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ABSTRACT Background and Aim: Transdermal fentanyl can be used for treatment of chronic pain and postoperative pain. The aim of this study was to compare the effect of transdermal fentanyl with that of IV morphine on post thoracotomy pain and their complications. Material and Methods: 40 patients ASA I, II who had been selected randomly for thoracotomy, was divided into two similar groups. After operation, morphine 0.1mg/kg was administered IV Q6h for morphine group in ICU and in fentanyl group fentanyl patch 50 μg/h was administered 2 hours before operation. Also in both groups morphine 0.1mg/kg was infused PRN. SPSS13 was used for data analysis & P<0.05 was considered significant. Results: Demographic parameters such as age, sex, weight and smoking were similar in two groups. Decrease of blood pressure was more in morphine group but it was not significant & increase of heart rate was more common in fentanyl group (p<0.01). Pain relief was more in fentanyl group (3.2 vs 4.6 score based on VAS). Morphine consumption in M group was three times more than that of fentanyl group (71±3.16 vs 22.5±9.79). Conclusion: Transdermal fentanyl was more effective than IV morphine for controlling post thoracotomy pain and respiratory changes were similar in both groups. Hypotension in morphine group was more common than that of fentanyl group but tachycardia was more prevalent in fentanyl group. Key word: Thoracotomy, Postoperative pain, Transdermal fentanyl, intravenous morphine Conflict of Interest: Nill Received: Dec 21, 2009 Accepted: March 13, 2010

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Background and Aim: Considering the increasing significance of diseases due to NTM all over the world, we investigated the burden of such diseases in our region. The aim of this study was to assess NTM prevalence from different clinical samples during a period of 8 years in Massih Daneshvari Hospital, in Iran. Material and method: This descriptive study was performed on 8322 samples obtained from pulmonary TB patients in Mycobacteriology Research Center from 2004 -2012. Using Tb1 and Tb2 primers, a 190 bp fragment of IS6110 gene was amplified in order to identify Mycobacterium species. Specimens with negative IS6110 PCR results were analyzed with PCR-RFLP using hsp65 gene, for NTM investigation. Results: Out of 8322 samples, we identified 124 (1.5%) strains of NTM. The mean age of the patients was 57 ± 18/9 years (age range: 7 - 88 years). 55/6 % of the patients were male. The most common species detected in our study were Mycobacterium simiae (44.3%), Mycobacterium chelonae (16.9%) and Mycobacterium kansasii (12.9%). Conclusion: We found a high prevalence rate of Mycobacterium simiae among our patients. Treatment protocols for NTM are different from the protocols for Mycobacterium tuberculosis complex, so early diagnosis of these species will be of great importance. Key words: NTM, Non tuberculous mycobacteria, hsp65 Received: Jan 22, 2013 Accepted: Feb 2, 2014

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Background and aims: Today, waste management is one of the important pillars of resource management in hospitals. The purpose of this study was to identify the effective factors in the management of special medical wastes at the source of their production, to analyze these factors, and to determine the most effective ones to improve the quality of management of such wastes.
Materials and Methods: In this research, the basics and dynamic components of systems were used to investigate the performance of hospital waste management in this field. For this purpose, the main indicators of the organization's performance were extracted from the research literature. Then, using the concepts of system dynamics, the effect of these factors was shown in the form of cause and effect diagrams. To explain the function of the proposed model, research variables were examined in the form of different scenarios to determine the effectiveness of each in different conditions.
Results: According to the presented flow diagram and the proposed scenarios, it was found that by using the optimal scenario, the various variables of the research, such as decontamination rate, collection, and unauthorized entry into urban waste reservoirs, through the explained relationships of the model in it improves about 15 to 40 percent.
Conclusion: The results obtained in this research ultimately lead to the reduction of environmental risks as well as the reduction of hazardous waste production, which can be a basis for explaining waste management strategies in medical centers.