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ABSTRACT Background and aim: Nausea and vomiting are common complications after surgery occurring in 20-70 percent of total surgeries and depends on factors such as anesthesia method and hemodynamic status, oxygen concentration, pain, etc. In some studies use of higher concentrations of oxygen prior to surgery has resulted in decreased incidence of nausea and vomiting and in some other studies such results had not been verified. In the present study, the effects of supplemental oxygen has been assessed on the incidence and severity of nausea and vomiting in the patients after cesarean surgery under spinal anesthesia Materials and Methods: This study was a randomized clinical trial and 122 women who were candidate for cesarean surgery were assigned randomly into intervention and control groups. Intervention group received 80 percent O2 equivalent to 12 liter per minute, continuously during surgery and after surgery in recovery room, and alternatively 6 hours by use of ventury mask in the ward. The control group received 30 percent O2, equivalent to 3-5 liters per minute with a regular mask as a routine measure. The incidence and severity of nausea and vomiting was recorded during surgery, up to 6 hours after surgery, in the recovery room and in the postpartum ward. Results: According to the results, the incidence of nausea during surgery showed no significant relationship but it showed a significant difference in the recovery room and at the postpartum ward in the intervention and control groups (p<0.01). Incidence of vomiting during surgery and at the postpartum ward in the intervention and control groups had no significant difference but it revealed a significant difference in the recovery room (p<0.001). There was a significant difference in the severity of nausea in the intervention and control groups during surgery, in recovery room and after 6 hours of surgery in the postpartum ward and the severity of nausea was higher in the control group (p<0.05). Conclusion: This study demonstrated that supplemental oxygen therapy during and after surgery by spinal anesthesia technique was not effective for the prevention of nausea. There was only a significant statistical difference in the rate of vomiting in the recovery room between the two groups. Use of supplemental oxygen decreased the need for analgesic drugs in these patients. Key words: Nausea and vomiting, Supplemental oxygen therapy, Cesarean surgery, Spinal anesthesia Conflict of Interest: Nill Received: June 7, 2010 Accepted: Jul 13, 2010

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ABSTRACT Background and aim: Cardiovascular diseases are one of the most common causes of death and also major health problems in the world. The classical methods such as Cox regression are used in most medical studies on survival distribution, while this model assumes a linear relationship between log hazard ratio and risk factors which is not useful in many cases. The present study was performed to use the method of penalized splines to analyze the survival rate of the patients who had acute myocardial infraction. Materials and Methods: This research was a prospective descriptive-analytical study of longitudinal type which included 650 patients with acute myocardial infarction. Patients were followed for one year from the moment of diagnosis of MI, for survival analysis. The collected data were recorded in a check-list for every patient. Two different multivariate methods, proportional hazard regression and Cox model with penalized splines were used. Data analysis was carried out using R version 2.12 software and significant levels were considered 0.05. Results: The mortality rate of the patients in a period of one year was 10.3% (67patients). History of smoking, hypertension, diabetes, hyperlipidemia, arrhythmia and heart block were detected in 48%, 33.4%, 17.7%, 15.3%, 30% and 10.3% of the patient respectively. Based on Cox model with penalized splines the factors affecting survival rate were age, ejection fraction and use of streptokinase. Conclusion: Knowledge of the survival rate and factors affecting survival in the patients with acute MI can be used to provide the patients with valuable services, and to take measures to control and reduce mortality rate which can lead to increased life expectancy of these patients. Key words: Survival, Myocardial infarction, Cox model, Penalized splines Conflict of Interest: Nill Received: Feb 6, 2011 Accepted: Jul 7, 2011

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Background and Aim: Disk herniation is one of the causes of low back pain that 90% of people experience this pain. There are many pharmacological and non-pharmacological methods to alleviate the low back pain, such as physiotherapy techniques (infra-red and hot pack, etc.). In this study we investigated the effect of infra-red and hot pack on the low back pain associated with disk herniation. Material and Methods: In this experimental study, 60 patients with disk herniation were selected and divided randomly into infra-red and hot pack groups. Severity of the pain was measured on the basis of a numerical rating scale up to 10. Intervention was performed three times a week for one month. Severity and duration of pain were measured before and after intervention. SPSS software was used for data analysis. Results: The results of this study showed that the mean scores of pain severity and duration in infra-red group was 65.67±8.33 minutes which decreased to 44.33±5.60 minutes after intervention. The respective values for the hot pack group were 81±8.6 and 50.33±5.60 minutes before and after intervention. Effect of infra-red and hot pack on pain reduction was the same after intervention but infra-red was more effective in reducing the duration of pain. Conclusion: Considering the effect of infra-red, it can be recommended for pain reduction as a safe non pharmacological method. Hot pack is also effective in reducing pain by producing humid heat and patients’ compliance with this method will be higher.

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ABSTRACT Background and Aim: The Cox proportional hazard model is the standard approach for analyzing survival data in many cases. One restriction of this method, however, is that it assumes that the log of the hazard function relates to the covariates through a linear function. As a consequence, it fails to estimate efficiently the effect of the non-linear terms. But we can estimate the survival rate by using spline functions. Our goal is to investigate the appropriateness of an alternative method, the so-called single index model, for estimation of the survival rate of the patients with acute myocardial infarction. Material and Methods: This was a descriptive analytical cohort study which included 650 subjects with acute myocardial infarction. The patients were followed up for one year to ensure survival or detect death events. Data were recorded in a pre-defined check list. In this study the relationship between the log of the hazard function and covariates were considered unknown. We estimated the coefficients of the model by using the polynomial spline and penalized partial likelihood. Data analysis was carried out by using R version 2.12 software and significant levels were considered 0.05. Results: We found the Cox model with unknown link function to have larger log likelihood than the standard Cox model. The effects of estimated parameters in both models were relatively different. Effects of diabetes and arrhythmia in Cox model with unknown link function were significant (P<0.05). In standard Cox model unlike Cox model with unknown link function the age was significant (P<0.05). Conclusion: Considering the results of this study Cox model with unknown link function could estimate the effect of factors such as diabetes and arrhythmia in the survival of the patients, in addition to the effects of streptokinase and ejection fraction. Key words: Survival analysis, Single index model, Cox proportional hazard model, Myocardial infarction. Received: May 10, 2012 Accepted: Jun 26, 2012

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ABCTRACT Background and Aim: Amniotic membrane is the inner-most layer of the three fetal membranes. The membrane is consisted of three layers epithelial layer, basal membrane, and connective tissue. Owing to expression of mRNA of elafin, HBD 1-3, and secretory leukocyte protease inhibitors, amniotic membrane has antimicrobial properties. The aim of the current study was to evaluate the in vitro antibacterial effect of human amniotic membrane on standard bacterial species of Salmonella enterica BAA-708, E.coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Klebsiella pneumoniae ATCC 7881, and Enterococcus faecalis ATCC 29212. Material and Methods: Fresh amniotic membranes were obtained from Organ Transplant Bank of Imam Khomeini Hospital in Tehran. The membranes were obtained from pregnant women who had negative tests for HIV, HBV, HCV, and syphilis after elective Cesarian section. The membranes were cut into 1.5× 1.5 cm pieces under sterile conditions. The membrane pieces were placed on Müller-Hinton agar medium containing the bacterial suspensions and then incubated at 37 °C for 24 hours. Results: The antibacterial properties of amniotic membrane against Salmonella enterica and E. coli were demonstrated by development of the no growth halo, but for Pseudomonas aeruginosa only a very narrow halo was observed. The halo was not developed for Klebsiella pneumoniae and Enterococcus faecalis. Conclusion: Amniotic membrane showed antibacterial effects against a wide spectrum of bacteria. With regard to the increasing antibiotic resistance, use of amniotic membrane against pathogenic bacteria can be considered valuable. Key words: Amniotic membrane, Standard bacteria species, Antibacterial effect, In vitro conditions. Received: Dec 9, 2011 Accepted: Aug 28, 2012

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ABSTRACT Background and Aim: Measurement of adenosine deaminase and its isoenzymes in serum has been used for diagnosis and differentiation of intracellular infections and malignancies of immune cells. The aim of this study was to compare ADA levels and its isoenzymes in HIV positive patients and HIV positive patients co-infected with hepatitis B and C and healthy individuals, as a quick and low-cost diagnostic biochemical marker. Material and Methods: This historical cohort study included 97 HIV positive IDU patients. After obtaining blood samples, serum was separated and examined for hepatitis B and C. We used Guisti method for measurment of ADA activity and EHNA inhibitor for the activity of its isoenzymes. Data analysis was performed by SPSS 16 (SPSS Inc., Chicago). Results: Our results showed that there was a high prevalence of HBV and HCV in HIV positive IV drug users. We found that total ADA activity in the patients groups was significantly higher than control group. Also HIV-HCV group showed a higher activity of this enzyme in comparison to HIV positive groups. Significant differences were found in regard to ADA2 isoenzymes among the four groups (P<0.05). But ADA1 activity showed no significant difference. CD4+ counts were lower in HIV-HCV and HIV-HBV patients than HIV positive patients. Conclusion: ADA activity was considerably increased in HIV positive patients co-infected with either HBV or HCV. According to the results of this study and because of its low cost and simplicity to perform, in addition to other markers, measurement of ADA activity in serum is a sensitive biological marker for assessment of intracellular infections, particularly hepatitis in HIV positive patients. Key words: IV drug user, Adenosine deaminase, Isoenzyme, HIV positive, HBV-HBV positive, HIV-HCV positive, CD4+. Received: Jul 3, 2012 Accepted: Dec 2, 2012 Conflict of interest: None declared

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Background and Aim: Teaching is defined as a set of interactive, targeted measures designed, performed, and evaluated by the lecturer. In this process, lecturer and students can be affected. Effective teaching requires strong links between objectives, teaching, learning, and training methods. This study was conducted to determine viewpoints of the students in Kurdistan University of Medical Sciences and Islamic Azad University, Sanandaj Branch about effective teaching and its related factors.

Material and Methods: This cross-sectional study included 520 students from Kurdistan university of Medical Sciences and Islamic Azad university of Sanandaj. We used a questionnaire including demographic data (age, gender, field of the study, course of the study, etc.) and 23 questions on the characteristics of effective teaching for data collection. Using SPSS version 16, data were analyzed by descriptive statistics such as frequency, mean, S.D; and, analytical statistics such as U Mann-Whitney and Kruskal- Wallis tests.   

Results: The most important features of effective teaching from the view point of the students were teacher's mastery (4.46±0.83) and interest (4.45±0.83). The least important characteristics of effective teaching were easy access to the teacher outside the classroom (3.84±0.91) and using teaching aids by the teacher (3.67±1.10). There were statistically significant differences between gender of the students and teaching method (p=0.007) and personal characteristics (p=0.02).

Conclusion: To improve the quality of education in these universities, it is recommended that characteristics such as teacher’s mastery and interest in their fields of teaching be considered important.

Keywords: Effective teaching, Teacher, Student, Attitude, Scholarship, Teaching method, Individual characteristic.

 

Received: Oct 04, 2015      Accepted: Jan 06, 2016

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Background and Aim: Beta thalassemia is one of the most common single gene disorders in the world which occurs due to a defect in the beta globin chain synthesis. In general, the majority of the patients with thalassemia, are suffering from decreased bone density. Osteoporosis is characterized by low bone mass and disorder of osteogenesis resulting in reduced bone strength. Considering the serious consequences of osteoporosis, this study was performed to evaluate the prevalence of osteoporosis in the patients with beta thalassemia major.

Materials and Methods: This study included 46 beta thalassemia patients above 5 years of age who had been admitted to the oncology ward of  Besat Hospital in Sanandaj. Chemical biomarkers were measured and the results of densitometry of the lumbar spine and femoral head were investigated for the presence of osteoporosis, osteopenia and normal findings. Using SPSS 20 software, we used one-way analysis of variance to assess the association between chemical biomarkers.

Results:  The mean (SD) age was 19.8 (7.7) years, 24 patients (52.2%) were women and 32 (69.6%) were above 15 years of age. In this study, the most frequent findings of densitometry were osteoporosis (34.8%) and normal lumbar spine (34.8%). Comparison between the chemical biomarkers and findings of the densitometry of the femoral head revealed different levels of ferritin in these patients (P = 0.011). This difference was observed in the patients who had osteoporosis and normal densitometry results (P = 0.009).

Conclusion: The results of this study showed no significant statistical relationship between chemical biomarkers and the densitometry results. Therefore, use of bisphosphonate is recommended for prevention of bone damage.

Keywords: Osteoporosis, Osteopenia, Thalassemia major, Biochemical marker, Densitometry, Sanandaj.

Received: Apr 25, 2015      Accepted: Aug 20, 2016

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Background and Aim: Excessive use or misuse of antibiotics leads to important consequences such as increased cost of treatment, bacterial resistance, treatment failure, drug toxicity and increased morbidity and mortality. Use of guidelines can result in increased knowledge of the physicians and decreased prescription of antibiotics with resultant change in the attitudes of the physicians towards this policy. 

Materials and Methods: This cross-sectional study included 356 physicians and was conducted in Sanandaj in 2015. The sampling method was census. The final questionnaire included 7 questions to assess knowledge, 18 questions to measure attitudes, (by means of a 5-point Likert Scale from very strong agreement to very strong disagreement), and 12 questions to assess performance. The reliability of the questionnaire was 54%. Using SPSS20 software, frequency and mean score of the questions were calculated.

Results: Among 356 questionnaires, 44.2% were filled out by specialists and 45.2% by the physicians who had graduated more than seven years ago. 56% of the physicians chose the correct answer for the questions on knowledge, and 25% of the physicians had knowledge about antibiotic resistance.  97.3% of the physicians agreed that antibiotics in our country have been used in excess. In this study, 233 (65.5%) physicians had high knowledge and self-confidence and 19.7% expressed low or lack of self-confidence about antibiotic prescription. WHO guideline and antibiotic guideline had been considered useful by 56% and 54.5% of the participants respectively. 49.9% of the physicians had not participated in any training course on antibiotic prescription. The highest and lowest frequency rates about sources of knowledge on antibiotic prescription belonged to internet (63.2%) and information provided by pharmaceutical companies (30.3%) respectively.

Conclusion: Considering the average level of knowledge of the doctors on antibiotic prescription and lack of participation of half of the subjects in training courses on antibiotic prescription after, attention to training courses<span dir="RTL" style="font-family: " b="" zar";="" font-size:="" 12pt;="" mso-bidi-language:="" fa;="" mso-ascii-font-family:="" "times="" new="" roman";="" mso-hansi-font-family:="" roman";"=""> with proper planning is recommended.

Keywords: Knowledge, Attitude, Practice, Doctors, Antibiotics, Sanandaj.

 

Received: May 23, 2016      Accepted: Dec 21, 2016

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Background and Aim: One of the indicators of recovery in the patients admitted to intensive care units is improvement of the level of consciousness. Various factors, including the type of care are effective in the changes of consciousness level of the patients. This study was conducted to determine the effect of nursing care plan based on “Roy adaptation model” in physiologic aspect on the level of consciousness of the patients in the intensive care unit.
Material and Methods: This triple-blind clinical trial included 100 patients in the intensive care unit in 2017. Two ICU units in Sanandaj hospitals were selected randomly as intervention and control groups. Eligible patients in each unit were randomly assigned to intervention and control groups. The intervention group received nursing care plan based on "Roy adaptation model” and the control group received routine care. We measured level of consciousness for every patient based on the GCS for 7 days, twice a day. We used SPSS version 21 for data analysis.
Results: The mean level of consciousness in the first three days and nights did not show any significant difference between the intervention and control groups. But there was a significant difference between the mean levels of consciousness from the fourth day and night on, between intervention and control groups (p <0.05).
Conclusion: Roy adaptation model was effective in increasing the level of consciousness after three days in the patients in the intensive care unit. Therefore, we recommend organized nursing care based on standard nursing models for all of the patients in the intensive care units.
Keywords: Level of consciousness, Roy adaptation model, Intensive care unit.
 
Received: Feb 4, 2017     Accepted: Jul 8, 2017

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Background and Aim: In recent decades, the survival rates of the children with cancer have improved significantly and their five-year survival rates have reached 80%, but there are still many concerns about the survival of adolescents and young people.
Methods and Materials: In this retrospective study, the data of 310 children and adults with leukemia in Kurdistan Province were extracted from their medical records. Univariate and multivariate survival analysis were performed through calculating hazard ratios using Cox relative risk model. Data analysis was carried out using Stata 12 software.
Results: This study included 201 adults with mean age of 50.8 years and 109 children with mean age of 5.2 years. The frequency of AML was higher in the adults (30.8%), while the frequency of ALL cases was higher in the children (86.2%). The respective one-year and five-year survival rates, were 94.4% and 49.5% in the adults, and 92.6% and 83% in the children. The hazard ratios (HR) were 5.18 (95% CI: 2.60-13) in the adults with ALL and 4.11 (95% CI: 1.55-10.4) in the adults with AML, and 2.78 (95% CI: 1.05-7.37) in the patients with CML. Based on the results of multivariate analysis, the rate of mortality in children with ALL was lower (HR=0.26, 95% CI: 0.08-0.77).
Conclusion: Timely diagnosis and provision of treatment services for the patients are recommended. Considering the high rate of survival in the patients with ALL especially in children, we recommend provision of appropriate treatment facilities and palliative care services, similar to those in other countries, for the patients with different types of leukemia with high rates of mortality.
Keywords: Survival rate, Related factors, Leukemia, Children, Adults, Kurdistan.
 
Received: Apr 26, 2017     Accepted: Feb 12, 2018 

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Background and Aim: Genital wart is the most common sexually transmitted infection and its role in cervical cancer has been confirmed. The aim of this study was to determine the presence of human papillomavirus (HPV) and the frequency of its genotypes in the patients with genital lesions referring to the clinics in Sanandaj, Iran.
Material and Method: This descriptive analytical study included 50 women with genital lesions referring to the clinics in Sanandaj City from February 2016 to February 2017. Biopsy samples were examined for four genotypes (HPV 16, 18 (high risk) and HPV 11, 6 (Low risk)) by PCR. Demographic information and risk factors were recorded in a questionnaire for every patient. Using spss v.20 software, data were analyzed by descriptive statistics. Fischer test was used to investigate the relationship between the risk factors and HPV infection.
Results: The results showed that 28 cases (56%) were HPV positive. Among the four genotypes of HPV, HPV 6 was the most frequent (32%), followed by the types of 18 (12%), 16 (6%) and 11 (2%). Co-infection of HPV-16 and 18 were found in 2 cases (7.1%).The mean age of the patients with HPV infection  was 34.07 ± 8.7 years and the mean age of the first sexual contact was 21.22 ± 4.8 years. No significant association was found between the risk factors and HPV infection (P> 0.05).
Conclusion: Considering the high prevalence of HPV infection and its asymptomatic course in many cases, early detection and treatment of the genital warts, especially HPV16 and 18, can lead to prevention of cervical cancer.
 

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Background and Aim:  Physicians’ knowledge and capabilities decrease over time; therefore, continuous medical education is important. Flipped class is a blended teaching method that inverts instructional cycle by delivering the educational content by innovative technology out-of-class.
 The aim of this study was to determine the effects of flipped class on satisfaction, active participation, and learning levels in general practitioners attending continuous medical education courses in the Kurdistan University of Medical Sciences in 2017.
Material and Methods: This interventional study included 120 general practitioners in Sanandaj who were attending the continuous medical education courses. They were randomly assigned to intervention (flipped class) and control (traditional class) groups. Data were collected by a researcher-made questionnaire in order to evaluate participant satisfaction, and a researcher made checklist for evaluation of active participation and a set of post-test questions for assessment of knowledge. The validity and reliability of the questionnaire and the checklist were assessed by using expert panels and measurement of Cronbach’s alpha respectively.Two weeks prior to the designated day, the intervention group started educational activities by finding answers to the questions. The control group did not receive any instruction until the designated day of the classes. On the designated day the control group listened to the lectures in traditional way. The educational content delivered to both groups was identical.
Results:  The results of the study showed that all the participants were satisfied with the continuous medical education classes.  However, the mean satisfaction level of the re-training period was significantly higher in the intervention group (P = 0.001). The mean post-test score in the intervention group (15.50 ± 2.25) was significantly higher than that in the control group (12.85 ± 2.18) (P = 0.0001). Also, the mean score of participation in the intervention group (9.01 ± 1.71) was significantly higher compared to that in the control group (7.60 ± 2.02) (P = 0.0001).
Conclusion: The results of this study showed that flipped classroom strategy was an effective way of continuous education programs for general practitioners. This approach not only improved the knowledge of physicians after continuous medical education programs, but also increased their satisfaction by increasing their active participation.

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Background and Aim: Safety is one of the important subjects in the pre-hospital settings. Determination and evaluation of safety attitudes of the emergency staff is the first step toward improving the safety of the staff and patients. In this study, we investigated safety attitudes and the factors affecting safety such as error and accident history, during mission, in the last year, in the staff of emergency medical services in Sanandaj.
Material and Methods: This was a cross-sectional descriptive study. We used census method. Study population included personnel of emergency medical services (72 people). We used a questionnaire for data collection. SPSS version 20 software was used for data analysis. Pearson correlation coefficient, Spearman correlation coefficient and chi-square test were used to determine the relationship between the variables and the safety attitudes.
Results: Based on the findings of this study, the safety attitudes of the emergency medical staff were significantly at a low level (mean: 3.11, p=±0/435). six dimensions of safety attitudes, including the cooperative atmosphere in the organization, safety climate in the organization, perceptual management, and job status had significant relationship with demographic characteristics. Job satisfaction criteria and stress recognition showed no significant relationship with demographic characteristics.
Conclusion: The results of this study showed that the safety attitudes of the emergency medical staff towards safety were significantly at a low level.Therefore education in order to improve the attitudes of the emergency medical staff is necessary. We recommend inclusion of safety attitudes conceot in educational programs for emergency medical staff.

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Background and Aim: Pulmonary thromboembolism is an important clinical problem in the patients after major surgeries and is often difficult to diagnose because of nonspecific clinical symptoms. Diagnosis of pulmonary embolism is based on medical imaging methods. The aim of this study was to evaluate the results of CT pulmonary angiographies of the patients with primary clinical diagnosis of pulmonary thromboembolism in Besat Hospital between 2014 and 2015.
Materials and Methods: This cross-sectional study included 160 patients with primary diagnosis of pulmonary embolism who had been referring to Besat Hospital from 2014 to 2015. Data were extracted from the patient’s `medical records and we used in a checklist for every patient for data collection. Using SPSS software, data were analyzed by descriptive statistics such as mean, median, standard deviation and ratio. Chi-square and t-test were used to find out the relationship between the variables.
Result: The results of this study showed that 56.3% of the subjects were female. The mean age of the participants was 45.49 ± 18.5 years, 25.65% were between 31 and 40 years of age and 29.4% had abnormal CT scan results indicative of a definite cause for pulmonary embolism. There was a statistically significant relationship between abnormal CT scan and the results of di-dimer test (p = 0.001). There was also a statistically significant relationship between gender and abnormal CT scan results, so that most patients with abnormal CT scan were male (p = 0.002). Mean age, blood pressure, di-dimer test, respiratory rate, and heart rate were higher in subjects with abnormal CT scan.
Conclusion: According to the findings of this study, male patients between 31 and 40 years of age with abnormal CT scans should be examined more closely in order to reduce the mortality rate of the patients.
 

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Background and Aim: Infection by drug resistant Pseudomonas aeruginosa causes important therapeutic problems. The present study was performed to investigate the antibiotic susceptibility and prevalence of antimicrobial resistance genes in P. aeruginosa.
Materials and Methods: In this cross sectional study, 61 clinical P. aeruginosa isolates were collected in Sanandaj between April and September 2017. Isolates were examined by disk diffusion method to determine susceptibility to 8 antibiotics and by polymerase chain reaction to detect the presence of extended-spectrum beta lactamase bla_CTX-M gene and plasmid-mediated quinolone resistance determinants, qnrA, qnrB, and qnrS. We also evaluated the effect of resistance to quinolones on cross resistance to other antibiotics. We used descriptive statistics for data analysis.
Results: Meropenem showed the highest susceptibility rate (88.5%), followed by piperacillin (85.2%), ceftazidime and amikacin (80.3%, each), imipenem (77%), cefepime (73.8%), ciprofloxacin (49.2%), and gentamicin (39.3%). Among 61 isolates, 32.8% showed multidrug resistance. Ciprofloxacin-resistant isolates had cross resistance to gentamicin (93.5%), cefepime (45.2%), ceftazidime and imipenem (38.7%, each), amikacin (35.5%), piperacillin (29%), and meropenem (22.6%). We detected qnrS in three isolates (4.9%). bla_CTX-M, qnrB and qnrA were not identified.
Conclusion: Our results suggested that ciprofloxacin may not be effective against P. aeruginosa. According to our knowledge, this is the first report of presence of qnr in P. aeruginosa from Kurdistan which highlights the need for continuous monitoring for prevention of the transmission of qnr.

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Background and Aim: In this experimental study, nicotine has been recognized to result in oxidative stress by inducing the generation of reactive oxygen species. The current research was designed to investigate the protective effect of rosmarinic acid, a radical scavenger and antioxidant, on Pro oxidant anti-oxidant balance of serum in nicotine treated mice.
Materials and Methods: Thirty-six mature male NMRI mice were divided into 6groups: (two controls, two nicotine-treated [0.5 mg/kg], and two nicotine plus rosmarinic acid [10 mg/kg]) were used in this study and treated for 15 and 30days respectively. The standard protocol was used to measure pro-oxidant-antioxidant balance, superoxide dismutase, and serum Catalase.
Results: As compared to control group (90±3.03315 HK), the 15-day results, in nicotine-treated group (100±5.17687 HK) there was a significant increase in the serum PAB ratio. Similarly, for samples of the day 30, there was a significant increase in the serum PAB ratio of nicotine-treated group (106±3.52136 HK) versus control group (87±1.32916 HK) (P≤0.05). SOD of 15(1.21±1.12) and 30 days (1.89±0.26) treated groups, showed significant decreased versus control groups (2.90±0.09), (2.82±0.08) respectively (P≤0.05).  
Catalase of 15(12.13±2.30) and 30 days (11.57±1.42) treated groups, showed significant decreased versus control groups (25.12±2.21), (24.1±1.29) respectively (P≤0.05).
Conclusion: These results indicate that rosmarinic acid improves the level of antioxidant enzymes and modifies pro-oxidant-antioxidant imbalance

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Background and Aim: Dexamethasone affects testis hemostasis through reduction of  testosterone level . In one study dexamethasone induced spermatogenesis defects through epithelial vacuolizations and sloughing of germ cell layer.
Material and Methods: Forty NMRI mice were randomly divided into four groups. Control and dexamethasone groups received normal saline and dexamethasone (5 mg/kg) respectively for 7 days. Dexamethasone and Nigella sativa(NS) (5 mg/kg) were given to the third group and the fourth group(Nigella sativa group) received 5 mg/kg  Nigella sativa for 7 days. Epididymal sperm parameters were used for evaluation of the effects of dexamethasone and Nigella sativa on testis.  
Results: Epididymal sperm parameters) count,motility and abnormal sperm) showed significant alterations in dexamethasone group (p<0.05). Treatment with NS+ dexamethasone significantly prevented these changes (p<0.05).
Conclusion:Numerous studies have been performed to evaluate destructive effects of dexamethasone on  male reproductive system. The aim of this study was to assess protective effect of Nigella sativa against the side effects of dexamethasone on male reproductive system. We found that dexamethasone could decrease sperm parameters. These changes were reduced by using Nigella sativa.