Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 533 539 EN Mohammad Azimi Alamouti Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Bakhtiyari Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Moradi Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Tahmineh Mokhtari Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Azim Hedayatpour Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fariba Zafari Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mohammad Barbarestani Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Multiple Sclerosis (MS) causes loss of the myelin sheath, which leads to loss of neurons. Regeneration of myelin sheath stimulates axon regeneration and neurons’ survival. In this study, olfactory ensheathing cell (OEC) transplantation is investigated to restore myelin sheath in an experimental model of MS in male mice.OECs were isolated from the olfactory mucosa of seven-day-old infant rats and cultured. Then, cells were evaluated and approved by flow cytometry by p75 and GFAP markers. A total of 32 mice (C57BL /6) were studied in four groups; 1) without any treatment (control), 2) Sham (receiving PBS), 3) MS model and 4) MS and OEC transplantation. MS was induced by adding Cuprizon in the diet of animals for six weeks. After the expiration of 20 days, histologic analysis was performed with approval of the presence of cells in the graft area and the removal of myelin and myelin regeneration with two types of luxal fast blue (LFB) staining and immunohistochemistry. The purity of the cells ensheathing the olfactory was 90%.  There was a significant difference in Myelin percentage of PBS and OEC recipient groups (P≤0.05). MBP and PLP of the myelin sheath in the group receiving OECs were more than MS group.According to the findings, in MS model MBP and PLP of the myelin sheath is reduced. In the group receiving OECs, it was returned to a normal level significantly compared to the sham group received only PBS significant differences were observed. The OECs transplantation can improve myelin restoration. https://acta.tums.ac.ir/index.php/acta/article/view/4288 https://acta.tums.ac.ir/index.php/acta/article/download/4288/4243

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 523 532 EN Mansoureh Shayeghi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Jalil Nejati Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Leila Shirani-Bidabadi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mona Koosha Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Badakhshan Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mulood Mohammadi Bavani Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Kourosh Arzamani Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Nayyereh Choubdar Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Bagheri Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abedin Saghafipour Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran. Arshad Veysi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fateh Karimian Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Amir Ahamd Akhavan Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hassan Vatandoost Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Insects with over 30,000 aquatic species are known as very successful arthropods in freshwater habitats. Some of them are applied as biological indicators for water quality control, as well as the main food supply for fishes and amphibians. The faunistic studies are the basic step in entomological researches; the current study was carried out emphasizing on the fauna of aquatic insects in Karaj River, northern Iran. A field study was carried out in six various sampling site of Karaj River during spring 2013. The aquatic insects were collected using several methods such as D-frame nets, dipping and direct search on river floor stones. Specimens were collected and preserved in Ethanol and identified by standard identification keys. Totally, 211 samples were collected belonging to three orders; Plecoptera, Trichoptera and Ephemeroptera. Seven genuses (Perla, Isoperla, Hydropsyche, Cheumatopsyche, Baetis, Heptagenia and Maccafferium) from five families (Perlidae, Perlodidae, Hydropsychidae, Batidae, Heptagenidae) were identified. The most predominant order was Plecoptera followed by Trichoptera. Karaj River is a main and important river, which provides almost all of water of Karaj dam. So, identification of aquatic species which exist in this river is vital and further studies about systematic and ecological investigations should be performed. Also, monitoring of aquatic biota by trained health personnel can be a critical step to describe water quality in this river. Understanding the fauna of aquatic insects will provide a clue for possible biological control of medically important aquatic insects such as Anopheles as the malaria vectors. https://acta.tums.ac.ir/index.php/acta/article/view/4293 https://acta.tums.ac.ir/index.php/acta/article/download/4293/4248

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 585 589 EN Feridoun Sabzi Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Donya Khosravi Department of Gynecology and Obstetrics, Preventive Gynecology Research center, Imam Hussein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. 2015 10 06 2015 10 06 Hemolytic anemia is exceedingly rare and an underestimated complication after aortic valve replacement (AVR).The mechanism responsible for hemolysis most commonly involves a regurgitated flow or jet that related to paravalvar leak or turbulence of subvalvar stenosis. It appears to be independent of its severity as assessed by echocardiography. We present a case of a 24-year-old man with a history of AVR in 10 year ago that developed severe hemolytic anemia due to a mild subvalvar stenosis caused by pannus formation and mild hypertrophic septum. After exclusion of other causes of hemolytic anemia and the lack of clinical and laboratory improvement, the patient underwent redo valve surgery with pannus and subvalvar hypertrophic septum resection. Anemia and heart failure symptoms gradually resolved after surgery. https://acta.tums.ac.ir/index.php/acta/article/view/4299 https://acta.tums.ac.ir/index.php/acta/article/download/4299/4254

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 11 593 593 EN Alireza Ghanadan Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kambiz Kamyab Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mazaher Ramezani Department of Pathology, Kermanshah University of Medical Sciences, Kermanshah, Iran. Azadeh Goodarzi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maryam Daneshpazhooh Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kamran Balighi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ansari Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Farzad Mirfallah Nassiri Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soroush Daklan Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 https://acta.tums.ac.ir/index.php/acta/article/view/4323 https://acta.tums.ac.ir/index.php/acta/article/download/4323/4257

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 540 546 EN Bagher Larijani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran Iran. Hamidreza Aghayan cGMP Grade Stem Cell Facility, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Parisa Goodarzi School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Fereshteh Mohamadi-Jahani Department of Biology, Payame Noor University, Tehran, Iran. Abbas Norouzi-Javidan Brain and Spinal Cord Injury Research Center, Cellular Fanavaran Knowledge-Based Organization, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Khadijeh Fallahzadeh cGMP Grade Stem Cell Facility, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Forough Azam Sayahpour Department of Molecular Systems Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Kazem Bidaki Department of Biology, Payame Noor University, Tehran, Iran. Babak Arjmand Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 In this study, our aim was to produce a generation of GMP-grade adipose tissue-derived mesenchymal stem cells for clinical applications. According to our results, we fulfill to establish consistent and also reproducible current good manufacturing practice (cGMP) compliant adipose tissue-derived mesenchymal stem cells from five female donors. The isolated cells were cultured in DMEM supplemented with 10% fetal bovine serum and characterized by standard methods. Moreover, karyotyping was performed to evaluate chromosomal stability. Mean of donors’ age was 47.6 ± 8.29 year, mean of cell viability was 95.6 ± 1.51%, and cell count was between 9×106 and 14×106 per microliter with the mean of 12.2×106 ± 2863564.21 per microliter. The main aim of this project was demonstrating the feasibility of cGMP-compliant and clinical grade adipose tissue-derived mesenchymal stem cells preparation and banking for clinical cell transplantation trials. https://acta.tums.ac.ir/index.php/acta/article/view/4290 https://acta.tums.ac.ir/index.php/acta/article/download/4290/4244

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 590 592 EN Nima Hosseinzadeh School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mihan Jafari Javid Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Takzare Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 Reinforced tubes are commonly used to minimize the opportunity of upper airway obstruction in patients at risk. There are a few reports of the airway obstruction resulted from kinked reinforced tubes. This report describes the obstruction of a reinforced tube in an adult patient who underwent tonsillectomy. Under general anesthesia; an armoured endotracheal tube was inserted into the trachea uneventfully. A few minutes after starting the surgery, the anesthesia machine detected a high airway pressure and an increased ETCO2 (end-tidal CO2) up to 50 mmHg.  Further evaluation showed spiral wire damage resulted from Mouth Gag device that led to airway obstruction. Early anticipation of the complications leads to proper management of such critical and life threatening complications and prevention of hypoxia, hypercapnia, pneumothorax, and pulmonary edema. Based on our experience using an armoured endotracheal tube in tonsillectomy does not guarantee a safe airway and intensive monitoring is necessary. https://acta.tums.ac.ir/index.php/acta/article/view/4300 https://acta.tums.ac.ir/index.php/acta/article/download/4300/4255

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 547 554 EN Reza Heidari School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Rafieh Alizadeh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Niloufar Abbasi School of Medicine, Tehran Medical Branch, Islamic Azad University, Tehran, Iran. Parichehr Pasbakhsh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Azim Hedayatpour Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Farajpour School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Khaleghi School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Abbasi Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Varicocele is one of the most common causes of primary male infertility. Pilea microphylla (PM) is being used as folk medicine. This study was aimed to investigate the effects of PM in a rat model of varicocele. A total of 30 male Wistar rats were divided into control, sham, varicocele, accessory varicocele and PM-treated groups. After 10 weeks of varicocele induction, sperm parameters and chromatin (Aniline blue, acridine orange and toluidine blue) were evaluated, except for the treated and accessory groups that received 50 mg/kg PM orally daily for 10 weeks and then were sacrificed. Sperm parameters significantly decreased in varicocele groups (P < 0.01).  Moreover, there was a negative correlation between the DNA fragmentation and sperm parameters in varicocelized rats. Administration of PM led to significantly increased sperm parameters and AO staining (P < 0.05). These findings suggest that PM improves sperm parameters and DNA fragmentation in varicocelized rats. PM can reduce the damage to sperm DNA but not chromatin condensation. https://acta.tums.ac.ir/index.php/acta/article/view/4291 https://acta.tums.ac.ir/index.php/acta/article/download/4291/4245

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 555 561 EN Kaveh Khazaeel Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran. Yazdan Mazaheri Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran. Mahmood Hashemi Tabar Cellular and Molecular Research Center, Jundi-Shapour University of Medical Sciences, Ahvaz, Iran. Hossein Najafzadeh Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran. Hassan Morovvati Department of Basic Sciences, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran. Alireza Ghadrdan Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University, Ahvaz, Iran. 2015 10 06 2015 10 06 Enrofloxacin is a synthetic chemotherapeutic agent from the class of the fluoroquinolones that is widely used to treat bacterial infections. It is metabolized to ciprofloxacin in the body as active metabolite. Fluoroquinolones change in the articular cartilage, especially with high doses and more than two weeks use. So, due to relatively excessive use of enrofloxacin in mammals and similarity of lambs to human subjects with respect to skeletal activity cycles, this study was done to investigate the effects of enrofloxacin on some cellular and molecular changes in growing lamb articular cartilage to evaluate some possible mechanisms involved these changes. Twelve, 2-month-old male lambs divided into three groups: control group received only normal saline; therapeutic group received 5mg/kg enrofloxacin subcutaneously, daily, for 15 days and toxic group received 35 mg/kg enrofloxacin in the same manner as therapeutic group. Twenty four hours after the last dose, the animals were sacrificed, and their stifle joints were dissected. Sampling from distal femoral and proximal tibial extremities was done quickly for further histological and molecular studies. Collagen-п content was studied with avidin-biotin immunohistochemistry method in different groups. Expression of Sox9 and caspase-3 was evaluated by Real–time PCR. Immunohistochemical changes were included decreases of matrix proteoglycans, carbohydrates, and Collagen-п in the toxic group. Some of these changes were observed in the therapeutic group with less intensity in comparison to the toxic group. Enrofloxacin were significantly decreased (P≤0.05). Sox9 expression in therapeutic and toxic groups compared to control group. But caspase -3 expressions in the toxic group significantly increased (P≤0.0001) with a comparison to other groups, while, between control and therapeutic groups, there were no significant differences. So, it can be concluded that enrofloxacin increases apoptosis in chondrocytes and decreases their numbers. Enrofloxacin use in growing lambs even at recommended therapeutic dose is not completely safe on articular cartilage. Moreover, higher doses of enrofloxacin induce severe changes in lamb articular cartilage. https://acta.tums.ac.ir/index.php/acta/article/view/4292 https://acta.tums.ac.ir/index.php/acta/article/download/4292/4246

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 562 567 EN Atabak Najafi Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Khodadadian Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Sanatkar Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Reza Shariat Moharari Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farhad Etezadi Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Arezoo Ahmadi Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Farsad Imani Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Khajavi Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 The empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. The aim of the present study was to evaluate the effect of procalcitonin (PCT) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (ICU) with systemic inflammatory response syndrome (SIRS).  A total of 60 patients were enrolled in this study and randomly divided into two groups, cases that underwent antibiotic treatment based on serum level of PCT as PCT group (n=30) and patients who undergoing antibiotic empiric therapy as control group (n=30). Our primary endpoint was the use of antibiotic treatment. Additional endpoints were changed in clinical status and early mortality. Antibiotics use was lower in PCT group compared to control group (P=0.03). Current data showed that difference in SOFA score from the first day to the second day after admitting patients in ICU did not significantly differ (P=0.88). Patients in PCT group had a significantly shorter median ICU stay, four days versus six days (P=0.01). However, hospital stay was not statistically significant different between two groups, 20 days versus 22 days (P=0.23).  Early mortality was similar between two groups. PCT guidance administers antibiotics reduce antibiotics exposure and length of ICU stay, and we found no differences in clinical outcomes and early mortality rates between the two studied groups. https://acta.tums.ac.ir/index.php/acta/article/view/4294 https://acta.tums.ac.ir/index.php/acta/article/download/4294/4249

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 568 572 EN Fatemeh Laloha Department of Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Negin Asiabar Department of Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Ameneh Barikani Department of Community Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Farideh Movahed Department of Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Ezzatossadat Haj Seyed javadi Department of Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. 2015 10 06 2015 10 06 The use of corticosteroids is one of the methods put forward for the strengthening and speeding up the process of labor. After identification of glucocorticoid receptors in human amnion, the role of corticosteroids in starting the process of labor has been studied in numerous studies.The purpose of this study was to determine the effect of intravenous Dexamethasone on preparing the cervix and on labor induction. A randomized, clinical, and double – blind trial was conducted on 172 women divided into a control and an experimental group. The inclusion criteria were that they had to be primparous, in or before the 40 the week of pregnancy, and with Bishop scores (B.S.s) of 4 or lower. The exclusion criteria were diabetes, preeclampsia, macrosomia, twin pregnancy, rupture of the membrane (ROM), breech, and women suffering from background diseases. The B.S.s of the women was measured in charge of the study, and each woman was intravenously injected with eight milligrams of Dexamethasone or eight milligrams of distilled water. Four hours after the injections, the B.S.s of the participants was measured, and they were put under the conditions of labor induction using oxytocin. Information was collected in checklists A and B. The patients were compared with respect to B.S., the time the induction started, the average interval between the start of induction and the beginning of the active phase of childbirth, and the average length of time between the start of the active phase and the second stage of childbirth.The first and five minutes Apgar scores of the two groups of women were compared. The frequencies, the means, and the standard deviations were calculated using the SPSS – 16 software, and analysis of the results was performed with the Student’s t- test and the chi-square test with P<0.05. There were no statistically significant differences between the two groups in terms of their age, period of pregnancy, and B.S. at the start of the study. The average B.S. of women four hours after the injections with Dexamethasone was 5.9 ± 1.57, and the corresponding figure for women in the control group was 4.6 ± 1.72. These figures were significantly different at P<0.001. The average interval between labor induction and the start of the active phase in the, group injected with Dexamethasone was significantly less than that of the control group (2.87±0.93 versus 3.80± 0.93 at P<0.001). The average duration of the active phase of the second stage of childbirth was 3.47±1.10 hours in the experimental group and 3.6 ± 0.99 hours in the control group at P<0.49. These two figures were not significantly different. The Apgar scores of the first and fifth minutes after the birth of the children of the two groups of women were not significantly different. It was found that intravenous Dexamethasone improves the Bishop score of the cervix and thus causes softening of the cervix and reduces the length of time between labor induction and the start of the active phase of childbirth.     https://acta.tums.ac.ir/index.php/acta/article/view/4295 https://acta.tums.ac.ir/index.php/acta/article/download/4295/4250

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 573 578 EN Ramin Mehrdad Department of Occupational Medicine, Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Khosro Sadeghniiat Haghighi Department of Occupational Medicine, Occupational Sleep Research Center (OSRC), Tehran University of Medical Sciences, Tehran, Iran. Amir Hossein Naseri Esfahani Department of Occupational Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 2015 10 06 2015 10 06 Professional firefighting is among the most demanding jobs. Prior studies have showed the notable prevalence of poor sleep quality among professional firefighters that may result in catastrophes. The aim of this study was in field confirmation of zolpidem usage (10 mg/PO/bed time) for short term management of poor sleeps quality among professional firefighters. In a double-blind, randomized, placebo-controlled crossover clinical trial among professional firefighters, 27 poor sleepers were assigned randomly to one of the two groups. Two 14 days experimental periods were separated by a 14-day washout phase. Sleep quality was assessed using the Persian version of Pittsburgh Sleep Quality Index (PSQI). Six of the 27 enrolled voluntaries dropped out. Two rare side effects of zolpidem occurred in the study. A significant improvement of the PSQI score was detected in zolpidem period versus placebo in both groups (7.14 ± 3.02 vs 12.38 ± 2.51, PP=0.89). Zolpidem significantly improved all components of PSQI (Subjective sleep quality, Sleep latency, Sleep duration, Habitual sleep efficiency, Sleep disturbances and Daytime dysfunction) in the current study except the use of sleep medication. Sleep onset latency was the component of PSQI with the greatest degree of abnormality among firefighters in a previous study. Interestingly, sleep latency was the component of PSQI with the most treatment effect of zolpidem in the current study. Zolpidem can be used as a part of treatment regimens in short time management of poor sleep quality among professional firefighters. https://acta.tums.ac.ir/index.php/acta/article/view/4296 https://acta.tums.ac.ir/index.php/acta/article/download/4296/4251

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 579 581 EN Zarrin Keihani Douste Department of Pediatric Neurology, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran. Mohhamad Taghi Haghi Ashtiani Department of Pathology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mamak Shariat Family Health Institute, Maternal Fetal Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Tehrani Family Health Institute, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Convulsion is one of the most common problems in children and hypocalcemia is one the most frequent etiological items in children’s convulsion. Corrected QT (QTc) in EKG is prolonged in hypocalcemia, so it can be a useful tool for evaluation of serum ionized calcium. In three groups (first seizure, multiple seizures, without seizure or control ) every 25 cases, QTc, serum ionized ca, total ca, ABG, and serum albumin level have been checked in the Department of Pediatrics of Imam Khomeini Hospital and outpatient department of Ahari children’s medical center in 2008. Prolonged QTc was observed in 72% of convulsive children (36 cases) but only 19% of non-convulsive children (5 cases) showed this pattern.  Ionized calcium was significantly higher in non-convulsive than convulsive groups.  There was no correlation between prolonged QTc and total serum calcium; however, this correlation with low ionized calcium was significant. QTc is an easy and rapid method for serum ionized calcium evaluation. https://acta.tums.ac.ir/index.php/acta/article/view/4297 https://acta.tums.ac.ir/index.php/acta/article/download/4297/4252

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 582 584 EN Shahla Afsharpaiman Department of Pediatrics, Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Ali Bagheri Hagh Department of ENT, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mohammad Kolbadi Nejad Department of Medicine, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. Susan Amirsalari New Hearing Technologies Research Center, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mohammad Torkaman Department of Pediatrics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Sleep problems are common in childhood, but there are limited studies regarding that in Iranian children and awareness of the sleep problems and their complication in Iranian parents. We arranged this study in which parents of children attending for a sick visit or routine growth control to assess whether sleep problems are under-reported at general pediatric visits. In a cross - a sectional study from April 2010 to April 2011 in 301 children aged 2-14 years old attending to pediatric clinics were enrolled. To investigate the general orientation of parents about their child sleep problem we asked them a global question at first regarding sleep of their child. After that, the Persian version of BEARS questionnaire was completed by them. Only 30 (9.9%) parents reported sleep problems in their children in response to primary global question but by collecting the data from BEARS questionnaire it was revealed 45.18% (136/301) of children had one or more of sleep disorders at all. As mentioned 136 (45.18%) children had slept problems of which the most frequent complaint (15.28%) was related to bedtime problems. The second complaint (11.96%) was awakening during the night children. A significant association between sleep problems and child gender was not found. Co-sleeping with parents was found in 55.48% of all children in this study. Despite the high prevalence and adverse effects of sleep disorders, the present study suggests that parents underreport sleep problems at consultation. We suggest children should be assessed for sleep disorders in monitoring and health screening visits. https://acta.tums.ac.ir/index.php/acta/article/view/4298 https://acta.tums.ac.ir/index.php/acta/article/download/4298/4253