---

ABSTRACT Introduction & Objective: There are many noninvasive methods to measure systolic blood pressure. A new noninvasive method by pulse oximetery has recently been reported. The purpose of this study was the comparison of systolic blood pressure measurement by pulse oximetery and with auscultatory method. Material & Methods: Systolic blood pressure measurement using pulse oximeter was compared with current auscultatory method. Thirty one healthy volunteers enrolled and were positioned in supine, prone and lithotomy for three 10 minutes periods. Blood pressure was measured at the end of each position by two methods. Results: There was a significant correlation between two method in all positions supine (r= 0.72), prone (r= 0.88) and lithotomy (r= 0.78). Conclusion: Pulse oximeter seems to be a useful non-invasive method of systolic blood pressure measurement. In order to increase the accuracy of this method, low speed of cuff inflation and deflation is strongly recommended.

---

ABSTRACT: Introduction & Objective: Positioning is an important part of perioperative care that optimal respiratory function is a main purpose. Thus oxygen saturation measurement in routine surgical positions could be a proper index of respiratory function. Material & Methods: To determine effects of supine , prone and litatomy positions on arterial oxygen saturation , 31 healthy volunteer were positioned in each three position for ten minutes periods . oxygen saturation was measured by pulse oximeter. Results: there was no significant difference between 3 position in oxygen saturation Conclusion: Absent of prone and lithotomy positions effect on oxygenation in this study may be attributed to the short time that the subjects were in each position (ten minutes). we suggest that evaluation of position effect on oxygenation require further investigation

---

Introduction & Objective: In some medical situations administration of muscle relaxants after intravenous anesthetics for tracheal intubation may be unnecessary or sometimes could be hazardous. In such situations, replacing an alternative drug for the facilitation of tracheal intubation is obvious. Remifentanil is a short acting opioid drug which may be useful in solving this problem. The aim of this study was to compare the effects of propofol or thiopental in combination with remifentanil in the absence of muscle relaxants on larengoscopy and intubation conditions in general anesthesia. Materials & Methods: This is a randomized double-blind clinical trial which was performed in 1386 in Be’sat hospital of Sanandaj. Forty two ASA 1 and 2 patients recruited to receive propofol, 2 Mg/Kg, or thiopental, 5Mg/K. All patients received lidocaine, 1.5 Mg/Kg, and remifentanil, 2.5 µg/Kg, 30 seconds before anesthetics administration. larengoscopy and tracheal intubation were done 90 seconds after induction of anesthesia. On the basis of mask ventilation, jaw relaxation, vocal cords position and patient's response to intubations and endotracheal tube cuff inflation the intubation conditions were assessed and recorded as excellent, good ,acceptable or poor. The mean arterial pressure and heart rate were measured before and after anesthetics administration and also 45 seconds and two and five minutes after intubations. Data were analyzed by X2, fisher exact test ant student T-test using SPSS software. Results: Excellent or good larengoscopy and intubation conditions were observed in 9 (%42.9) of thiopental patients and 20 (%95.2) of propofol patients (p<0.05). Mean arterial pressure and heart rate decreased more significantly in propofol group in comparison with the thiopental group (p<0.05). Conclusion: Combination of remifentanil and propofol or thiopental could facilitate ventilation via face mask in all patients. Although combination of propofol and remifentanil is better than thiopental and remifentanil for tracheal intubation without muscle relaxants, it induces more homodynamic changes.

---

Introduction & objective: Unilateral Twin Ectopic Pregnancy is very rare and only 100 cases have been reported till now. Bilateral Twin Ectopic pregnancy is the rarest type of Dizigotic twin pregnancy. We have reported a case of Bilateral Twin ectopic pregnancy with live simultaneous IIntra Uterine Pregnancy that its prevalence is unclear. We didn’t find any similar cases in the literature. Case: The patient was a 34-year-old woman with intermittent crampic pain in both abdominal lower quadrants for 2 days. The patient had a history of abortion and also a secondary infertility and HMG Injection. The ultra-sonography showed a 12 week pregnancy uterus with bilateral ovarian cyst where one of them was ruptured and a large amount of fluid in pelvic cavity was seen. Therefore, a decision was made for surgery. During operation, two much dilated non ruptured area in left falopian tube and two ectopic pregnancies in the right fallopian tube were seen which one of them was ruptured. Conclusion: Considering the ectopic pregnancy, when encountering women in reproductive age, is necessary and any pregnant woman with abdominal pain must be considered for.

---

Introduction & Objective: Melasma is an acquired hypermelanosis disease and can cause superficial problems in women if left untreated. The objective of this study was to compare the efficacy of 2% hydroquinone and Melfade in the treatment of Melasma. Materials & Methods: This is a randomized clinical trial study conducted at Kurdistan University of Medical Sciences in 2008. Sixty two women with Melasma disease were recruited and randomly assigned to two groups. Two percent hydroquinone was prescribed for the first group (n=31) and Melfade for the second group. After 12 weeks of daily drug consumption by the patients, they were examined by a dermatologist for assessment of recovery. The collected data was analyzed by the SPSS software. Results: Response to treatment with hydroquinone and Melfade- was the same and no significant differences were found between the two groups. (P>0.05) onclusion: Results of this study demonstrated that topical Melfade is as effective as 2% hydrquinone in treatment of Melasma, Therefore it can be considered as an alternative drug in the treatment of Melasma.

---

Background & Aim: Candida albicans is the most common cause of fungal infections which is increasing all over the world. Finding new methods or agents for control of these fungal infections is necessary. The aim of this study was to evaluate the antifungal activity of Catechin against standard strain of C.albicans. Methods: This experimental study was conducted at Tarbiat Modares University of Medical Sciences in 2010. Serial dilutions of Catechin solution were prepared in 96 well micro plates. Minimum Inhibitory Concentration (MIC) was assessed by Microdilution broth technique. Biofilms of C. albicans were developed on flat-bottomed 96-well microtiter plates and the antifungal effect of Catechin was evaluated. Data were analyzed using t-test statistical method. Results: MIC50 of 5.77 µg/ml, MIC90 of 8.33 µg/ml and MFC of 9.47 µg/ml were found for Catechin. Biofilm inhibitory concentration of Catechin and fluconazole for susceptible strain of C. albicans was19.35, 4 µg/ml and for resistant strain was 23.53, 8 µg/ml respectively. Conclusion: Catechin had suitable antifungal effect against C.albicans biofilms in comparison with fluconazole. It seems that this herbal agent can be used for the elimination of Candida.

---

Background & Aim: Due to various medical complications and high prevalence of periodontal disease in our society, the present study was designed for assessment of correlation between periodontal disease during pregnancy and low birth weight and preterm delivery. Methods: In this case-control study, the periodontal status of 50 women with infants who had less than 2500 gr birth weight and 100 matched control counterparts were evaluated at 2007-2008 in Akbarabadi and Mahdieh hospitals in Tehran. The periodontal parameters of GI, PI, CPI and probing depth indices were assessed on 6 teeth of Ramford index. The data were analyzed using Chi-square and Mann-Whitney U and logistic regression tests. Results: PD index was 0-3 mm in 90.0% of cases and 85.0% of controls with no significant differences. In 2.0% cases, GI was poor, in 34.0% was fair and good in 64.0% the rates were 3.0%, 34.0% and 63.0% in controls with no significant differences (p>0.93). CPI index was poor in 8.0% of cases, fair in 30.0% and good in 62.0% while it was poor in 3.0%, fair in 33.0% and good in 64.0% of control subjects with no significant differences (p>0.63). PI index was poor in 4.0%, fair in 32.0% and good in 64.0% of cases with no significant differences vs. control groups (p>0.68). However, the incidence of preterm birth had significant difference between two groups (P<0.0001). Conclusion: In this study, no significant correlation was observed between periodontal disease parameters and low birth weight of infants. However periodontal disease parameters may be correlated with preterm birth.

---

Abstract
Background & Aim: Sleep disturbance is one of the major complaints of patients referring to clinical clinics. Empirical and cross-sectional studies have shown a two-way relationship between pain and sleep, in which an inappropriate sleep can lead to pain relief and pain can interfere with the quality and continuation of sleep. The aim of this study was to determine the relationship between the quality of sleep before surgery and the severity of headache after spinal anesthesia.
 
Methods: This cross-sectional study was descriptive-analytic. In this study, 90 pregnant women who were candidates for voluntary cesarean section with spinal anesthesia were selected randomly after receiving written and informed consent. Sleep quality one month before delivery was measured by Pittsburgh sleep inventory questionnaire and the spinal anesthesia severity score was assessed in 48 hours after spinal anesthesia and seven days later by numerical pain scale. Data were analyzed using descriptive statistics, Spearman correlation coefficient, mean and standard deviation.
Results: The mean and standard deviation of 90 subjects in the study was 29.8±5.56. The mean and standard deviation of sleep quality score were 13.13±2.1. In 48 hours after spinal anesthesia, 24(26.7%) of the participants reported a degree of headache. On the 7th day after spinal anesthesia, 27(30%) participants reported a degree of headache. A significant relationship was seen between sleep quality score and severity of headache during 48 hours after spinal anesthesia (p=0/039). No significant relationship was observed between sleep quality score and severity of headache in 7 days after spinal anesthesia (p=0/59). There was a significant correlation between severity of headache 48 hours after spinal anesthesia and severity of headache 7 days later (p=0/0001). There was no significant relationship between sleep quality score and age. There was no significant relationship between age and severity of headache 48 hours after anesthesia.
 
Conclusion: The relationship between sleep quality and spinal headache has been shown to be due to the role of sleep and its disorders on neurotransmitter sleep systems and indirect effects on dopaminergic and opioidergic, serotonergic and melatonin systems.