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Introduction: Iron deficiency anemia (IDA) is the most common form of anemia and one of the most important health problems. Iron supplementation for high risk groups can prevent IDA and its complications in the community. We need to have a holistic approach to control IDA with minimum cost and complications. Considering the high prevalence rate of IDA in Iran, assessment of the effects of micronutrients in the treatment of IDA is essential. The current study was designed to study the complete iron therapy program in Iran and evaluate the effect of simultaneous administration of vitamin A and C on hemoglobin (Hb) levels. Methods: A triple blind randomized clinical trial was conducted in secondary schools for girls in Shahinshahr city of Iran. 120 students were selected after initial screening for clinical presentation of anemia. They were assigned to three groups. All the cases were administered 50mg elemental iron, 0.5mg folic acid and 11mg elemental zinc. However, group A received placebo, group B received 250mg vitamin C and placebo of vitamin A and group C received 250mg vitamin C and 100000 IU vitamin A. The hemoglobin levels were measured on day one and eight weeks later. Data was analyzed using software SPSS version 11.5 and statistical test used was one way ANOVA test. Results: There were statistical significant differences between the final Hemoglobin levels of the three groups (P<0.001). Hb increase in group C was significantly higher as compared to the control group (P<0.012). There was a difference between the Hb levels of group B and C, but this difference was not significant. Conclusion: The findings showed that simultaneous supplementation of iron, folic acid and zinc with vitamin A and C is very effective for increasing hemoglobin levels. Further investigations are needed to confirm this hypothesis for treatment of IDA.

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Introduction: Undoubtedly, reproduction is a necessity for survival and successful pregnancy is an immunological paradox. In the present study, we investigated the proportional changes of CD4+CD25bright T cells, CD4+CD25dim T cells in peripheral blood in unexplained recurrent spontaneous abortions (URSA) and compared it with normal pregnant women by antibody monoclonal method. Methods: The study group comprised of women with miscarriages of unexplained etiology who had normal karyotypes, anticardiolipin antibodies, prolactin levels and normal spousal spermograms. They did not have polycystic ovaries and also did not receive any drugs at the time of the study. PBLs lymphocytes were isolated, then FITC-conjugated and anti-CD4 and PE-conjugated anti-CD25 antibody levels were measured. Then results of the study and control group were analyzed and compared. Results: The absolute number of CD25 bright cells in the CD4‏+T cells in peripheral blood was statistically significantly lower in the study group as compared to the control group(P=0.000). The absolute number of CD4+CD25dimT cells in peripheral blood was statistically significantly higher in the study group as compared to the control group (P=0.000). Conclusion: As decrease in the number of CD4+CD25+Tcells or their functional deficiency may be linked with miscarriage, CD4+CD25+‏ Tells could serve as a novel biomarker for monitoring in URSA patients, but more studies are needed in this field.

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Introduction: Immunological processes are most important in recurrent spontaneous abortion(RSA). According to studies T lymphocytes and natural killer cells(NK cells) are two effective cell groups in RSA. The aim of this study was to investigate the percentage and absolute number of natural killer(NK) cells in women with RSA with unknown etiology. Methods: 24 Women with a history of recurrent pregnancy losses with unknown etiology. We compared the percentage of peripheral blood NK cells with a group of fertile patients. Lymphocytes from peripheral blood were isolated by ficoll paque density centrifugation. Lymphocytes were stained using anti CD56 and(FITC)-anti CD16 and CYQ-CD3 monoclonal antibodies for identification of NK cells and was used anti CD56 and(FITC)-anti CD69 for detection of activated NK cells. We used BD FACS calibure flow cytometry for data analysis. Results: On the basis of the obtained results, absolute number of CD16+56+ cells showed significant increases in Recurrent spontaneous abortion(RSA) in comparison with control group(P= 0.43). Also absolute number of CD16+56bright cells had significant increase in RSA(P=0.00). There was no significant difference(P= 0.08) of CD16+56dim cells between RSA and control group. In RSA, the absolute number of CD69+cells significantly increased(P=0.02). Also, results showed significant increase in the absolute number of CD56+/CD69+ cells in RSA(P=0.04). Conclusion: The results suggested that the higher percentage of NK cells in peripheral blood of RSA patients compared to control group may indicate the same increase in number and cytotoxicity of uterin NK cells.

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Introduction: Clinical pelvimetry is very uncomfortable for the patient and is associated with subjective error, while external pelvimetry is a simple and acceptable method for patients. The objective of this study was to compare the diagnostic accuracy of clinical and external pelvimetry in prediction of dystocia in nulliparous women. Methods: In this study between December 2008 and January 2009, 447 nulliparous women with a single pregnancy in vertex presentation and gestational age 38-42 weeks referring to the Ommolbanin hospital of Mashhad were included. External pelvic dimensions were assessed at the time of admission and clinical pelvimetry was performed by another examiner. These measurements were not available to the clinician in charge of the delivery. Dystocia was defined as caesarean section and vacuum or forceps delivery for abnormal progress of labor ( active uterine contractions, arrest of cervical dilatation or cervical dilatation less than 1 cm /h in the active phase for 2 hours, prolongation of second stage beyond 2 hours or fetal head descent less than 1cm/h). Statistical tests included Fisher exact test and Chi- square test. Results: The highest sensitivity obtained from clinical pelvimetry was 33.3% and related to diagonal conjugate less than 11.5 cm. The sensitivity of external pelvic dimensions was higher than clinical pelvimetry that was highest for the Michaelis transverse diameter(60.72%). Conclusion: External pelvimetry in comparison to clinical pelvimetry is a better method for identifying dystocia in nulliparous women and can replace clinical pelvimetry in antenatal care programs.

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Introduction: S. aureus, the second most common cause of nosocomial infections, is regarded as an important factor in the severe infections of the community. Methicillin-resistant strains of this bacterium involve a major pathogen which can cause disease and mortality in Iran and the world. Its treatment seems to be difficult due to the prevalence of resistance to most commonly-used antibiotics. In fact, methicillin -resistant strains need to be identified precisely and rapidly. Therefore, this study intended to assess the resistance to methicillin via the disk diffusion method and PCR for mecA gene. Methods: This study was conducted on 100 strains of Staphylococcus aureus collected from clinical various samples of Moheb and Milad hospitals in Tehran. Sensitivity to antibiotics was determined by the disk diffusion method and gene resistance (mecA) was examined by PCR method. Moreover, specific primers were explored and the results were compared. Results: The prevalence of methicillin-resistant strains by the disk diffusion method was 50% (n=50), whereas 74% (n=74) were determined to have mecA gene via PCR analysis. Out of these 100 samples, 61 samples belonged to Moheb hospital, among which 47.54% (n=29) were observed to be methicillin-resistant by disk diffusion method and 60.65% (n=37) via PCR method. Other 39 samples were obtained from Milad Hospital, of which 84/53% (n=21) demonstrated resistance to methicillin via disk diffusion and 87/94% (n=37) via PCR method. Conclusions: The study findings revealed that due to high prevalence of methicillin resistance, a quick and detailed identification method of MRSA is required. Since disk diffusion method proposes relatively high false-negative results and is observed to have a time-consuming nature, PCR can be taken in to consideration as the best method in order to identify methicillin-resistant strains.

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