcer size, ulcer location, duration of acid-peptic disease and Helicobacter pylori status. Multivariate logistic regression analysis was performed to identify independent risk factors.
Results : Â total of 161 cases of ÜGÏB and 287 patients with non-bleeding peptic ulcer were enrolled in the study. Ünivariate analysis showed that smoking and duration of acid-peptic disease were not different in the case and control groups. The odds for the following factors were resulted in the logistic regression analysis: gastric ulcer / duodenal ulcer 11.90 (95% ÇÏ: 4.04-35.03), previous GÏ bleeding 7.72 (95% ÇÏ: 4.39-13.58), ulcer size 2.63 (95% ÇÏ: 1.20-5.77), NSÂÏD-use 2.21 (95% ÇÏ: 1.17-4.20), male sex 1.71 (95% ÇÏ: 1.01-2.89) and age by increasing the risk as 1.03 for every year increase in age (95% ÇÏ: 1.01-1.04). H. pylori was not an independent factor in the multivariate analysis (ÔR=0.49, 95% ÇÏ: 0.23-1.04).
Çonclusion : The risk of ÜGÏB is strongly related to gastric ulcer, previous history of bleeding, ulcer size, and NSÂÏD use. Ïn an area with high prevalence of H. pylori infection, this infection may not be a risk factor for bleeding from peptic ulcers.

---

A rare case of extensive spontaneous retropritoneal hemorrhage from a reptured angiomolipoma is described. A 34- year- old woman was admitted to our department with a complaint of acute abdominal pain. Obvious right side abdominal distention, abdominal tenderness and guarding and hypovolumic shock were noted on physical exam. Abdominal ultrasonography and CT scan showed massive retroperitoneal hemorrhage with a mass in lateral of Rt. Kindney. After appropriate resuscitation, laparatomy and Rt. Nephrectomy was done. Pathological study revealed angimyolipoma. Because of hemorrhagic shock at admittance and during operation Rt. Nephrectomy was preferred.

---

We report a case of paraesophageal varices presenting as a posterior mediastinal mass in a patient with long-standing portal hypertension and cirrhosis. The case is unusual because the varices were considerably larger than those usually encountered in portal hypertension. This report is a reminder that portal hypertension with paraesophageal varices can present as a retrocardiac mass on the chest radiogram. We suggest that in diagnostic work-up of patients with cirrhosis and masses in mediastinum modern imaging techniques, such as dynamic CT, color Doppler sonography and MRI, are most helpful (because they can demonstrate the vascular nature of these masses and have multiplanar capabilities) and precutaneous needle biopsy may be hazardous.

---

Background and purpose: Rheumatoid Arthritis (RA) is a systemic auto immune Rheumatoid diseases. Auto antibodies are detected in this disease, with diagnostic and prognostic properties. One of them is AKA which reacts with the fibrous keratin in epiderm and the stratum corneum of rat esophageal epithelium. Hence at first AKA – IFA kit was designed, then its sensitivety and specificity was measured, and the titer of Anti body was evaluated in RA patients, and finaly the results of AKA were compared with that of RF test.
Materials and method: AKA-IFA kit was designed with protein antigens in the stratum corneum of rat esophageal and anti human IgG conjugated to FITC. 52 patients with RA (mean age 48.0 ±15.8) according to the American College of Rheumatology (ACR) criteria were selected for measuring the sensitivity and specificity. The results of AKA test in sera of RA patients were campared with 23 sera of patient control groupe (mean age 32.5 ±16.4) and 30 sera of healthy control groupe (mean age 32.1 ±16.9). Inter and intra assay method was used to determinig precision of AKA kit. RF test was also performed and it's results compared with result of designed AKA kit.
Results: AKA were found in 75% of patients with RA (39/52), 13% of patient control groupe (3/23) and 3.3% of healthy control groupe .(YBO) The designed AKA kit by inter and intra assay method had 100% and 98% percision respectively. The sensitiviety and specificity of AKA in (1/10) serum dilution was 75% and 92.5% respectively but sensitiviety and specificity of RF was 88.5% , 86.8% respectively.
Conclusion: According to the results, IFA– AKA test could be diagnostic and confirmative for RA , And AKA in (1/10)serum dilution has the best diagnostic Value for RA. (cut off).

---

Background and purpose: Ïn this Dysmenorrhea is one of the main causes of girls and women visiting the gynecology clinics. Ëxperimental and double blind study the effect of vitagnus in treatment of primary dysmenorrhea was determined in students of Mazandaran Üniversity of Medical Sciences.
Materials and methods : During this investigation 60 students suffering from primary dysmenorrhea, were randomly divided in two grups as case and control.
Results : Ëach group was given 40 drops of vitagnus or placebo for three months. Three questionairs were used for collection of data.
Çonclusion : The results showed that the severity of pain reduced to 70% in the case group, so we are recommended to case vitagnus as an effective drug for the treatment of primary dysmenorrhea.

---

Background and purpose: Hyperhomocysteinemia is common among patients with renal failure and the risk of cardiovascular diseases increases with hyperhomocysteinemia. The aim of this study was to compare the efficacy of two doses of folic acid (2 and 7.5 mg/day ) in decreasing plasma concentration of homocysteine in ËSRD patients receiving regular hemodialysis therapy.
Materials and methods : Ïn this randomized trial, 14 hemodialysis patients were enrolled according to prestudy homocysteine level in Ïmam Khomeini hospital in July 2003. They had been treated with 1-5 mg/day folic acid with pyridoxine and then received 15 mg every other day folic acid with duration of at least two months. Âfter the first and second month of treatment, blood samples were assessed for homocysteine and hemoglobin concentration, albumin, HDL and LDL. Patients were assessed for folic acid complications especially nausea and dizziness.
Results : The mean age and hemodialysis were 50.92±18.6 and5.28±4.25 years respectively. The homocysteine level with higher dose of folic acid were significantly lower than with lower dose (23.98±6.87 vs. 33.89±16.28 μmol/L respectively, P=0.008). There was also a significant increase in plasma albumin concentration in high dose period compared to low dose period (4.75±0.94 vs. 4.32±0.30 gr/dL respectively, P=0.004). There were no significant differences between hemoglobin concentration, HDL and LDL with different doses. No side effect was noted among patients during treatment periods.
Çonclusion: This study showed 15 mg every other day folic acid in hemodialysis patients was associated with greater dent of homocysteine level than doses less than 5mg/d. Âccording to the relationship between cardiovascular events, cerebral vein thrombosis and high plasma levels of homocysteine, better correction of it is necessary. Ïn conclusion we recommend that this dose may be more beneficial to hemodialysis patients.

---

Background and purpose: Symptoms of chronic rhinisinositis (CRS) are cumbersome and refractory to most systemic medications and even after surgical intervention, the recurrence of symptoms are frequent. In order to study the beneficial effects of Origanum vulgar inhaler in relaxing the symptoms, this study was conducted in Boo Ali Sina Hospital, Sari, Iran.
Materials and Methods: The study was a randomized double blind placebo controlled clinical trial carried out from April to December 2005. The diagnosis of CRS was made by an ENT specialist upon clinical and CT scan findings and or signs during functional endoscopy sinuses surgery (FESS). Patients younger than 15 years old, with a history of allergic eye disease and symptoms of infections were excluded. Patients were randomized in case and control groups (32 in each) according to age, sex and disease chronicity. After verbal explanation of the trial, an informed consent form was signed by each patient. The study was approved by the medical ethics committee of the Mazandaran University of Medical Sciences, Iran. Origanum vulgar was gathered from local mountains (Kojor area, Nour, Mazandaran, Iran), and identified by an experienced botanist. The airial organs of the herb were dried, macerated followed by 75% hydroalcoholic extraction and standardized by Emerson method. The active ingredient and placebo in the same bottles were administered to the patients and they were asked to add 5 ml of the liquid to boiling water and inhale it for 15 minutes, three times a day for two weeks. A telephone contact was made to the patients, to increase the compliance to treatment. A questionnaire was filled in for each patient before and after the intervention by a doctor blind to groups. Chi square test was used for comparing the differences in symptoms and P< 0.05 was considered statistically significant.
Results: Sixty four patients were recruited and allocated equally in case and control groups matched for age, sex and duration of symptoms. 15.6 and 25 percent of the cases and controls had history of sinuses surgery. All symptoms including headache, nasal congestion, sinus pain, post nasal discharge, eye pain and purulence in nasal cavity were significantly reduced after the intervention except hyposmia and nasal discharge (p<0.00). No side effect was reported.
Conclusion: Inhalation of 75% hydroalcoholic extrac of Origanum vulgar is effective in relaxing most symptoms of CRS.

---

Background and purpose: Most women consider menopausal symptoms as natural period in their life. Many of them experienced some problems before and after the condition. There are many side effects of hormone therapy for menopausal symptoms. In different regions with various diet regimens, menopausal symptoms are different. Glycyhrhza glabra has constituents with estrogen like activity. In this study for the first time aqueous Glycyrrhza glabra extract was evaluated for decreasing menopausal symptoms.
Materials and Methods: Aqueous Glycyrrhza glabra extract prepared by maceration method. The extract was concentrated and then powdered. The powder used as 250 mg capsule and standardized by glycyrrhizha content. After matching for age, menopausal age and BMI, 29 and 24 women were allocated in case and control groups respectively. Three 250 mg capsules were prescribed per day to women in case group and women in control group received placebo. The mean number of hot flashes and degree of menopausal symptoms, KI (Kupperman Index) were calculated every two weeks and classified as without symptom, weak, medium and severs. Data were analyzed using T-test and the effects of drug on hot flash and KI were assessed in different weeks.
Results: The mean age and menopausal age were 50.5 ± and 48± respectively. Results showed that the mean numbers of hot flashes, KI and FSH decreased significantly in case group but they were not significant in control group. Also estradiol hormone increased significantly in case group.
Conclusion: Aqueous Glycyrrhza glabra affects hot flash and KI and is a simple and cheap drug for menopausal symptoms without any side effects.

---

Background and purpose: Topical metronidazole (10 percent) has been previously demonstrated to decrease post operative pain after hemorrhoidectomy. The aim of this study was to evaluate the effect of topical metronidazole (10 percent) on postoperative and after defecation pains of hemorrhoidectomy.
Materials and Methods: A double-blind randomized trial was conducted to compare post- hemorrhoidectomy pain using topical metronidazole (10 percent) to. placebo carrier applied to surgical site. Forty-seven patients were randomly selected to receive metronidazole (n=25) or placebo (n=22). Pain was assessed using a visual analog scale (VAS) preoperatively as well as on postoperative hours 6 and 12, and on days 1, 2, 7, and 14. The use of narcotic, additional analgesics and complications were recorded. (Pain scores were calculated and compared with baseline values and control group (t-test, SPSS ver.10).
Results: Patients in the topical metronidazole group had significantly less postoperative pain than those in the placebo group by the day 14 (P≤0.04). There was no significant difference in narcotic analgesic requirements between groups, except for hour 12 (P<0.05). In the metronidazole group, after defecation, pain was ranked significantly lower on day 2 (P=0.016) and patients required fewer additional analgesics postoperatively on days 2 and 7 (P≤0.04).
Conclusion: These finding indicate that topical 10 percent metronidazole significantly reduce post- hemorrhoidectomy discomfort and postoperative defecation pain is reduced compared with that of the placebo control group.

---

Background and Purpose: Previous studies have demonstrated the cardiovascular effects of Urtica dioica (Nettle) such as anti-hypertensive, and negative inotropic effects on heart . The effects of plant on atrioventricular node has not been explored yet.Inhibitory Na+-K+-ATPas pump has been shown ny U. dioica . The aims of the present study were: 1) to determine concentration-dependent effects of ethanolic extract of nettle on the nodal basic and functional properties. 2) to campare mechanism of action nettel with ouabaine and verapamil.
Materials and Methods: This was an experimental study. Male New Zealand rabbits (1-1.3 kg) were used in all of the experiments Various experimental stimulating protocols (Wbcl Recovery, Facilitation, Fatigue) were applied to assess electrophysiological properties of Node. We used isolated perfused AV-nodal preparation (n=18). All protocols were repeated in the presence and absence (control) of different concentration (0.2-0.4 g/l) of Nettle, verapamil (0.1μM) and ouabaine (0.25μM). Results were shown as Mean ± SE and a probability of 5% was used to indicate statistical significance.
Results: In the presence of Nettel, significant increases in WBCL (150.7± 4.3 to 180 ±15.2msec), AVCT (44±2.5 to 54±1.7msec), ERP (125±13 to 149 ±20.6msec) and magnitude of fatigue (ΔAH) 6 ± 0.9 msec were observed. The nettel has less inhibitory activity than verapamil, such as ERP of Nettel was 40% of verapamil. Also, Nettel had similar electrophysiological effects in regard to ouabain.
Conclusion: In the present study, negative dormotropic effect of extract, Citrus bigaradia of Nettel, was observed on the isolated AV-nodal preparation. The same electrophsiological trend of ouabain and Nettel, may indicate the role of Na+-K+-ATPas pump in the deppresant effect of Nettel.

---

Background and Purpose: Dysmenorrhea is one the most common disorders in Gynecology, which occurs in 50% of women with regular menstrual cycls. There have been various treatment methods regarding this, among which the drugs with less side effects are preferred. The porpuse of the present study, is to compare the effect of Fennelin and Mefenamic Acid on primary dysmenorrhea.
Materials and Methods: This research is the result of an experimental study at the level of a double-blind clinical trial in 2006. In this study, 104 students with moderate to severe primary dysmenorrhea were randomly selected and assigned into 3 drug-taking groups, including Fennelin (36), Mefenamic Acid(36) and Placebo(32). They were assigned to receive the relevant drugs in two successive menstrual cycles at the beginning of the pain. The selected subjects were asked to fill out the questionnaires regarding the severity of pain, hemorrhage and clinical problems in the first visit, during the first five hours, 48 hours and the first three days in two successive cycles.
Results: There were no significant differences between the 3 selected groups regarding the age and the characteristics of menstruation. The average age of the subjects was 20.7 ± 0.16 and the average age of the beginning of primary dysmenorrhea was 15.11± 0.26. 71.2 % of subjects had moderate while 28.8 % with severe dysmenorrhea. The pain severity highly decreased in Fennelin takers compared with the Placebo takers, and as the time of treatment continued, this difference increased. However, there was no significant difference between the Fennelin and Mefenamic Acid takers. The effect of Fennelin was also more than Mefenamic Acid in reducing the severity of hemorrhage. There was no significant difference between the 3 groups regarding the clinical symptoms, but there was considerable reduction in the severity of clinical problems in Fennelin takers compared with the two other groups. According to the drug-takers, Fennelin was more effective in reducing the complaints compared with Placebo however, it had no significant difference from Mefenamic Acid.
Conclusion: The effect of Fennelin in relieving primary dysmenorrhea is not less than Mefenamic Acid, and it can be useful in reducing the severity of pain, hemorrhage and clinical symptoms. Therefore, due to the safety of herbal drugs, it can replace the chemical drugs.

---

Background and Purpose: The role of trace elements (Cu, Zn) in chronic inflammatory states has provided interest, as many of them are co-factors in metabolic processes, involving arthricular tissues and immune system function. The purpose of the current study was to evaluate zinc and copper plasma concentration in rheumatoid arthritis (RA) patients, who were referred to the Sari Outpatient Clinics and were compared with control group.
Materials and Methods: We studied plasma concentrations of Zn and Cu in 40 patients with RA and compared them with sex and age matched of healthy subjects (N=40). Plasma Cu and Zn concentrations were determined by an analysis of 100 Perkin Elmer model flame atomic absorption spectrometer (FAAS)
Results: The plasma Zn concentration in the patient group was statistically lower than control group. The plasma copper was not statistically different in comparison with control group. There was no correlation between Cu and Zn concentration in patient group. In contrast to Cu, there was a significantly positive correlation between Zn and Zn/Cu ratio. However, the decrease of Zn/Cu is more influenced by decreasing the Zn concentration.
Conclusion: It appears the decrease of Zn plasma concentration in patients (comparison with control group) is more important than the differences in plasma Cu concentration, but the use of Zn supplement for RA patients needs more investigation.

---

Background and Purpose: Lipophilic yeast of the genus Malassezia are members of normal human cutaneous micro flora which are also associated with several skin diseases. It is strongly suspected that Malassezia species are responsible for pityriasis versicolor (PV), and seborrhoeic dermatitis (SD). Considering various sensitivities among Malassezia species to antifungal, accurate species identification will facilitate the treatment of relevant diseases. Malassezia species can be identified through their morphological features and bio-chemical characteristics. However, these phenotypic methods are usually time consuming, and lack sufficient discriminatory power. Development of DNA- based methods for detection and identification of Malassezia species provide helpful alternatives for solving problems. The aim of this study was to examine the distribution of Malassezia species in patients with pityriasis versicolor and seborrhoeic dermatitis, using molecular methods.
Materials and methods: A total of 63 clinical isolates of Malassezia spp, 30 strains isolated from patients with PV and 33 strains isolated from patients with SD, were studied. To investigate the strains at molecular level, genomic DNA of Malassezia isolates were extracted and amplified within the ITS1 region (located between 18S and 5.8S rDNA) by polymerase chain reaction (PCR) assay. DNA sequencing of ITS1 of rDNA in Malassezia spp was performed to type the species. Restriction fragment length polymorphism (RFLP) analysis of ITS1 PCR product with two restrictive enzymes CFOI and BSTF5I, was used in subsequent species identification.
Results: In this study, 37 patients with PV (20 females, 17 males 2 to 64 years old), 81.1% (30 case) yielded growth of Malassezia in culture, while the frequency of isolation of M. globosa was 53.3% (16 case), M .furfur 40% (12 case) and M. sympodialis 6.7% (2 case). Of the 41 patients with SD (22 females, 19 males 1 to 52 years old), 80.5% (33 case) yielded growth of Malassezia in culture, while the frequency of M. furfur was 42.4% (14 case), M.globosa 39. 4% (13 case), M. restrict 15.2% (5 case) and M. sympodialis 3% (1 case). This PCR-RFLP Profile allows us to clearly identify important Malassezia species. The results of the PCR-RFLP analyses of clinical isolates were in complete agreement with those from DNA sequencing, morphological features and bio-chemical characterization.
 Conclusion: In patients with PV, the most frequently isolated species were M. globosa, followed by M .furfur. However, in patients with SD, the most frequently isolated species were M. furfur, followed by M. globosa. The PCR-RFLP system applied for the ITS1 fragment of the rDNA is a reliable, simple and rapid method for identification of the most important Malassezia species, but further work will be necessary in applying these techniques to additional patients.

---

Background and purpose: Seborrhoeic dermatitis (SD) is a common skin disorder. Malassezia yeasts have an important role in the etiology of SD. Since anti-fungal agents, especially in azoles are effective for treating SD, in this study, the effect of ketoconazole 2% solution on clinical signs and Malassezia in SD patients were assayed.
Materials and methods: 100 patients with SD were enrolled in this study. Patients were scored in regard to the severity of lesions at the initial evaluation and every 2 weeks for a 1 month period. Microscopic examination and culture of patients scale in days 0 and 28 were used for isolation and identification of Malassezia species. Patients were divided into two groups (ketoconazole 2% solution and shampoo) and followed after 14 and 28 days, and then clinical response was graded.
Results: 58% of patients showed lesions on their heads. In day 0, 51% of patients showed > 7 yeasts in each microscopic field. 77% of scale samples were positive to Malassezia spp. Growth and M. globosa (57.1%) had the most frequency. In day 28, 89.6% and 82.6% of treated patients with solution and shampoo showed 1-3 yeast in within entire smear, respectively. 94.8% and 82.6% of scale samples were negative to Malassezia spp growth, respectively. In day 0, patients with moderate SI had the most prevalence, whereas in day 28, patients with mild SI were predominant. Statistical test showed the correlation is significance only between SI and treatment with solution.
Conclusion: The results of our study showed that according to decrease of yeast load and increase of improvement of SD signs after treatment with ketoconazole 2% solution, compared with ketoconazole 2% shampoo, 2% ketoconazole solution can be considered as an appropriate agent in treatment of Sd.