نعمت الله آهنگر

One of the applications of honey is in wound healing. A stapler normally connects the skin graft to the underlying bed. Due to its high cost and lack of production in Iran, and causing physical damage to the tissue, an alternative method is needed.

This study aims to compare the effects of using medical honey and staplers for skin graft fixation in patients with burn wounds in the north of Iran.

In this clinical trial, 80 patients with deep second-degree and third-degree burns less than 40% of total body surface area were included and were randomly divided into two groups of honey (n=40) and stapler (n=40). Demographic information and the percentage of burns were extracted from patients’ medical files. The graft rejection, number of hospitalization days, grafted skin displacement, graft contracture, pain severity, existence of edema or hematoma, itching severity, and infection after grafting were investigated and recorded.

Of 80 patients, 34 were male (42.5%) and 46 were female (57.5%). The mean age of the patients was 39.29±15.42 years. A significant difference was observed in the mean number of hospitalization days after grafting (P<0.001), incidence of infection, hematoma, edema, and severity of pain and itching (P<0.001), which were lower in the honey group. The graft contracture rate was lower in the stapler group (P<0.001). Graft rejection was not observed in any groups.

The use of medical honey for skin graft fixation reduces the duration of hospitalization and adverse effects such as pain, itching, edema, hematoma, and infection compared to staplers. This method is as efficient as the routine treatment.

Statins are among the most widely used drugs in treatment of cardiovascular diseases. Reducing the side effects of these drugs is of great importance in preventing treatment failure. The aim of this study was to investigate the role of rs4149056 polymorphism in statin-induced myopathy in patients with cardiovascular diseases in West of Mazandaran province, Iran.

A descriptive cross-sectional study was carried out in 161 patients taking atorvastatin who attended Cardiovascular Clinic in Ramsar Imam Sajjad Hospital and Tonekabon Shahid Rajaee Hospital, 2017-2018. All patients were given atorvastatin at 40 mg daily for 8 weeks and all lipid markers and CPK enzyme levels as a measure of myopathy were measured. Then, the patients received atorvastatin at 20 mg for 4 weeks and all lipid markers were measured again. PCR-ARMS method was used to determine the distribution of rs4149056 polymorphism.

According to findings, reducing the dose of atorvastatin caused significant differences in total cholesterol and LDL levels (P<0.05), but the mean of these changes was not significant between different genotypes (P>0.05). Drug dose change caused significant differences in levels of triglycerides in patients with TC genotype and HDL in patients with CC genotype (P<0.05). Moreover, in patients with CC genotype, the percentage of those with high levels of CPK was two times higher than patients with normal CPK.

Current study could be of help in predicting the incidence of myopathy in patients receiving statins and preventing the side effects of these drugs.

The aim of the present study was to investigate the protective properties of melatonin (MT) gainst oxidative stress, mitochondrial dysfunction, and apoptosis induced by tramadol-reproductive toxicity in male rats.

The rats were divided into the 7 groups of control, melatonin (1.5 mg/kg), tramadol (50 mg/kg), and melatonin (1, 1.5 and 2.5 mg/kg) administered 30 minutes before tramadol and vitamin C group (100 mg/kg). All injections were performed intraperitoneally. After administration for 3 consecutive weeks, the animals were
killed and testis tissues were used for assessment of oxidative stress markers including lipid peroxidation LPO), glutathione (GSH) content and protein carbonyl (PrC), and sperm analysis. Mitochondria were isolated from rat’s testis using differential centrifugation technique and were studied in terms of mitochondrial
viability, mitochondrial membrane potential (MMP), and mitochondrial swelling. The other part of the tissue sample was placed in RNA protector solution for assessment of Bax and Bcl-2 gene expression through realtime polymerase chain reaction (real-time PCR) assay.

Tramadol caused a significant decline in epidermal sperm count, motility, and morphology, as well as a significant decrease in GSH level and mitochondrial function, and a significant evaluation of LPO, PrC, MMP, and mitochondrial swelling. In addition, tramadol induced a significant decrease in Bcl-2 gene expression, and increase in Bax gene expression. However, pretreatment of rats with MT improved sperm analysis, and testicular antioxidative status, and mitochondrial function. Furthermore, MT pretreatment regulated testicular Bcl-2 and Bax expressions.

Considering the protective effects of MT against reproductive toxicity induced by tramadol, this compound can be used as a possible agent for the prevention and treatment of tramadol-induced reproductive toxicity

The aim of this study was the investigating rational use of opioid and non-opioid injectable analgesics in patients admitted to surgery and emergency wards of Imam Sajjad general hospital, Ramsar, Iran.

This descriptive and retrospective study was performed between July to August 2016 on 1181 files of patients receiving injectable analgesics and admitted to surgery and emergency wards of Imam Sajjad general hospital. Different information including indication, dose of administered drug and duration of treatment were recorded and compared to the AHFS guideline.

Among 1181 subjects, 675 patients were admitted to surgery and 506 patients to emergency wards. The main indications of injectable analgesic administration were trauma, cancer pain, chest pain and lumbar neuropathic pain, respectively. Of the 1181 patients, 568 cases received opioids, 341 cases received non-opioids and 272 cases received both opioid and non-opioids. Among the opioids, morphine was the most prescribed and among the non-opioids ketorolac was the most. Mostly encountered adverse effects were nausea and vomiting, hypotension and headache. Overall, 23.62% of the prescriptions were in accordance with guideline and 76.37% of them weren’t compatible.

Because of high inconsistency with guideline, it seems to need more attention on promoting medical staff information about prescription and rational use of injectable analgesic drugs.

 Neonatal jaundice is due to increased bilirubin and is seen in 50% of the term and 80% of preterm neonates. Due to dangerous side effects of this disease, prompt referral of neonates is important in accurate diagnosis and treatment. Meanwhile, the knowledge and attitude of mothers about neonatal jaundice is of great importance. So, this study was performed to assess the knowledge and attitude of postnatal mothers over neonatal jaundice in Tonekabon, North of Iran.

This descriptive observational study was conducted on 365 mothers, whose neonates were born with jaundice and delivered at Shahid Rajaee general hospital, Tonekabon, from September 2016 to May 2017. The subjects were interviewed using a structured questionnaire. The questionnaire was used to evaluate the subject’s knowledge and attitude about neonatal jaundice. Statistical analysis was performed suitably by chi-square and pearson correlation using SPSS 22.

In response to questions, mother's knowledge about neonatal jaundice was the most and the attitude over causes of jaundice in neonates had the least correct response. Among cases, 78.36% had moderate or lower knowledge, and 4.93% had less than a moderate attitude. There was also a significant relationship between age, socioeconomic status and mother's education with knowledge about neonatal jaundice.

Findings show the importance of increase in mother’s knowledge about neonatal jaundice, providing them helpful settings for education and promoting their life's level and style.

Diabetesis one of the most common chronic conditions and a major public health concern in Iran. Increasing awareness regarding diabetes can reduce mortality and economic burden on health systems.

To determine the level of diabetes related health knowledge, attitude and practice (KAP) among diabetic patients residing in west of Mazandaran Province.

This descriptive cross-sectional study was carried out on the patients with type-2 diabetes, referredto Ramsar 13Aban Pharmacy and Shafa outpatient clinic from May 2016 to Feb 2017. 240 patients were enrolled in the study and a questionnaire was filled through face-to-face interview. Level of KAP was evaluated by calculating the scores and the data were analyzed by SPSS software.

The mean age of patients was 58.27 (159 females and 81 males). The level of patients’ Knowledge, attitude and performance about diabetes were 59.36%, 38.5% and 51.35%, respectively. There was a positive significant relationship between patients’ level of knowledge and their educational level. The attitude score was lower in patients without family history. Moreover, better performance level was observed in females and in patients treated with insulin plus oral antidiabetic agents.

Results of the present study indicat ethe low level of KAP among diabetic patients about self-care and proper education of diabetic patients by regular programs can lead to better control, prevention of disease progress and decrease in health system costs.
Conflict of interest: non declared

Drug errors are a potentially hazardous occurrence that can be used in the treatment systems as one of the challenges and criteria for patient safety assessment. In this study, some of the main medication errors were evaluated in internal wards of Ramsar Imam Sajjad Hospital. This was a descriptive prospective cross- sectional study. Subjects were including 200 files of patients hospitalized in internal wards of Imam Sajjad hospital between March and September 2017. Gathered data were including demographic data obtained from patient’s file, drug orders documented in patient’ s file and drug orders transferred to patient’s drug cardex. Medscape was used for evaluating of any drug interactions. A total of 1888 prescribing were noted from 112 different drugs, in overall 200 investigated files, 166 cases of drug interaction were noted. There was significant relationship between number of drug use and hospitalization period with detection of drug interaction (p<0.05). Of 1720 registered orders, 223 medication errors occurred by the physicians and 36 errors by the nurses in drug transcription and administration. Physicians’ contribution in medication error was more (86.1 %). Nurses ’contribution in transcription error and drug order running was 13.9 %.   Appropriate feedback of results of the present study could be effective and valuable in reducing medication error.

Background and

The aim of this study was to determine the genetic variability of CYP1A1 m1 and m2 polymorphisms in cancer patients compared with healthy population in the west of Mazandaran province, Iran.

A case-control study was carried out in 120 non-relative healthy volunteers (60 males and 60 females) and 84 non-relative patients (39 males and 46 females) with diagnosis of cancer, attending the Hematology/Oncology ward in Ramsar Imam Sajjad Hospital between July 2016 and December 2017. Peripheral blood samples (3ml) were taken from the participants and stored at -20°C. The PCR-RFLP method was used to determine the distribution of CYP1A1 gene polymorphisms.

Among the two gene variants m1 and m2, individuals with AG and GG genotypes of CYP1A1 m2 polymorphism were found to have a significantly higher and increased risk for cancer (OR=3.94, 95%CI=2.05-7.57, P= 0.00, OR=9.46 , 95%CI=1.92-46.49, P= 0.00, respectively) and the TC genotype of CYP1A1 m1 polymorphism also had a significantly higher and increased risk for cancer (OR= 2.6 , 95% CI = 1.4-4.6, P=0.00). The ‘G’ allele was detected to have a strong association with cancer (P<0.001). The ‘C’ allele also showed strong association with the incidence of cancer (P<0.001). Thus, both CYP1A1 m1 and m2 polymorphisms showed an increased risk for cancer.

Our study suggested that the presence of ‘C’ allele of m1 polymorphism and ‘G’ allele of m2 polymorphism as the leading alleles that increase cancer susceptibility in the studied population

Background and

Hydrogels are used as carriers to control drug release. Ostrich oil has fatty acids which plays an important role in growth, division, and health of cells and cause wound healing and have anti-inflammatory effects.

In this experimental study, pH sensitive hydrogel was produced by chitosan deviation and open ring Poly-vinyl pyrrolidon (OR-PVP). The physicochemical characteristics of ostrich oil hydrogel was studied and its analgesic effect on mice was investigated by hot plate and formalin test.

Compared with other formulations, formulations containing chitosan with high molecular weight showed better results. The ratio of OR-PVP to high molecular chitosan was 0.4 for the best formulation. All formulations with 30% ostrich oil were found to have good analgesic effects.

This study showed that ostrich oil hydrogel could reduce inflammation and
central pain

Background and Estrogen hormone is a physiological regulator of breast tissue proliferation and changes in its signaling pathways, including the alpha-estrogen receptor, occurs during breast cancer and its progression. Single-nucleotide polymorphisms (SNPs) in genes can lead to differences in cancer susceptibility and response to treatment in different populations. In the present study, we investigated rs2234693 C/T single-nucleotide polymorphism in ESRα gene in breast cancer patients and healthy population in west of Mazandaran province, Iran.
A case-control study was performed in 91 healthy women without family history of breast cancer and 71 women with breast cancer admitted to oncology department in Ramsar Imam Sajjad Hospital between April and September 2017. Peripheral blood (3 ml) was taken from the subjects and stored at -20°C. The PCR-RFLP method was used to determine the distribution of rs2234693 polymorphisms.
The incidence of breast cancer in individuals with homozygous TT genotype was significantly higher (p To the best of our knowledge, this study for the first time suggested that T allele of rs2234693 C/T polymorphism might be a leading allele that cause increased breast cancer susceptibility in west of Mazandaran province.

Background and Proton pump inhibitors (PPIs) are one of the main therapeutic agents for acid-dependent diseases. Inappropriate use of this group of drugs especially Intravenous form of pantoprazole can lead to unnecessary cost. The aim of this study was to assess the IV Pantoprazole utilization in a teaching hospital in North of Iran.
This cross sectional study was performed within four months in 100 patients hospitalized in Ramsar Imam Sajjad Hospital, 2016. Demographic data, type and doses of Pantoprazole, risk factors for stress ulcer, and other relevant clinical data were recorded. Appropriate use of Pantoprazole was assessed according to recommendations provided by Fact Drug Information 2016, Medscape 2016, and UpToDate 2016.
Among the patients 54% had indication for receiving a PPI and only 16% had indication for parenteral form of PPI. Oral PPIs could have been used in 73% of the patients but they received parenteral form of Pantoprazole. In 92% of IV injections, a vial of 40 mg Pantoprazole was dissolved in 10 ml distilled water and injection was done in less than 10 seconds which was incompatible with guidelines.
In current study, utilization of Pantoprazole was not compatible with guidelines in most cases, including right indication, right preparation methods and right rate of drug administration.

Background and The main purpose of this study was determination of different genotypes and phenotypes of N-acetyltransferase 2 gene and its relationship with drug-induced liver injury among patients in Mazandaran province, Iran, which was done for the first time.
A total of 65 newly diagnosed unrelated pulmonary tuberculosis patients (47 men, 18 women) was enrolled in the study. A combination of polymerase chain reaction -restriction fragment length polymorphism method was used to investigate different allels of N-acetyltransferase-2. The patients were followed for occurrence of antituberculosis induced hepatotoxicity during the course of treatment. Relationship between N-acetyltransferase-2 phenotypes and antituberculosis induced hepatotoxicity was evaluated.
Frequency of slow, intermediate and fast acetylator genotypes in patients were 34%, 60% and 6%, respectively. Hepatotoxicity was diagnosed in 13.64% of slow acetylators, in 2.56% of intermediate acetylators and interestingly in none of the fast acetylators. The Chi-Square Test showed no significant difference between different acetylation phenotypes and risk of hepatotoxicity (P = 0.1086).
These results could improve treatment profile, prevent from drug-related adverse effects such as hepatotoxicty and lead to better outcomes in tuberculosis patients.

Background and Considering the importance of pain management in cancer patients, this study aimed to assess the prevalence of pain, its severity, analgesics used to control pain, and the extent of pain control in cancer patients attending a medical center in North of Iran.
One hundred cancer patients attending Ramsar Imam Sajjad Hospital (2015) were prospectively enrolled in the study. Clinical and demographic data and all analgesics used were recorded. Pain intensity were determined based on the Numeric Rating Scale from 0 (pain-free) to 10 (the most severe pain ever experienced) in two sequential visits, 3 weeks apart.
The average age of participants was 54.7±3 years. NSAIDs (98 cases, 98%) and opioids (49 cases, 49%) were the most common analgesics prescribed. Among opioids, codeine (67.3%) and morphine (24.5%) were used more frequently. The pain score was 3.94±0.342 at first visit and 3.65±.316 following analgesic use (P=0.002). For opioid users, the pain scores were 4.29±0.53 and 3.84±0.506, respectively (P=0.007).
The pain scores statistically reduced, however, the decrease was not clinically prominent since the pain severity was between 3 and 4 in NRS scale. More attention to pain control is recommended in cancer patients while considering the standard pain management guidelines.

Background and In recent years, consumption of commercial protein supplements and hormones that improve body appearance endangers the health of athletes especially in bodybuilding sport. Recently, use of plant extracts to reduce the side effects of drugs and improving physical activity has gained a lot of attention. The aim of this study was to investigate the effect of a supplement (mixture powder of Fenugreek seeds, rhizomes of Ginger and Alhaji manna) on increasing muscle strength and body composition in athletes in Mashhad, Iran, 2015.
A quasi-experimental study with pretest and posttest design was carried out in which 40 male athletes were selected using stratified random sampling. The participants had at least one year activity in fitness clubs. They were divided into control and experimental groups (n = 20 per group). The experimental group performed specific exercises for six weeks and had a daily intake of 5 grams of the supplement (in non-training days and one hr before the exercises). Data analysis was done in SPSS V.20 applying Mann Whitney and Wilcoxon tests.
The Wilcoxon test showed that taking the supplement in six weeks of bodybuilding exercises increased the factors influencing body composition and muscle strength in the experimental group (p≤0.05).
According to this study, a mixture powder of Fenugreek seeds, rhizomes of Ginger and Alhaji manna is helpful in improving muscle strength and body composition in athletes.

Background and Valproic acid (VPA) is used worldwide as a major drug in the intervention of epilepsy and in control of several kinds of seizures. The aim of our investigation was to evaluate the nephrotoxic potential of VPA and protective effects of zinc and selenium against VPA-induced nephrotoxicity in Wistar rats.
In this study, the animals were divided into five groups: control, VPA (200 mg/kg IP), VPA Zn (10 mg/kg IP), PA Se (1 mg/kg IP), and VPA Zn Se. After the administration of VPA for 4 consecutive weeks, the animals were killed and kidney tissues were separated. Finally, oxidative stress markers including glutathione (GSH) content, lipid peroxidation (LPO), protein carbonyl (PCO) were measured and blood was taken for measuring biochemical markers (BUN and Cr).
The administration of VPA for 4 consecutive weeks resulted in an increase in kidney marker (BUN and Cr). Also, oxidative stress was evident in VPA group by increased lipid peroxidation (LPO), protein carbonyl (PCO) and glutathione (GSH) oxidation. Zn and Se administration was able to protect against deterioration in kidney markers and suppressed the increase in oxidative stress markers.
Our study showed the critical role of oxidative damage in Valproate-induced nephrotoxicity that markedly inhibited by administration of Zn and Se. Therefore, Zn and Se supplementation could be suggested for prevention of valproate-induced nephrotoxicity.

Background and Cyclooxygenase II enzyme is one of the most important enzymes of prostaglandin synthesis pathway that also causes inflammations in human body. In the present study, the anti-inflammatory activity of eight new synthesized compounds with COX II inhibitory potential was evaluated in carrageenan induced paw edema in mice. Different doses of the compounds (10, 25 and 50 mg/kg), celecoxib (positive control, 10 mg/kg) and normal saline-tween (negative control) were intraperitoneally administered to the mice (female, 25-30 g, n=6). After 30 min, carrageenan was injected subcutaneously into the subplantar tissue of the left paw in all groups. The volume of paw was measured in different treatment groups at 0, 1, 3 and 5 hours following the carrageenan injection and percentage changes of paw volume was calculated. Data were reported as Mean ± SD. T-test was used to compare the results and P < 0.05 was considered significant. At the 10 mg/kg dose, all compounds showed significant anti-inflammatory activity just in 1st hour. At the 25 mg/kg dose, some compounds had significant anti-inflammatory activity in all investigated times, and at 50 mg/kg dose, all compounds showed significant anti-inflammatory activity in 1st, 3rd and 5th hour compared to the group injected with normal saline- tween. This study found 4-(4-Methylsulfonylphenyl)-3-phenyl-2(3H)-thiazole thione derivatives with good anti-inflammatory activities.

Beta-actin is a housekeeping gene, which is used as an internal standard in various biological studies. Recently, it was reported that the expression of commonly used housekeeping genes including ß–actin changes in disease states or under certain experimental conditions. Based on the reports about the effects of sex hormones on the expression of the ß- actin gene, in this study, we examined the sex differences in the expression levels of ß- actin gene in different tissues of the rat.

Total RNA was extracted from the brain, spinal cord, heart, kidney and liver tissues in male and female rats as well as uterus in females. The RT-PCR method was used to measure the levels of ß-actin gene expression in all tissues.

The expression of ß-actin gene in the brain and spinal cord of male rats was significantly higher than its expression in female animals (P<0.05). It was also found that the expression of ß-actin gene in the heart and uterus of females were significantly higher in comparison with other tissues (P<0.001 and P<0.05 respectively). Similarly, ßactin gene expression in the heart tissue of male rats was significantly higher than other tissues (P<0.001).

It is suggested to validate the constancy of ß-actin gene expression under the experimental condition, before using this house keeping gene as an internal standard in molecular biology studies.

Background and The human multidrug resistance gene (MDR1) encodes for P-glycoprotein (P-gp) which is a transmembrane transporter protein acts as an efflux pump for a number of xenobiotics. It plays a protective role for cells against DNA damage caused by toxins and drugs. The wobble C3435T polymorphism at exon 26 has been associated with different expression levels and activities of this gene. Differences in allele frequency of the C3435T polymorphism have been demonstrated between distinct ethnic groups. In this study, we examined this polymorphism in a healthy population in Mazandaran province (North of Iran). Genomic DNA was extracted from the peripheral leukocytes of 150 healthy volunteers under the supervision of two physicians in Sari Blood Transfusion Center. All subjects gave their written informed consent to participate in the research. Polymerase chain reaction–restriction fragment length polymorphism method was used for the detection of C3435T single nucleotide polymorphism and the results were confirmed by direct sequencing method. The frequencies of the CC, CT and TT genotypes were 10.7 %, 64 % and 25.3%, respectively. The frequency of T allele (57.3%) was significantly higher than C allele (42.7 %) (P<0.05). This study is the first to show the C3435T polymorphism of MDR1 gene in a population in Mazandaran province of Iran. These data may be relevant for dose recommendation of P-gp substrate drugs and can help for individualizing drug therapy of organ transplantation and important diseases such as cancer and AIDS, congestive heart failure and others.

Background and

CYP1B1 is involved in the metabolism of exogenous and endogenous substrates and plays a key role in hormone and xenobiotic induced carcinogenesis. Polymorphisms in CYP1B1 could result in modifications in its enzyme activity and are known to be associated with cancer susceptibility related to environmental toxins and hormone exposure. Moreover, the association of CYP1B1 polymorphisms with glaucoma has been reported. In the present study, we determined the frequency of Leu432Val (G4326C) polymorphism of this gene in a healthy population from Mazandaran province of Iran.

A total of 150 unrelated healthy subjects from Mazandaran province, residing in Sari, coming for blood donating at Sari Blood Transfusion Center were enrolled. A total of 5 ml of peripheral blood was taken from individuals. Genomic DNA was extracted using DNG+Blood DNA kit. The polymerase chain reaction–restriction fragmentlength polymorphism method was used for the detection of G4326C single nucleotide polymorphism in each subject.

The frequencies of the GG (Val/Val), CG (Leu /Val) and CC (Leu/Leu) genotypes were as 12%, 40.7% and 47.3%, respectively (P < 0.05). The frequency of G allele in Iranian population (Mazandaran province, Sari) was 32.3% and the frequency of C allele was 67.7%.

Results of the present study might be important in understanding the distribution of Leu432Val CYP1B1 polymorphism in the Mazandaran province of Iran. Moreover, these results could be helpful in predicting the risk of cancer and glaucoma.

Background and Diazinon is an organophosphate insecticide used mainly in agriculture, horticulture, and animal husbandry. Exposure to diazinon affects the redox process, the activity of antioxidant enzymes and could increase the lipid peroxidation in many organs. This study aimed at examining the chronic effect of diazinone on cell membrane lipid peroxidation and the protective effect of l-carnitin on this process. In this study, male Wistar rats were divided into 8 groups. The groups were administrated normal saline (control group), diazinon (20 mg/kg), l-carnitine (50,100,150 mg/kg), and a combination of diazinon with the mentioned doses of l-carnitine, intraperitonealy (IP) for 4 weeks. The rats were anesthetized with ketamine 24 hours after the last injection and 2 ml blood was taken from their heart. Then, Lappena method was used to measure the serum concentrations of malodialdehiyde (MDA). The data was analyzed using SPSS and the differences between the groups were analyzed applying cruskal-wallis and Mann-Whitney test at the significance level of 0.05. The serum concentration of MDA was significantly higher in rats exposed to diazinon compared with the control group (P= 0.009). A significant decrease was seen in the serum concentration of MDA in the groups exposed to diazinone/l-carnitine (P= 0.014). Diazinon induce the production of free radicals and oxidative stress. Probably, l-carnitine can reduce diazinon-induced lipid peroxidation in cell membrane by scavenging free radicals.

Background and The objective of this study was to determine the influence of 3 vitamin K epoxide reductase complex subunit 1 (VKORC1) polymorphisms (-1639G>A، 1173C>T and 3730G>A) on warfarin dose requirement in patients from Mazandaran province، Iran. A total of 29 patients taking warfarin for at least 3 months and had stable dose requirements were enrolled in the study. DNA samples from these patients were genotyped for polymorphisms in VKORC1 gene and statistical analysis was performed to examine the associations between demographic characteristics (eg، age، sex، weight، height and BMI)، genetic factors، and maintenance dose of warfarin In -1639G>A polymorphism، 25 patients (86. 2%) were AA، 2 patients (6. 9%) were GA and 2 patients (6. 9%) were GG genotype. Mean dose of warfarin in patients with AA genotype was lower but their INR was higher than two others genotypes. In 1173C>T، 26 patients (89. 7%) were TT، 2 patients (6. 9%) were CC and one patient (3. 4%) was CT. Mean dose of warfarin in patients with CT genotype was lower but their INR was higher from two others genotypes. In 3730G>A، 28 patients (96. 5%) were GG and only one patient (3. 5%) was GA. INR in this patient was higher than other genotype. Significant correlation was obtained only between -1639G>A polymorphism and warfarin dose requirement In the present study، we observed genetic polymorphism in all 3 regions. -1639G>A polymorphism was important determinants of warfarin dose requirements in our patients. Correlation between dose requirements and INR with polymorphisms was similar to other studies; however، percentage of genotypes in each polymorphism was different from other populations.

Background and The wide spread use of pesticides in public health and agricultural programs has caused environmental pollution and increased risk of acute and chronic of human poisonings. Diazinon after malathion is one of the most commonly used OPCs in the world. Several studies suggest that organophosphate compounds that cause oxidative stress and lipid peroxidation. The study was performed on the male Wistar rats. Animals were randomly divided into 15 groups and 4 weeks Chemicals (Diazinon، L-carnitine، and selenium) recived intraperitoneally. Group 1 (normal saline)، 2 (soya oil)، 3 (Diazinon 20 mg/kg)، 4، 5 and 6 groups (doses 50، 100 and 150 mg/kg L-carnitine)، 7، 8 and 9 groups (doses 50، 100 and 150 mg/kg L-carnitine + Diazinon 20 mg/kg)، group 10، 11 and 12 (doses 0. 5، 1 mg/kg 2 sodium selenite)، 13. 14 and 15 groups (doses 0. 5، 1 mg/kg 2 sodium selenite + Diazinon 20 mg/kg). 24 hours after last injection، the animals received ketamine anesthesia and liver tissue was removed. After liver tissue homogenization، glutathione (GSH) level were determined by Elman method. Data was analyzed by SPSS software using one-way variance analysis and Tukey’s test. Diazinon in compared with the control group decreased glutathione level and L-carnitine in a dose-dependent manner increases GSH levels. Selenium with 0. 5 mg/kg dose resulted in a significant increase in GSH level compared with diazinon alone (P> 0. 05). Diazinon induced the production of free radicals and oxidative stress. The depleted GSH content is indicator of oxidative tissue injury. Selenium and L-Carnitine improved the body''s antioxidant status against organophosphate pesticide، such as diazinon