medical journal of mashhad university of medical sciences1735-401358620150823Evaluation of cutoff point and power of neutrophil to lymphocyte ratio in diagnosing chronic inflammation in End-stage renal disease (ESDR) patientsEvaluation of cutoff point and power of neutrophil to lymphocyte ratio in diagnosing chronic inflammation in End-stage renal disease (ESDR) patients289294500010.22038/mjms.2015.5000FANarges Sadat ZahedAssistant professor of nephrology, shahid beheshti university of medical sciences, Tehran. Iran1Zinab Karimi Mahaliresident of internal medicine, shahid beheshti university of medical sciences, Tehran. IranJournal Article20150922Introduction: Inflammation can increase mortality and morbidity rate of ESRD patients. In some studies Neutrophil to lymphocyte ratio and Platelet to lymphocyte ratio were evaluated to detect inflammation. This study was conducted to evaluate the deterministic power, specificity and sensitivity of Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio in detecting inflammation indicated by Serum Albumin and C-reactive protein (CRP). <br />Materials and Methods: According to our inclusion and exclusion criteria, we recruited 120 patient with ESRD admitted to Loghman hospital and Ashrafi Esfehani hospital were examined retrospectively in our study. Data were collected from hospital documents. <br />Results: Basis on our study, Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio didn’t show a significant difference between normal patients and patients with inflammation. <br />Conclusion: Although Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio are related to inflammatory conditions, but sensitivity and specificity of these testes are low for detecting inflammation.Introduction: Inflammation can increase mortality and morbidity rate of ESRD patients. In some studies Neutrophil to lymphocyte ratio and Platelet to lymphocyte ratio were evaluated to detect inflammation. This study was conducted to evaluate the deterministic power, specificity and sensitivity of Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio in detecting inflammation indicated by Serum Albumin and C-reactive protein (CRP). <br />Materials and Methods: According to our inclusion and exclusion criteria, we recruited 120 patient with ESRD admitted to Loghman hospital and Ashrafi Esfehani hospital were examined retrospectively in our study. Data were collected from hospital documents. <br />Results: Basis on our study, Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio didn’t show a significant difference between normal patients and patients with inflammation. <br />Conclusion: Although Neutrophil to lymphocyte ratio and Platelet and lymphocyte ratio are related to inflammatory conditions, but sensitivity and specificity of these testes are low for detecting inflammation.medical journal of mashhad university of medical sciences1735-401358620150823Comparison of FGF21 level in type 2 diabetic patients with healthy subjects and correlation of its with metabolic syndrome componentsComparison of FGF21 level in type 2 diabetic patients with healthy subjects and correlation of its with metabolic syndrome components295301499110.22038/mjms.2015.4991FARobab AboutorabiAssociate professor of endocrinology- endocrine research center- Ghaem hospital- mashhad- iranShokoufeh BonakdaranAssociate professor of endocrinology- endocrine research center- Ghaem hospital- mashhad- iranSaeed Islamimethodologist- Mashhad University of Medical Sciences, mashhad,iranFatemeh Abbasi BanazadeFellow of Endocrinology- - Mashhad University of Medical Sciences, mashhad,iran.Journal Article20150922to have a potent antidiabetic effect in animal models. In human studies activity of this factor is associated with development of metabolic syndrome. The aim of this study was to compare the concentration of this factor in type 2 diabetic patients and healthysubjects and also relation of this factor with metabolic syndrome componentswas investigated. <br />Methods: 30 type 2 diabetic patients and 40 healthy subjects were enrolled in this study. Demographic data of patients were recorded. HbA1c, FBS, lipid profiles, insulin level,liver enzymes and FGF21 were measured for all subjects. Insulin resistance was calculated by homeostatic model assessment of insulin resistance(HOMA-IR) formula.FGF21 level was compared between diabetic patients with healthy control group and also relation of this factor was determined with metabolic syndrome components. <br />Results:Difference of FGF21 level was not significant between type 2 diabetic patients and healthy subjects.There were not significant correlation between FGF21 level and metabolic syndrome components. FGF21 was positively associated with SGPT level. <br />Conclusion: It seems that FGF21 is not related to metabolic syndrome components in Iranian population, but this observation remains to be determined by large clinical studies.to have a potent antidiabetic effect in animal models. In human studies activity of this factor is associated with development of metabolic syndrome. The aim of this study was to compare the concentration of this factor in type 2 diabetic patients and healthysubjects and also relation of this factor with metabolic syndrome componentswas investigated. <br />Methods: 30 type 2 diabetic patients and 40 healthy subjects were enrolled in this study. Demographic data of patients were recorded. HbA1c, FBS, lipid profiles, insulin level,liver enzymes and FGF21 were measured for all subjects. Insulin resistance was calculated by homeostatic model assessment of insulin resistance(HOMA-IR) formula.FGF21 level was compared between diabetic patients with healthy control group and also relation of this factor was determined with metabolic syndrome components. <br />Results:Difference of FGF21 level was not significant between type 2 diabetic patients and healthy subjects.There were not significant correlation between FGF21 level and metabolic syndrome components. FGF21 was positively associated with SGPT level. <br />Conclusion: It seems that FGF21 is not related to metabolic syndrome components in Iranian population, but this observation remains to be determined by large clinical studies.medical journal of mashhad university of medical sciences1735-401358620150823Study of Risks in emergency department at Tabriz Imam Reza hospitalStudy of Risks in emergency department at Tabriz Imam Reza hospital302309499810.22038/mjms.2015.4998FAMahbub PuraghaeiAssistant Professor of emergency medicineJafar Sadegh TabriziAssociate Professor of health services managementSaeed Aslan AbadiProfessor of pediatrics surgeryPeyman Moharam ZadehAssistant Professor of emergency medicineRoya GhiamiResident of emergency medicineNavid ElmdustGeneral Physician0000-0002-8429-3781Journal Article20150922Introduction: Risk management is to prevent the risk and also manage it after occurrence and includes diagnosis, evaluation, analysis, control, reduction and prevention of the risk. The aim of risk management is to reduce the risks concerning patients and increase work safety for staffs. In this study risk management was evaluated in different steps in Imam Reza emergency department (ED). <br />Methods: In this action research study, first we performed three focus group discussions (FGD) sessions including FGD session with ED nurses, a session with emergency medicine residents and a session with the laboratory, drug store and radiology staffs. Using these sessions, a questionnaire was design to clarify risks and to priority processing. To evaluate and define risk level in ED we used experts’ panel. For each risk, risk severity, its incidence and risk level was calculated. According to the risk level, their priority was processed and intolerable risks were defined for planning an intervention. <br />Results: Based on expert panel, 11 subgroups with 415 risks were gathered. Among these, 3 risks including high volume of attendants, staff shortage and high patients load were recorded as intolerable risks in risk level 1, 2 and 3. The intervention was designed to reduce the attendants by giving 2 attendant cards for each patient. <br />Conclusion: In this study we observed that intolerable risks are high volume of attendants, staff shortage and high patients load and the intervention program was designed to reduce the risks.Introduction: Risk management is to prevent the risk and also manage it after occurrence and includes diagnosis, evaluation, analysis, control, reduction and prevention of the risk. The aim of risk management is to reduce the risks concerning patients and increase work safety for staffs. In this study risk management was evaluated in different steps in Imam Reza emergency department (ED). <br />Methods: In this action research study, first we performed three focus group discussions (FGD) sessions including FGD session with ED nurses, a session with emergency medicine residents and a session with the laboratory, drug store and radiology staffs. Using these sessions, a questionnaire was design to clarify risks and to priority processing. To evaluate and define risk level in ED we used experts’ panel. For each risk, risk severity, its incidence and risk level was calculated. According to the risk level, their priority was processed and intolerable risks were defined for planning an intervention. <br />Results: Based on expert panel, 11 subgroups with 415 risks were gathered. Among these, 3 risks including high volume of attendants, staff shortage and high patients load were recorded as intolerable risks in risk level 1, 2 and 3. The intervention was designed to reduce the attendants by giving 2 attendant cards for each patient. <br />Conclusion: In this study we observed that intolerable risks are high volume of attendants, staff shortage and high patients load and the intervention program was designed to reduce the risks.medical journal of mashhad university of medical sciences1735-401358620150823The effect of Antibiotic Stewardship targeted against vancomycin and carbapenems in pediatric intensive care unit of Doctor Sheikh hospitalThe effect of Antibiotic Stewardship targeted against vancomycin and carbapenems in pediatric intensive care unit of Doctor Sheikh hospital310315499610.22038/mjms.2015.4996FAFarzaneh MohammadiResident of Pediatrics
Mashhad University of Medical Sciences
Imam Reza Hospital Mashhad IranGholamreza KhademiAssistant Professor of Department of Pediatrics
Mashhad University of Medical SciencesMonavar AfzalaghaeeAssistant Professor of Department of social medecine
Mashhad University of Medical Sciences
School of medicine. Mashhad Iran0000-0003-2029-6577Mohammad Saeed SasanAssociate Professor of Department of Pediatrics
Mashhad University of Medical Sciences
Imam Reza Hospital Mashhad IranJournal Article20150922Introduction: The inappropriate use of Broad- Spectrum antimicrobials in intensive care units (ICU) is a universal problem. The main goal of this study was to implement <em>antibiotic stewardship program</em> (ABS) concentrated on vancomycin and carbapenems, in pediatric ICU (PICU) of Sheikh hospital. As an accessory purpose we looked for the effect of ABS on the rate of antibiotic administration, length of hospital stay and mortality <br />Material and Methods: This study was performed in 2 stages, at the first phase; we determined the causes of nosocomial sepsis and their antibiotic (AB) resistance pattern in the PICU, and then according to those findings a guideline for administration of vancomycin and carbapenems was performed. In the second stage the files of PICU patients were reviewed every other day (for 3 months), and recommendations about the compatibility of the prescriptions with the guideline were given to the responsible doctor. At the end, we compared the effects of the intervention with one month of prospective record of AB prescriptions without any recommendation. <br />Results: We recorded 1676 and 673 patient/days during 3 month of ABS and 1 month of control. During ABS period, vancomycin use decreased from 294 to 178 for 1000 patient/days (P=0.001), carbapenems administration changed from 433 to 193 for 1000 patient/ days (P=0.001), the LHS decreased from 11.4 to 8.4 days (P=0.06) and mortality rate decreased from 10.2% to 7% (P=0.4). <br />Conclusion: In a situation like Dr Sheikh PICU , implementation of ABS for vancomycin and carbapenems hasafavorable effect on AB usage rate. <br /> Introduction: The inappropriate use of Broad- Spectrum antimicrobials in intensive care units (ICU) is a universal problem. The main goal of this study was to implement <em>antibiotic stewardship program</em> (ABS) concentrated on vancomycin and carbapenems, in pediatric ICU (PICU) of Sheikh hospital. As an accessory purpose we looked for the effect of ABS on the rate of antibiotic administration, length of hospital stay and mortality <br />Material and Methods: This study was performed in 2 stages, at the first phase; we determined the causes of nosocomial sepsis and their antibiotic (AB) resistance pattern in the PICU, and then according to those findings a guideline for administration of vancomycin and carbapenems was performed. In the second stage the files of PICU patients were reviewed every other day (for 3 months), and recommendations about the compatibility of the prescriptions with the guideline were given to the responsible doctor. At the end, we compared the effects of the intervention with one month of prospective record of AB prescriptions without any recommendation. <br />Results: We recorded 1676 and 673 patient/days during 3 month of ABS and 1 month of control. During ABS period, vancomycin use decreased from 294 to 178 for 1000 patient/days (P=0.001), carbapenems administration changed from 433 to 193 for 1000 patient/ days (P=0.001), the LHS decreased from 11.4 to 8.4 days (P=0.06) and mortality rate decreased from 10.2% to 7% (P=0.4). <br />Conclusion: In a situation like Dr Sheikh PICU , implementation of ABS for vancomycin and carbapenems hasafavorable effect on AB usage rate. <br /> medical journal of mashhad university of medical sciences1735-401358620150823The effect of four weeks aerobic training with using L-carnitine supplement on lipid profile and blood glucose in diabetic menThe effect of four weeks aerobic training with using L-carnitine supplement on lipid profile and blood glucose in diabetic men316321506010.22038/mjms.2015.5060FAMohammad RamezanpourAssistant of prof. department of physical education and sport sciences, Islamic azad university, mashhad branch, mashhad, iranMohammad MatbooM.Sc. student of exercise physiology, Islamic azad university, mashhad branch, mashhad, iranEyed Mahmoud HejaziAssistant of prof. department of physical education and sport sciences, Islamic azad university, mashhad branch, mashhad, iranJournal Article20150927Introduction: some researches show that the amount of L-carnitine is low in diabetic patients. L-carnitine consumption could be result in metabolic processes improvement in diabetic patients. <br />The aim of this study is investigating the effect of four weeks aerobic training accompanied by using L-carnitine on glucose and lipid parameters in patients with diabetes type 2. <br />Materials &Methods: In this semi experimental study, 20 diabetic men at the average age of 51.2 ± 2.58 divided into two groups. The first group had aerobic training and using 500 mg L-carnitine and the second group had aerobic training using placebo simultaneously. Training done for four weeks (3days in week) with 60% - 80% of maximum heart rate. Blood exams done before training and after it and data compared with t- test in independent groups. <br />results: fasting blood glucose had significant decrease in the L-carnitine group comparing the placebo group. There was no significant difference in blood level of triglyceride, cholesterol, LDL and HDL between two groups. <br />Conclusion: Finding indicate that L-carnitine cause significant decrease in fasting blood glucose but doesnt cause significant difference in lipid profile in diabetic men.Introduction: some researches show that the amount of L-carnitine is low in diabetic patients. L-carnitine consumption could be result in metabolic processes improvement in diabetic patients. <br />The aim of this study is investigating the effect of four weeks aerobic training accompanied by using L-carnitine on glucose and lipid parameters in patients with diabetes type 2. <br />Materials &Methods: In this semi experimental study, 20 diabetic men at the average age of 51.2 ± 2.58 divided into two groups. The first group had aerobic training and using 500 mg L-carnitine and the second group had aerobic training using placebo simultaneously. Training done for four weeks (3days in week) with 60% - 80% of maximum heart rate. Blood exams done before training and after it and data compared with t- test in independent groups. <br />results: fasting blood glucose had significant decrease in the L-carnitine group comparing the placebo group. There was no significant difference in blood level of triglyceride, cholesterol, LDL and HDL between two groups. <br />Conclusion: Finding indicate that L-carnitine cause significant decrease in fasting blood glucose but doesnt cause significant difference in lipid profile in diabetic men.medical journal of mashhad university of medical sciences1735-401358620150823Frequency of Klebsiella Pneumoniae Producing Carbapenemase KPC in Clinical specimens of Mashhad during 2014Frequency of Klebsiella Pneumoniae Producing Carbapenemase KPC in Clinical specimens of Mashhad during 2014322329505910.22038/mjms.2015.5059FAFateme RoudbariDepartment of cell and biology, Faculty of science,University of Mazandaran, Babolsar, IranKiarash GhazviniAntimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-8538-1425Somayeh Heydari ForkDepartment of cell and biology, Faculty of science,University of Mazandaran, Babolsar, Iran.Mahdi KouhiNoghondarMSc Antimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, IranSaeed Amel JamedarAntimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, IranMasoud YoussefiAntimicrobial resistance Research Center, Buali research institute, Mashhad University of medical Sciences, Mashhad, Iran
Department of Microbiology and Virology, School of medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20150927Introduction: <br /><em>Klebsiella pneumoniae</em> producing B-Lactamase is an important medical concern. Therefore we aimed to investigate broad spectrum lactamase KPC-producing <em>Klebsiella pneumoniae</em> in clinical samples in Mashhad during 2014. <br /> <br />Material and method <br />After identification by biochemical methods, antibiotic susceptibility of <em>Klebsiella pneumoniae</em> isolates against 10 different antibiotics was identified using disk diffusion technique. To evaluate the presence of carbapenemase KPC enzyme, modified Hodge test (MHT) was performed and the minimum inhibitory concentration (MIC) of Meropenem as an indicator of Carbapenem class of β-Lactam antibiotics was determined using agar dilution test. <br /> <br />Results <br />Among the isolated bacteria, high level of resistance against cefazolin (54.44%), cefepime (49.46%), ceftazidime (45.19%), trimethoprim-sulfamethoxazole (46.26%) was observed. Modified Hodge test was performed for all 136 ESBL <em>Klebsiella pneumonia</em>isolates and 20 were found to be positive for MHT. Furthered MIC test revealed that 2 isolate had MIC=4 μg/ml, 3 isolate had MIC=2, and remaining 15 isolates had MIC more than 8. <br /> <br />Conclusion <br />This study underscores the risk of increasing carbapenem resistant <em>Klebsiella pneumonia </em>specieswhich demands further attention in clinical settings.Introduction: <br /><em>Klebsiella pneumoniae</em> producing B-Lactamase is an important medical concern. Therefore we aimed to investigate broad spectrum lactamase KPC-producing <em>Klebsiella pneumoniae</em> in clinical samples in Mashhad during 2014. <br /> <br />Material and method <br />After identification by biochemical methods, antibiotic susceptibility of <em>Klebsiella pneumoniae</em> isolates against 10 different antibiotics was identified using disk diffusion technique. To evaluate the presence of carbapenemase KPC enzyme, modified Hodge test (MHT) was performed and the minimum inhibitory concentration (MIC) of Meropenem as an indicator of Carbapenem class of β-Lactam antibiotics was determined using agar dilution test. <br /> <br />Results <br />Among the isolated bacteria, high level of resistance against cefazolin (54.44%), cefepime (49.46%), ceftazidime (45.19%), trimethoprim-sulfamethoxazole (46.26%) was observed. Modified Hodge test was performed for all 136 ESBL <em>Klebsiella pneumonia</em>isolates and 20 were found to be positive for MHT. Furthered MIC test revealed that 2 isolate had MIC=4 μg/ml, 3 isolate had MIC=2, and remaining 15 isolates had MIC more than 8. <br /> <br />Conclusion <br />This study underscores the risk of increasing carbapenem resistant <em>Klebsiella pneumonia </em>specieswhich demands further attention in clinical settings.medical journal of mashhad university of medical sciences1735-401358620150823The effect of 12 weeks resistance exercise on plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly womenThe effect of 12 weeks resistance exercise on plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly women330337500210.22038/mjms.2015.5002FAMaryam MokhtariDepartment of Exercise Physiology, University of Shiraz, Shiraz, IranFarhad DaryanooshAssistant Prof of Physical Education and Sport Science, Department of Exercise Physiology, University of Shiraz, Shiraz, Iran.Journal Article20150922 Introduction: Adipokine including Apelin and Nesfatin secreted by adipose tissue and . The aim of present study was to investigate the effect of 12 weeks resistance exercise on plasma plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly women <br />Materials and Methods: In this study, 30 hypertensive elderly women were chosen and randomly divided in to two groups: Control and Resistance exercises group (training , 3 times a week for 12 weeks). Blood pressure, heart rate; and also plasma Apelin and Nesfatin concenterations were measured before and at the end of study. Data evaluated by using the dependent and independent t-test significant level data p≤ 0.05 was done. <br />Results: That was found after 12 weeks of Resistance exercise significant differences in serum levels Apelin (reduce, p=0.02) and Resting heart rate (reduce, p=0.03) in the experimental group was occurs but in the control group,no significant changes in serum levels Apelin (p=0.50) and Resting heart rate (p=0.12) was occurs. Also, after 12 weeks of Resistance exercise no significant differences in serum levels Nesfatin (p=0.15) in the experimental group was occurs but in the control group, significant changes in serum levels Nesfatin (increase, p=0.05) was occurs. <br /> <br />Conclusion: The 12-week resistance exercise , could reduction resting heart rate and blood pressure And thus eliminates the need to increase Apelin and decrease Apelin observed (negative feedback). The study did not exercise as an effective incentive to reduce Nesfatin. Introduction: Adipokine including Apelin and Nesfatin secreted by adipose tissue and . The aim of present study was to investigate the effect of 12 weeks resistance exercise on plasma plasma levels of Apelin-12, Nesfatin-1 and resting heart rate in hypertensive elderly women <br />Materials and Methods: In this study, 30 hypertensive elderly women were chosen and randomly divided in to two groups: Control and Resistance exercises group (training , 3 times a week for 12 weeks). Blood pressure, heart rate; and also plasma Apelin and Nesfatin concenterations were measured before and at the end of study. Data evaluated by using the dependent and independent t-test significant level data p≤ 0.05 was done. <br />Results: That was found after 12 weeks of Resistance exercise significant differences in serum levels Apelin (reduce, p=0.02) and Resting heart rate (reduce, p=0.03) in the experimental group was occurs but in the control group,no significant changes in serum levels Apelin (p=0.50) and Resting heart rate (p=0.12) was occurs. Also, after 12 weeks of Resistance exercise no significant differences in serum levels Nesfatin (p=0.15) in the experimental group was occurs but in the control group, significant changes in serum levels Nesfatin (increase, p=0.05) was occurs. <br /> <br />Conclusion: The 12-week resistance exercise , could reduction resting heart rate and blood pressure And thus eliminates the need to increase Apelin and decrease Apelin observed (negative feedback). The study did not exercise as an effective incentive to reduce Nesfatin.medical journal of mashhad university of medical sciences1735-401358620150823Compare Imaging Findings in Crohn's Disease with Intestinal and Peritoneal Tuberculosis to differentiate these diseasesCompare Imaging Findings in Crohn's Disease with Intestinal and Peritoneal Tuberculosis to differentiate these diseases338345499410.22038/mjms.2015.4994FAJahanbakhsh Hashemi, associate professor of radiology, Mashhad Medical Faculty0000-0001-8490-379xDonya Farrokhassociate professor of radiology, Mashhad Medical FacultyAmin Bojdiassistant professor of Infectious Disease , Mashhad Medical FacultyEhsan KhoshbakhtRadiologistMoein KheirollahiResident of Radiology, Mashhad Medical Faculty.Journal Article20150922Introduction: we aimed to determine the best differential diagnosis between Crohn's disease and intestinal tuberculosis. Abdominal and pelvic ct exams with oral and IV contrast and small bowel barium study findings are selected to differentiate intestinal tuberculosis from crohn’s disease. <br />Methods: This was a cross-sectional retrospective study between 2001 -2011. The data was gathered from the medical records of patients with peritoneal and intestinal tuberculosis and Crohn's disease who were referred to Ghaem and Emam raza Hospitals. Twenty six patients with Crohn's and 22 cases of intestinal tuberculosis were selected. The data was extracted from the bowel and mesentery imaging methods including abdominal and pelvis CT-scan with oral and IV contrast, CT enterography, and small intestinal transit. The frequency of ten visible radiographic findings of medical records of patients was assessed and diagnostic value of each variable was evaluated in differentiating the two diseases. <br />Results: There was a significant difference between the age of the patients with TB and Crohn's(p=0.013). Data of CT-scan showed there was a significant difference between the patients with and without thickening and multiple strictures (p=0.01), mural strification(p=0.015), mural calcification (0.038), mesentic hypervascularity or natural mesenteric vasculature, ascites, lymphadenopathy(all, p<0.001), fibrofatty proliferation(p=0.015), and necrosis(p=0.001). The other data showed that there was a significant association between mural strification and mesentic hypervascularity(p<0.001). <br />Conclusion: our study showed CT-scan is effective in proper diagnosis of TB by imaging findings and could differentiate Crohn's disease. The mural calcification was evaluated as distinguishing factor of TB from Crohn’s disease. Necrotic lymphadenopathy in CT-scan can be assessed as a tool for differentiated TB from Crohn's disease.Introduction: we aimed to determine the best differential diagnosis between Crohn's disease and intestinal tuberculosis. Abdominal and pelvic ct exams with oral and IV contrast and small bowel barium study findings are selected to differentiate intestinal tuberculosis from crohn’s disease. <br />Methods: This was a cross-sectional retrospective study between 2001 -2011. The data was gathered from the medical records of patients with peritoneal and intestinal tuberculosis and Crohn's disease who were referred to Ghaem and Emam raza Hospitals. Twenty six patients with Crohn's and 22 cases of intestinal tuberculosis were selected. The data was extracted from the bowel and mesentery imaging methods including abdominal and pelvis CT-scan with oral and IV contrast, CT enterography, and small intestinal transit. The frequency of ten visible radiographic findings of medical records of patients was assessed and diagnostic value of each variable was evaluated in differentiating the two diseases. <br />Results: There was a significant difference between the age of the patients with TB and Crohn's(p=0.013). Data of CT-scan showed there was a significant difference between the patients with and without thickening and multiple strictures (p=0.01), mural strification(p=0.015), mural calcification (0.038), mesentic hypervascularity or natural mesenteric vasculature, ascites, lymphadenopathy(all, p<0.001), fibrofatty proliferation(p=0.015), and necrosis(p=0.001). The other data showed that there was a significant association between mural strification and mesentic hypervascularity(p<0.001). <br />Conclusion: our study showed CT-scan is effective in proper diagnosis of TB by imaging findings and could differentiate Crohn's disease. The mural calcification was evaluated as distinguishing factor of TB from Crohn’s disease. Necrotic lymphadenopathy in CT-scan can be assessed as a tool for differentiated TB from Crohn's disease.medical journal of mashhad university of medical sciences1735-401358620150823Report of a very rare patient with angina pectoris due to aortic valve papillary fibroelastomaReport of a very rare patient with angina pectoris due to aortic valve papillary fibroelastoma346350500510.22038/mjms.2015.5005FAHamid HoseinikhahAssistant Professor of Cardiovascular Surgery, Mashhad University of Medical SciencesAlireza Sepehri ShamlooResearch AdministratorMehdi VahdatiPerfusionist of cardiac surgery wards Imam Reza Hospital, Mashhad University of Medical SciencesAliAsghar MoeinipourAssistant Professor of Cardiovascular Surgery, Mashhad University of Medical Sciences0000-0002-4208-800XGholamreza Gorgiji-perfusionist AND nursing of cardiac surgery wards Imam Reza Hospital, Mashhad University of Medical Sciences, IranJournal Article20150922Introduction: Aortic Valve Papillary Fibroelastoma (AVPF) is the most common benign tumor of cardiac valves. Most cases of AVPF are completely asymptomatic and the diagnosis is made incidentally. However, ischemic heart attack, atrial and ventricular arrhythmia, and also thromboembolism complication especially in CNS system, are the most common presentations in symptomatic cases. Herein, we report a very rare case of AVPF in an old age patient presented with stable angina. <br />Case presentation: A 60-year old woman was referred to our clinic with symptoms of stable angina. Transesophageal echocardiography showed a tumor suspected mass (1 X 1 cm) on aortic valve. Angiography was reported normal. Considering the presence of the symptomatic mass, patient underwent open cardiac surgery and tumor resected. Report of biopsy revealed the AVPF. <br />Conclusion: Although treatment of asymptomatic AVPF is controversial; but, for symptomatic masses, surgical resection for avoidance of its complication is recommended. Result of surgical resection of AVPF usually is excellent and mortality, morbidity, and recurrence rate are almost lowIntroduction: Aortic Valve Papillary Fibroelastoma (AVPF) is the most common benign tumor of cardiac valves. Most cases of AVPF are completely asymptomatic and the diagnosis is made incidentally. However, ischemic heart attack, atrial and ventricular arrhythmia, and also thromboembolism complication especially in CNS system, are the most common presentations in symptomatic cases. Herein, we report a very rare case of AVPF in an old age patient presented with stable angina. <br />Case presentation: A 60-year old woman was referred to our clinic with symptoms of stable angina. Transesophageal echocardiography showed a tumor suspected mass (1 X 1 cm) on aortic valve. Angiography was reported normal. Considering the presence of the symptomatic mass, patient underwent open cardiac surgery and tumor resected. Report of biopsy revealed the AVPF. <br />Conclusion: Although treatment of asymptomatic AVPF is controversial; but, for symptomatic masses, surgical resection for avoidance of its complication is recommended. Result of surgical resection of AVPF usually is excellent and mortality, morbidity, and recurrence rate are almost low