Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 218 219 EN Mojtaba Kamali Aghdam Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Kambiz Davari Department of Pediatric, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. Kambiz Eftekhari Department of Pediatric, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 08 2016 01 09 Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas. https://acta.tums.ac.ir/index.php/acta/article/view/5251 https://acta.tums.ac.ir/index.php/acta/article/download/5251/4769

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 165 172 EN Mahshid Attari Department of Biology, Islamic Azad University, Qom Branch, Qom, Iran. AND Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Jamaloo Department of Biology, Islamic Azad University, Qom Branch, Qom, Iran. Sahar Shadvar Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Nahid Fakhraei Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Withania somnifera (WS) possess anti-inflammatory and antioxidant properties. WS preparations have a potential therapeutic role in the central nervous system (CNS) related disorders in animal models. In this study, the possible protective effect of acute aqueous WS root extract on behavioral despair was explored and compared with fluoxetine, an antidepressant with selective serotonin (5-HT) reuptake inhibitor activity (SSRI). Further, the probable involvement of nitric oxide (NO) determined to measure immobility time in forced swimming test (FST) and tail suspension test (TST) in male mice. Immediately after assessment of locomotor activity, the immobility time was evaluated. WS was administered intraperitoneally (200, 400 mg/kg; i.p.) 60 min before the behavioral tests. To assess the involvement of NO in the possible protective effect of WS, a non-specific NO synthase inhibitor, NG-L-arginine methyl ester (L-NAME, 10 mg/kg, i.p.) was administered 30 min before the extract administration (400 mg/kg, i.p.), 90 min before the tests. Acute WS extract (200, 400 mg/kg, i.p.) dose-dependently decreased the immobility time in FST, P<0.05, P<0.001, respectively and 400 mg/kg proved the most effective dose and this dose was comparable to fluoxetine (20 mg/kg, i.p. WS (400 mg/kg, i.p.) also lowered the immobility measure in TST (P<0.05). However, these effects were not related to change in locomotor activity. Moreover, L-NAME (10 mg/kg, i.p.) did not influence the effect of the extract on the behavioral tests. As a consequence, the immobility time was virtually constant between the group received the extract (400 mg/kg) alone, and the group received L-NAME (10 mg/kg) before the extract. It is probable that NO does not mediate this beneficial effect, and WS may affect other neurochemical systems and pathways. https://acta.tums.ac.ir/index.php/acta/article/view/5549 https://acta.tums.ac.ir/index.php/acta/article/download/5549/4761

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 220 221 EN Farzaneh Motamed Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Gholamhossein Fallahi Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Faezeh Ahmadi Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Bazvand Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Maedeh Ahmadi Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Kambiz Eftekhari Department of Pediatric Gastroenterology, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nima Rezaei Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Immunology, School of Medicine, Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Universal Scientific Education and Research Network (USERN), Tehran, Iran. 2015 12 15 2016 03 04 Cystic fibrosis (CF) is a hereditary disease of mucous and sweat glands, which affects the respiratory and gastrointestinal systems. Herein, we describe a 3-month-old girl with a history of recurrent episodes of urinary tract infections that required hospitalization. She was referred to our center at the age of three months, with massive gastroesophageal variceal bleeding. In physical examination, she had clubbing, hepatosplenomegaly, and mild ascites. Laboratory studies revealed high serum levels of liver enzymes and low level of Albumin. As of suspicious to CF, sweat tests were performed twice which confirmed the diagnosis of CF. Gastrointestinal bleeding due to gastroesophageal varices is a rare complication of CF, which could result as a consequence of hepatobiliary involvement of disease. Early diagnosis of CF could prevent severe complications and even death in this group of patients. https://acta.tums.ac.ir/index.php/acta/article/view/5269 https://acta.tums.ac.ir/index.php/acta/article/download/5269/4770

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 173 175 EN Alborz Salavati Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Abdolrasoul Mehrsai Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farzad Allameh Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farimah Alizadeh Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Farshad Namdari Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Hosseinian Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Elaheh Salimi Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fariba Heidari Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Gholam Reza Pourmand Department of Urology, Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Coronary artery disease (CAD) and vascular insufficiency are consequences of modern lifestyle, and vasogenic erectile dysfunction (ED) is one of the leading causes of sexual dysfunction which could be prevented like ischemic heart disease if the risk factors are discovered and managed. Seventy-five men scheduled for coronary angiography were asked to fill out the IIEF5 questionnaire and underwent serum lipoprotein-a, uric acid, lipid profile, testosterone, Sex Hormone Binding Globulin (SHBG), dehyderoepiandrostendion sulfate (DHEAS) tests; and the results were compared with those of erectile dysfunction patients with and without coronary artery disease. Ten out of 32 CAD patients (30%) and 6 of 43 normal coronary men had ED Prevalence (P=0.04). The average serum uric acid in ED patients with normal coronary was 5.6 (± 0.68) 6.5 ±078 mg/dl in ED patients of CAD group P=0.034. Men with both ED and CAD had significantly higher levels of lipoprotein-a compared to those CAD patients with normal sexual function. Higher uric acid and lipoprotein-a levels are correlated with the presence of ED in patients with CAD. https://acta.tums.ac.ir/index.php/acta/article/view/5550 https://acta.tums.ac.ir/index.php/acta/article/download/5550/4762

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 222 225 EN Marino Marčić Department of Neurology, University Hospital Split, Split, Croatia. Ljiljana Marčić Department of Radiology, University Hospital Split, Split, Croatia. Krešimir Kolić Department of Radiology, University Hospital Split, Split, Croatia. Marina Titilić Department of Neurology, University Hospital Split, Split, Croatia. 2015 11 30 2016 04 03 We presented the case of a patient with internal watershed infarction with a nonspecific clinical presentation including hemiplegia, hemisensory deficit, and speech disturbance. Neuroimaging and ultrasound diagnostic procedure are important tools for diagnosis of these rare ischemic events that count for about 6% of all strokes.  Specific therapy is mandatory for the diagnosis of watershed infarction and different from the therapeutical measures than can be taken for embolic and atherothrombotic strokes. Our patient was a 69-year-old, right-handed Caucasian woman who presented to our facility with acute right side weakness and speech disturbance. He had hypothyroidism, permanent atrial fibrillation, diabetes mellitus and she was hypotensive. She reported dizziness few days before the accident. Imaging studies revealed internal watershed infarction. Therapeutic procedures were taken to restore low cerebral blood flow. Internal watershed infarction is rare (less than 10% of all strokes) but well recognized a clinical feature of stroke. Specific pathophysiology generally is connected with hypoperfusion and hemodynamic mechanisms. Specific therapy is mandatory for these conditions. https://acta.tums.ac.ir/index.php/acta/article/view/5225 https://acta.tums.ac.ir/index.php/acta/article/download/5225/4771

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 176 184 EN Mohammad Reza Abassi Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Amin Safavi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Masoumeh Haghverdi Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Babak Saedi Department of Otolaryngology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Kidney failure affects different aspects of normal life. Among different manifestations, sleep problem can be considered as a common complaint of ESRD (End Stage Renal Disease) patients. In this study, we aimed to investigate the interrelationship between sleep disorders in ESRD patients and their characteristics. Through a cross-sectional study (2010-2011), 88 ESRD patients undergoing maintenance hemodialysis thrice weekly were recruited to enter the study. We used a self-administered questionnaire into which the data were reflected. The patients selected their specific sleep disorders using a nine-item scale while the Epworth Sleepiness Scale (ESS) determined both the presence and severity of sleep disorders. The data was finally analyzed with their baseline characteristics, dialysis characteristics, medication/stimulants use, and clinical and biochemical parameters. Over 95% of the patients had, at least, one specific sleep disorder while the ESS revealed 36.36% of patients as normal, 59.09% as having mild sleep disorders, and 4.54% as having moderate to severe sleep disorders. Sleep disorders were significantly correlated with older ages (P=0.035), dialysis dose (P=0.001), blood creatinine levels (P=0.037), upper airways obstruction (P=0.035), hepatomegaly (P=0.006), hepatic failure (P=0.001), higher blood TSH levels (P=0.039), history of hypothyroidism (P=0.005), and the use of levodopa (P=0.004), anti-hypertensive medications (P=0.006), benzodiazepines (P=0.006), Eprex (Erythropoietin) (P=0.001), Venofer (Iron Sucrose Injection) (P=0.013), and phosphate-binders agents (P=0.018). Sleep disorders are common findings among ESRD patients and seem to be a more complicated issue than a simple accumulation of the wastes products in the body. Whatever the causes of sleep disorders are, disorder-specific treatments should be considered. https://acta.tums.ac.ir/index.php/acta/article/view/5551 https://acta.tums.ac.ir/index.php/acta/article/download/5551/4763

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 185 190 EN Laleh Eslamian Department of Obstetrics & Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 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.tum