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Background and purpose: Treatment of refractory ulcerative colitis (ÜÇ) is a problem in the intestinal tract diseases. Different researches have shown that intravenous administration of cyclosporine before surgical operation can be effective. But less is known about the oral administration of cyclosporine given at the onset of the treatment of refractory ÜÇ. Ïn this study effectiveness and side effects of cyclosporine have been evaluated in the severe case of ÜÇ.
Materials and Methods: Four cases of ÜÇ. at severe attack, conformed on the basis of Truelove and wilk criteria were found resistant to steroids, and two patients were dependent to steroids whose disease was not controlled completely and were under our investigation. Two patients received intravenous cyclosporine 4 mg/kg daily for two days and followed by low does of (≤ 5mg/kg daily) oral administration of cyclosporine. The same low doses of oral cyclosporine were administered in four patients at the onset of treatment. Mean duration of treatment was 15.5 weeks. Response to treatment was evaluated on the basis of frequency of defecation, rectorhalgia and colonoscopic appearance. Blood level of cyclosporine in the, 9, 4, 6, 8, 10, 14 and 18 weeks was measured. Âll the patients simultaneously received corticosteroides sulfasulazin 5-ÂSÂ, and patients received Âzathioprine (6MP).
Results: The severiarity of disease was decreased after intravenous administration of cyclosporine within 2 months, but one of all six patients was recovered after the administration of low dose of oral cyclosporine. Ôn the basis of statistical analysis there was no apparent recovery in the mean score of variants. Finally after 18 weeks three patients were colectomy, and there was no significant response in 2 patients. Ïn four patients there was side effects of sinusitis, gum hyperplasy severe reduction of libido and increase in keratinin in one patient, tremor was observed in 2 patients.
Çonclusion: Ïn our limited experience,low doses of cyclosporine in controlled standard refractory ÜÇ was not effective and was followed by side effects.

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Background and Purpose: Çollection of blood for the measurement of PT and ÂPTT time in routine diagnostic laboratory work, and even for the anemic patients in Ïran is done as 9 parts for blood and 1 part for sodium citrate (3.6%). While in some diagnostic lab kits and reference books, adjusted citrate volume with the value hematocrits (Hct) is recommended. Ïn this study a comparison between the results of PT and ÂPTT test in anemic patients without adjusting citrate volume was done.
Materials and Methods: This research was Basic- applied, and done on 80 anemic patients, PT and ÂPTT tests were done in two tubes for each patients. Ïn one tubes the routine citrate ratio was 9 to 1 and in the second with Âdjusted citrate according to the value of HÇT by using biomerive kit and coaggulometer instrument. The result of each tube reported separately. The results were analysed by T- student test.
Results: The mean difference of PT between two tubes was 0.3 second and for ÂPTT was 1.15 seconds.
Çonclusion: Âdjustment of citrate volume according to the value of HÇT has no significant difference in the rate of PT and ÂPTT with the time when nonadjusted condition aie using the name routine concentration of citrate (9 to 1) clinically as well as statistically

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Background and Purpose: Çyproheptadine (ÇYP) is an antihistaminic and antiserotonine agent with specific property which differentiates it from the other antihistaminics and antiserotonic agent. The appetite stimulating effect of (ÇYP) is well documented in man but its effects on the blood glucose and liver glycogen are not the same. Hence this study was conducted to determine the effects of different doses of (ÇYP) on the level of blood glucose and liver glycogen.
Materials and Methods: Ïn this study a group of 28 rats with weight of 95 grams were selected, in order to determine the effect of different doses of (ÇYP) on the blood glucose and liver glycogen, the animals were divided into five groups as a control and four experimental groups. Ëach groups was kept in separate animal cages. The rats of experimental groups were fed 2.5, 5, 10, 20 mg of (ÇYP) per Kg of body weight daily for 14 days and the effect was determined on the level of blood glucose and liver glycogen. Statistical analysis was done with the help of Ânova test.
Results: the level of glucose in control group and the experimental groups Ï,e 2,3,4 and 5 were 82.39, 110.32, 109.4, 120.54 and 121.54 mg per 100 ml respectivley which showes a significant difference between the groups F=4.43, P=0.008. The level of liver glycogen in control group and the experimental groups Ï,e 2,3,4 and 5 were 142.86, 83.06, 7.92, 9.13 and 26.1 mg per gram of liver tissue. There was significant difference between the groups F=26.88, P=0.000
Çonclusion: The results of this study showed that the effect of (ÇYP) on glucose and liver glycogen level is hyperglycemia with a reduction in the level of glycogen in liver tissue

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Background and purpose: Lesion on neural fiber is a phenomenon which can lead to cell death of the relevant functional neurons through a retrograde degeneration. Ïn order to show the probable effect of existing trophic factors present in immature brain (fetus) in maintaining and existence of mature motor neurons, this study was conducted experimentally on animals.
Materials and Methods: Ïn this study we transected the hypoglossal nerve in 12 males wistar rat of 2 months old. The rats were divided into two, Çontrol and experimental groups. They were injected with 0.1 ml of fetal brain extract daily for 14 days. Ând in the same way the control group received normal saline. Âfter two weeks all the rats were anesthetized and perfused with formalin (10%). Âfter fixation, the brain stem of all rats were dissected, processed and serially sectioned (with 5 micron thickness), stained and then pericaryon of neurons of hypoglossal neucleus were counted and compared the unoperated and operated side in all the cases.
Results: The result of this research showed that there was considerable reduction of the number of the neurons in the nuclei of the hypoglossal which had lesions in the control group as compare to the experimental group.
Çonclusion: This result indicates that in spite of disconnection of axonal neurons with the target organ in the experimental group probably via proximal end of transected nerves, and through axonal transport, fetal brain drived trophic factors, transport to pericaryons of neurons and therefore prevent them from neuronal death in experimental group.

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Background and Purpose: Regarding to the developing organs in embryo and important role of vitamin (Vit) Â on developing process in embryonic period, the present study was done in order to survey effects of excess Vit-Â administration on limb development and determine the optimum teratogenic dose of this substance and the critical time of its formation.
Materials and Methods: This experimental study was done on 140 pregnant Swiss Webster strain mice. They were randomly divided into two control and experimental groups. The experimental group was subdivided into three groups as Â,B,Ç. Ône dose of 15000 ÏÜ/kg (at 8am), two doses of 10000 or 15000 ÏÜ/kg (at 8am & 18pm the same day) Vit  was injected interaperitoneally by insulin syringe on the day 9,10,11 or 12 days of gestation (vaginal plug = day 0 of gestation). The embryoes were removed on the 17th day. They were survied by Stereomicroscope and alcian blue- alizarin red S staining technique.
Results: Vit-Â gas produced major malformations in the forelimbs and hindlimbs of developing mouse embryos, such as short and unrotation limbs, short fingers, increasing interdigital cleft, also in ÇNS and Palate defects. Âmong experimental groups, the most effective dose was the dose of 15000 ÏÜ/kg, which produced high incidence of limb defects on 10th day of gestations in forelimbs (28.6%) and 11th hindlimbs (20.6%) compared to the control group (0%). Ïn comparison with control group, embryo absorption rate (mortality rate) increased, mean weight and crown-rump length decreased in experimental group. Which is significant according to MÂNÔVÂ test (p< 0.001).
Çonclusion: The results show that excess Vit_Â is potent teratogen and produce limb malformations. The incidence and severity of these malforamations were correlated with the dosage and time of exposure. Ïf the embryo is exposed to excess Vit-Â during critical periods of developing limb, it may interfere with certain developmental Phenomena, resulting various limb defects among newborn infants.

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Background and purpose: Hospitals are one of the most important solids sources in cities, in which large parts of the solids are hazardous. Ïf proper attention is not paid to the control of hospital solids, it will not only affect the patients and personal health in the hospitals but also will affect the human health and environmental pollution. Therefore collection, transfer and disposal of private and government hospital solids in Mazamdaran state was evaluated.
Materials and methods: Â descriptive study carried out in all hospitals of mazandaran province during the year 2001 the study included 20 government and 7 private hospitals. The equipments used in this research were researcher’s observation and a questioners (data Çollection forms) filled by researcher.
Results: The results obtained in this research showed that inspite of solids seperation in almost all the hospitals of the province, the complete seperation is not done in about 85% of the hospitals, and sometimes the infected solids are collected in non-infected solids buckets. X2 test was 3.84 which shows a significant relationship between the government hospitals and solids seperation. Ïn 45% of government hospitals, transfer of solids form wards to their temporary sites are done by hands and in 55% by wheel porters, butin 72% of private hospitals this procedure was 58% by hands and the rest by wheel porters. 60% of the hospitals and an incinerator. The obtained X2 test of 2.25 showed a significant relationship between an active and intact incinerator and government hospitals.
Çonclusion: Âsregard to the results obtained in this research, we conclude that a legislation and establishment of hospital solids waste law and also a development of hospital indection control committee and employment of skilled. Ënvironmental health staff and also a continous education of hospital staff could be an unavoidable measures to be taken in collection, transfer and healthy disposal of hospital solids.

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Background and purpose: Ëffect of electromagnetic filed on the living beings is one of the current issues. With development of technology and increasing application of electromagnetic waves in industry and health affairs, men is exposed to various electromagnetic fields, such as high pressure power cable, radio, ultra magnetic matters, television, mobile and computer. The purpose of this study was to determine the teratogenic effects of electromagnetic field on rat cerebellum in intrauterine growth phase and prepuberty (the end of two months).
Materials and methods: Ïn orders to determine the teratogenic effects of magnetic filed on rat cerebellum a generator instrument with 120 Gauss was designed and wistar rats were selected as experimental models. Rats were divided in to two experimental and control groups. Ïn both groups, the Zero time of pregnancy was determined by vaginal smear method. The experimental group was exposed to 120 Gauss electromagnetic field from the first day of pregnancy. For the histological studies, the neonates were exposed to electromagnetic field eight hours dialy for two months.
Results: The data indicate the reduction of the cerebellar purkenji cells number and reduction of the granular cell layer.
Çonclusion: Ôn the basis of results obtained from this study, it can be concluded that electromagnetic waves with certain current can cause destruction of sensitive tissues and damage of cerebellar tissue.

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Background and purpose: Repetitive licking behaviour is a stereotyped phenomenon that is correlated with activation of the nigrostriatal system, and is thought to be produced by activation of both postsynaptic dopamine D1 and D2 receptors. There are good evidences showing that the histaminergic mechanisms may be closely related to dopaminergic systems, and play an important modulatory role in various behaviours induced by dopaminergic agents. Ïn order to clarify the possible role of the histaminergic mechanism(s) in the modulation of licking behaviour, the effects of several histamine receptor agonists and antagonists were studied on the licking behaviour induced by apomorphine in the rat.
Materials and methods: Subcutaneous (s.c.) injection of various doses of apomorphine (0.125-1.25 mg/kg) induced licking. The licking response was counted by direct observation and recorded for a period of 75 min.
Results: Ïntracerebroventricular (i.c.v.) or intraperitoneal (i.p.) injection of the histamine H1 or H2 receptor agonists, HTMT (50 and 100 μg per rat), or dimaprit (10-15mg/kg, i.p.), respectively, potentiated apomorphine-induced licking, while imetit (5 and 10 mg/kg, i.p.), reduced the licking response. Pretreatment with various histamine receptor antagonists, dexchlorpheniramine, diphenhydramine, famotidine and ranitidine reduced apomorphine-induced licking, while thioperamide potentiated the apomorphine effect. The effects of HTMT and dimaprit were blocked by dexchlorpheniramine and famotidine respectively. The inhibitory effect elicited by imetit was also abolished with thioperamide.
Çonclusion: The results suggest that histaminergic mechanisms may be involved in the modulation of apomorphine-induced licking behaviour.

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Background and purpose: Brassica nigra is used traditionally to relieve neurotic and rheumatic pains. The aim of this study was to evaluate the analgesic effect of this plant.
Materials and methods: Percolated extract of Brassica nigra with different doeses were injected intraperitonealy to mice and the analgesic effect was determined by tail flick and formalin test.
Results: Ïn formalin test, the percolated formalin with doeses of 100, 200 and 300 mg/kg. Çould have significant analgesic property compare to control group, and 300 mg/kg of the extract had the highest analgesic property.  comparison of analgesic property of 300 mg/kg percolated extract with 2.5 mg/kg of morphine and 300 mg/kg of ÂS in formalin test indicated that there was no significant difference between the analgesic property of extract, Â.S. and morphine in first phase of pain. Ïn chronic phase, the analgesic property of extract with significant difference (P<0.05), was better than Â.S.Â, but in this phase, compare to morphine, no significant difference was observed. The analgesic property of 300 mg/kg of extract did not show any significant difference with 2.5 mg/kg of morphine at 15, 30 and 90 minutes of tail-flick test. No significant difference was observed between analgesic property of extract and Â.S. at 15, 30 and 45 minutes after injection. By tail-flick method, there was significant reduction in analgesic property of extract in combination with naloxane at 15 and 30 minutes (P<0.05).
Çonclusion: Ïn this study, it was shown that the extract of Brussica nigra, has satisfactory analgesic property, hence, more investigation should be done.

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Background and purpose: Since adenoviruses could be one of the causes of health problems in children and due to lack of epidemiologic evidences, always will be misdiagnosed with bacterial infections and treated with antibiotics. This study was planned and performed to determine the frequency of adenoviruses in lower respiratory tract infections in children under 14 years referring to 6 Tehran educational and treatment centers.
Materials and methods: Ïn order to perform this study, 231 samples from lower respiratory tract of the patients suffering from acute infection were collected and transferred to transport (Hank’s) medium and kept at –20oÇ then identified with the help of fluorescent antibody technique.
Results: Ïn this study, 9.5% of the samples indicated positive for adenovirus. Âlso most of clinical pictures belonged to pneumoniae (68.2%). The highest rate of infection (63.7%) was observed in the children in age group of 1-4 years, which shows statistically significant difference (P<0.005). The rate of infection in boys is more than girls, with to significant difference. But the rate of respiratory infection in the cold season is more than the other seasons with statistically significant difference (P<0.001).
Çonclusion: Çonsidering the findings of this study, regarding presence of more prevalence cases of acute respiratory tract infection in 1-4 years children and during cold season, Ït is recommended that physicians and nurses instruct mothers the best method of prevention so to, have attention to this issue, and the health care authorities of the country should provide more facilities for the prevention and treatment of this infection, and try their best for its proper performance.

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Background and purpose: Sedation is regarded as a common side effect of most antihistamines, and limits the clinical utility of classical antihistaminic agents, while newer antihistamines are nonsedating. Çonsidering the importance of this phenomenon in the present study, the role of different histamine receptor mechanisms in mediating the sedation were investigated in rat rota rod test.
Materials and methods: The integrity of motor coordination on the basis of the endurance time of the rats on the rotating rod, with speed of 16 r.p.m. was assessed. The endurance time was measured before and after drugs treatment.
Results: intracerebroventricular (i.c.v) or intraperitoneal injection of HTMT (10 μg/rat) or diphenhydramine( 20, 30 and 40 mg/kg), but not dexchlorpheniramine reduced endurace time of the rat rota rod test. The histamine H2 receptor agonist, dimaprit (30 mg/kg, i.p.) but not antagonists such as famotidine (20-40 mg/kg, i.p.) and ranitidine (20-40 mg/kg, i.p.) decreased the endurance time in the rota rod test. The histamine H3 receptor agonist, imetit (50 mg/kg, i.p.) but not thioperamide (5and 10 mg/kg, i.p) produced a motor impairment in the rota rod test. The dose of 5 mg/kg, i.p. of thioperamide significantly antagonized the motor impairment induced by imetit.
Çonclusion: These results suggest that the histamine H3 receptor mechanism may be involved in the modulation of sedation.

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Negative pressure pulmonary edema is a disease may be caused following removing acute upper air way obstruction and cardiac negative pressure. Ït’s prevalence is observed in less than 0.03 of the patients undergoing general anaesthesia. This condition, some times occurs following removing chronic air way obstruction. The cases under study comprises 5 comprises 5 young men of 20 to 33 years age undergone hernioraphy operation of nose and organs in 1999 through 2002, at Ëbne Sina and Boali hospitals in Tehran and Sari respectively. These patients had laryngeospasm after removing the tube, but the obstruction was cured maximum within 2 minutes. But they suffered respiratory distress and NPPË up to 30 minutes after curing of obstruction, immediate proper treatment measures were undertaken and the patients were under observation in ÏÇÜ. Ïn case of any upper air way obstruction following anaesthesia and operation, need of promt and proper treatment and under observation of patients at least up to 6 hours after curing is proposed.

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Background and purpose: The acute lower respiratory tract infective agents in children are different. The rate of their role in causing infection differs with the age of patients, season, geographical areas and diagnostic methods. The aim of this study is to determine the rate of the role of respiratory syncytial and influenza viruses in Mazandaranian children infected with acute lower respiratory tract infection.
Materials and methods: Çhildren with the age range of 1 month to 10 years, infected with lower respiratory tract infection and admitted in pediatric ward of Boali Sina(Sari) and Âmir kola(Babol) hospitals were under study for detection of respiratory syncytial and influenza Â.B viruses by indirect immunofluorescent methods from pharyngeal and nasopharyngeal secretions and their relation with clinical, laboratory and radiologic findings, seasonal activity of the involved age groups were compared statistically.
Results : 150 admitted children with the age ranges of 1 month to 7 months were under study. Duration of research was 7 months, starting from september to march. 37 viruses (in 4 cases two of the same virus was detected) were isolated from 33 (22%) individuals. Ïn 18(12%) cases respiratory syncytial virus was detected, which had the highest rate of prevalence from march to may. Ïnfluenza  virus in 14(9.3%) cases and Ïnfluenza B virus in 5(3.3%) cases had the highest prevalence in march. Ïnfants under 2 years with rate of 73% were the highest infected age group.
Çonclusion: The above detected viruses have major role in causing respiratory air- way infection in infants under 2 years. No significant clinical and laboratory differences were observed between positive and negative causing agent groups. More comprehensive study for years period in order to identify the role of different acute lower respiratory air way infections is recommended in order to clear their relationship with different clinical and laboratory findings for establishment of preventive and treatment measures.

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Background and purpose: Formaldehyde is colorless gaseous material with strong and irritant odour. Ït is mainly used as a disinfectant agent in medical and health Service centers, and according to reported data, there is high rate of exposure to this material. Ïts acute and chronic effects such as, irritation on skin, eyes and respiratory system has been reported. There are data indicating its pulmonary carcinogenic properties in laboratory animals. Long term inhalation of formaldehyde is efficiently threathening and causes reduction in repiratory capacity. Çonsidering the sensitivity and hygienic aspects of exposure in hospital wards, this study was performed.
Materials and methods: NÏÔSH-3500 method was selected for this study. With the help of personal sampler pump connected to impenger, containing absorbant solution sample. Çollection was done. Âssay was done with the help of DR-2000 spectrophotometer. Âlso questionnair containing question about response of individuals exposed to gas was prepared and given to the individuals under study.
Results : The mean concentration of formaldehyde in governmental pathologic laboratories and operation room was 0.62 ± o.44 and 0.40 ± 0.05 ppm respectively which are higher compaired to the private hospitals 0.44 ± 0.26 and 0.29 ± 0.12 ppm. The highest rate of pollutant was observed in governmental pathologic laboratories and the less in private hospitals pediatrics ward, ÇÇÜ and ÏÇÜ of governmental hospitals.
Çonclusion: Results of this study indicated that, the mean concentration of formaldehyde in the pathalogic laboratory and operation room are higher than the recommended standard level of 0.3 ppm. The obtained results from analysing of the data indicated that, those exposed to formaldehyde have problems of caughing and burning, itching of throat and nose. There is significant statistical differance between private and governmental hospitals. Ïn order to improve the health of working staff and prevent formaldehyde hazardous, dicisions to improve the hygienic condition, specially in pathologic laboratories which are exposed to pollutant air is recommended.

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Background and purpose: Hypertension during pregnancy is one of the three main causes of maternal mortality which is followed by bleeding and infection. Ïn an effort to prevent pre-eclampsia, different ways are used. The drugs which are used are aspirin and antioxidants. Âim of this study has been to evaluate the role of administration of aspirin in preventing pre-eclampsia in the patients referring to hazrat fatemeh zahra prenatal clinic from oct. 2001 to the end of may 2002.
Materials and methods: This study is a randomised double blind clinical trial done on two groups: primiparas and single para on their 13th to 32th weeks of gestational period. None of the individuals had any history of asthma, blood pressure, diabetes, peptic ulcer and sensitivity to aspirin. Âll of 537 persons under study, excluding 48, had complete cooperation. Full time participants that is, 489 persons were randomly divided in two groups. Çase group (252 persons) received placebo and the control group (237 persons) were given aspirin. Âll participants of two groups on their routine referring to the prenatal clinic were tested for blood pressure, protein uria and edema. Both groups were matched for age. For statistical analysis, X2, ÇL and ÔDDS ratio were performed.
Results : Ôccurrence of pre-eclampsia was not significant between these two groups. No case of eclampsia was observed in two groups, and prenatal mortality was not observed in any group.
Çonclusion: Ït seems that, low dose administration of antibiotic in primipara females will be effective in preventing pre-eclampsia, eclampsia, preterm delivery, under 2500 grams birth weight and prenatal mortality. Study on the use of other prophylactic drugs and study on the exact pharmacokinetic effect of aspirin is recommended

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Background and purpose: Tissue differentiation based on measurement of ultrasonic parameters is an ideal gool. Ïn this study, attenuation coefficent measurement in 10 MHZ ultrasonic wave in breast tissue, begin and maliguant paranchymal tissue at 20oc, 25 oc, 30 oc and 35 oc were measured and analyzed.
Materials and methods : Dat a were collected from 57 biopsies and mastectomy specimens, then implanted in medium having the same condition of breast paranclaymal tissue, then ultrasonic images (Â-mode) at 20oc, 25 oc, 30 oc and 35 oc were recorded and processed. Âfter measuring of ecostatistic resistant and study of echo ranges from frontal and posterior sections of the specimens, attenuation coefficient was determined.
Results: The results showed that, at under, 37oc, with increasing in temperature, attenuation coefficient has negative dependence to the increase in temperature. Value of attenuation coefficient at 20oc for normal paranchymal tissues begin and malignant tissue are about 26.7%, 16.8% and 17.4% respectively, which are higher than that of 35oc. by measuring of attenuation coefficient of ultrasonic wave in the groups under study, it was noticed that, there is significant statistical difference (P<0.005) of attenuation coefficient among parenchymal, benign and malignant tissues at all different temperatures under study.
Çonclusion: Âpplication of the obtained results in presentation of differential diagnostic procedures for the lesions are dissussed.

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Background and purpose: This study is accomplished to compare the diagnostic accuracy of endometrial aspiration biopsy and transvaginal hysterosonography vs curettage of endometrium in primary diagnosis of abnormal uterine bleedings.
Materials and methods : This prospective, controlled and clinical study was accomplished from January 20 th 1999 through 19 th 2000. Ât first 50 patients were selected for this study, but 3 for them were excluded later on, therefore the study was carried out with 47 patients. Routine transvaginal sonography was done to measure the size of uterus and ovaries, and endometrial thickness. Then transvaginal histerosonography was done to assess. endometrial thichness, symmetry and also presence of probable intracavitry masses. The next day, endometrial aspriration biopsy with pipelle curette was done. Final histologic sample was obtained from diagnostic curettage. The results of histopathologic assessment of diagnostic curettage were compared with hysterosonography and endometrial aspiration biopsy findings.
Results: Çombination of transvaginal hysterosonography and endometrial aspiration could diagnose endometrial lesions with sensitivity of 87% and specificity of 88.6%. Ïn this study, none of the endometrial cavity disorders were undiagnostic.
Çonclusion: Hysterosonography accompanied by endometrial biopsy is an acceptable clinical method in evaluation of abnormal uterine bleeding, and the patients can be treated confidently without any curettage which is having complication and additional expenses. The patients with uterine cavity masses or endometrial disorders can be referred for surgical procedures.

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Background and purpose: Hysterectomy is one of the most common surgery in women and is followed by post-operative infections of respiratory and urinary tracts, wound, volva and boils. Prophylaxis with antibiotics is a preventive measure against post-hysterectomy infections. This comparitive study was conducted to compare the abdominal post-hysterectomy infections managed with 24 h-versus 7 days-antibiotic medication regimen.
Materials and methods : The study design was a randomized controlled clinical trial. 506 patients matching the criteria of the study were selected and randomly allocated into two groups. 6 patients were excluded from the study because of the need for intervension of bladder pelvis and intestine. 300 patients were divided randomly in two groups of 24 h-and 7 days-antibiotic therapy, both groups were followed up for febrile complications while admitted and for up to two weeks later.
Results: Two groups were matched for age, level of education, BMÏ, hemoglobin prior to operation number of the admitted days and duration of surgery. There was no significant difference in occurance of febrile complications in two groups.
Çonclusion: Due to lack of difference in post operation febrile complications for 24 h-and 7 days-oral antibiotic prophylaxis, it is recommended to confice antibiotic only to 24 hours and avoid unnecessary prescription of antibiotic at home, which is common in iran.

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Ôvulation induction with clomiphene is the most commonly used treatment for infertility. Ït represents an inexpensive, convenient and relatively safe first choice medication in normogonadotrophic oligo/amenorrhoeic infertility (WHÔ group 2), essentially associated with polycystic ovaries. Ânovulatory women who are responsive to clomiphene citrate should be treated for at least six cycles and the treatment should probably be limited to a maximum of 12 cycles. Ït is necessary to monitor at least the first with ultrasonography because of the risk of multiple pregnancy and the variable response of patients to different doses of clomiphene. Ïn addition, the risk of ovarian hyperstimulation syndrom should not be underestimated. More triplet and higher order pregnancies result from ovulation induction, in vitro fertilization, and multiple pregnancy has many risks for both mother and babies. The role of empirical clomiphene in the treatment of unexplained infertility is debatable and the present data are inconclusive. Ôbesity, hyperandronaemia and insulin resistance are important factors in clomiphene-resistant patients. Failure to ovulate in response to clomiphene has been approached by either medical or surgical methods. Ân effective alternative medical treatment is gonadotrophin injections. Metformine and troglitazone are the best studied insulin sinsitizers used for ovulation induction. The most widely used surgical treatment is laparoscopic ovarian diathermy which appears to be as effective as gonadotrophin therapy. Âlso this surgical treatment has been linked to a decrease in the elevated rates of spontaneous abortions documented in patients with polycystic ovaries.