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Background: Laparoscopic cholecystectomy, one of the most common elective surgical procedures, is a minimally invasive surgical procedure for patients with gallbladder diseases. Objectives: This study aimed to evaluate the effect of laparoscopic cholecystectomy on coagulation tests among patients undergoing the surgery in Ali Ibn Abi Taleb Hospital in Zahedan. Methods: Following a quasi-experimental design, 21 cases scheduled for laparoscopic cholecystectomy for whatever reasons at Ali Ibn Abi Taleb Hospital in Zahedan (Iran) were selected. To study the serum levels of blood factors, blood samples were collected at three stages, i.e., before the surgery (time point 1), 30 minutes after pumping the carbon dioxide gas into the abdomen (time point 2), and 30 minutes after removing the last port from the abdomen (time point 3). Data were analyzed using repeated measures. Results: According to the findings, laparoscopic cholecystectomy surgery only had a significant effect on the PT coagulation factor at the 99% confidence level. Also, PT was increased and significantly differed at time points 2 (30 minutes after pumping) and 3 (30 minutes after removing the port) compared to time point 1 (30 minutes before the surgery). Conclusions: Generally, it can be argued that despite observing some variations in the PT coagulation factor during the laparoscopic surgery, the INR level did not change. Hence, it can be considered as a safe surgical intervention for renal and liver functions.

Background To compare efficacy of pipelle biopsy as an office biopsy method with dilatation curettage (D&C) for women referring Ali Ebn e Abitaleb hospital of Zahedan university of medical science in 2015 - 2016. Methods In this cross sectional study, 200 patients with Abnormal Uterine Bleeding (AUB) who had referred to gynecology clinic of Ali Ebn e Abitaleb Hospital of Zahedan University of medical science, were selected. The patients were randomly allocated to the two groups based on permuted block design method. In 1th group (n = 100), pipelle biopsy was performed as office biopsy and 2th group (n = 100), dilatation curettage (D&C) was performed in operation room. Sampling was done by the same surgeon and was interpreted by the same pathologist. Results The samples were adequate in 1th group (n = 88), 88% and in 2th group (n = 98) 98%. Fisher test was used for statistical analysis. It reported statistical significant difference between pipelle biopsy and dilatation curettage (D&C) in terms of histopathology and samples efficacy (P = 0.01). Conclusions Obtained results demonstrated that efficacy of pipelle biopsy is high. Totally this procedure is safe and cost-effective with low complications. However, we should be careful to alternate pipelle biopsy instead of dilatation-curettage (D&C) in AUB approach.

Background: Pleural tuberculosis occurs in 4% of newly diagnosed cases of tuberculosis. T-cells have an important role on the immunity against mycobacterial infections and as a result, the level of soluble interleukin 2 receptors (SIL-2R) as a marker of T-cell activation is elevated in patients with tuberculous pleural effusion. Materials and Methods: In this cross sectional study, the diagnostic accuracy of SIL-2R level was assessed in separating tuberculous from non- tuberculous effusions in Zahedan, Iran. From 112 patients fulfilled entrance criteria for exudative pleural effusion, 88 patients were included and underwent diagnostic procedures to identify the origin of pleural effusion. The SIL-2R was evaluated at various cut-off levels by nonparametric receiver operating characteristic (ROC) curve, and values affording greatest diagnostic accuracy were selected. Results: SIL-2R level in TB group was 9147±3573 while this level in non-TB group was 2724±1326 and the difference was statistically significant (p=0.001). The cut-off point in our study was 4200 U/ml and the area under curve was 0.930 with 95% CI: 0.881–0.979 (p=0.001). The sensitivity and specificity for this level is 86 and 89%. Conclusion: Several factors lead to the variation in the level and cut-off point of SIL-2R in different regions. Our cut-off point was lower than other studies. The level of SIL-2R in patients with tuberculosis is significantly higher than parapneumonic effusions. We suggest that measuring the SIL-2R level in pleural fluid of tuberculous patients is a useful diagnostic tool in diagnosing tuberculous pleural effusion.

To our knowledge, there is no report regarding adenosine deaminase activity (ADA) in gestational diabetes mellitus (GDM). The aim of the present study was to investigate the level of serum ADA activity in normal pregnancy, GDM and normal non-pregnant women.The serum catalytic concentration of ADA was measured in samples of 20 GDM, 40 normal pregnant and 20 non-pregnant healthy women.Adenosine deaminase activity was significantly higher in GDM (24.30 +/- 8.04 IU/L) and pregnant women (23.88 +/- 8.66 IU/L) than those of normal non-pregnant individuals (11.85 +/- 3.23 IU/L) (P0.0001), but the ADA level was not significantly different from GDM and normal pregnant women (P = 0.97).Adenosine deaminase activity was significantly higher in GDM and pregnant individuals than normal group in this study. Previous reports in this field are contentious; therefore, ADA activity could be regulated in different population by immunologic and genetic factors.

Alpha-1-antitrpsin (AAT) is the main antiprotease of plasma. Concentration of serum alpha-1-antitrypsin (AAT) may not be delegate of the functional capacity of this antiprotease. To our knowledge there is not any report regarding the functional level of AAT in gestational diabetes mellitus (GDM). The aim of the present study was to determine serum trypsin inhibitory capacity (sTIC) in gestational diabetes mellitus.This case-control study was performed in 41 GDM and 40 healthy pregnant women. sTIC was measured by enzymatic assay.The serum trypsin inhibitory capacity was significantly lower (p0.001) in GDM (5.84+/-2.27 micromol/min/ml) than healthy pregnant women (7.24+/-1.91 micromol/min/ml).In gestational diabetes mellitus reduction of serum trypsin inhibitory capacity may be due to non-enzymatic glycosylation of alpha-1-antitrypsin or oxidation of methionin in the active site of alpha-1-antitrypsin which remains to be cleared.

Background. Recently, it has been suggested that human herpes virus 6 (HHV6) may play a role in the pathogenesis of multiple sclerosis (MS). Our purpose is to determine the incidence of reactivated HHV6 in MS patients.Methods. Viral sequence analyzed by qPCR in the peripheral blood mononuclear cells (PBMCs), serum, and saliva samples of different subtypes of MS patients (n=78) and healthy controls (n=123). HHV6 IgG and IgM antibody levels measured by ELISA technique in the plasma samples of both groups. Likewise, cerebrospinal fluid (CSF) samples of some MS patients (n=38) were analyzed for viral sequence.Results. Results demonstrate increased levels of anti-HHV6-IgG (78.2% versus 76.4% in controls;P=NS), and IgM (34.6% versus 6.5% in controls;P<0.05) in MS patients. Furthermore, RRMS and SPMS patients showed relatively higher anti-HHV6 IgG and IgM compared to PPMS (P<0.001). Moreover, load of cell-free viral DNA was higher in RRMS and SPMS patients and detected in 60.2% (47/78) of MS patients, compared with 14.6% (18/123) of healthy controls (P<0.001). Moreover, load of cell-free viral DNA was higher in RRMS and SPMS patients and detected in 60.2% (47/78) of MS patients, compared with 14.6% (18/123) of healthy controls (P<0.001).Conclusions. The results extend the observation of an increased frequency of systemic reactivated HHV6 infection in MS patients with developed stages of disease.

"nOne of the great challenges in the treatment of infectious diseases is the resistance of pathogenic bacteria against antibiotics, and antibiotic resistance to Shigella is broadly observed in different parts of the world. The object of this study was to determine Shigella antibiotic resistance pattern against the antibiotics such as ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, chloramphenicol, nalidixic acid, ciprofloxacin and ceftriaxone. In this cross-sectional study, a total of 147 Shigella strains were collected from the diarrheic patients referring to different medical centers of Zahedan. Specific antisera were used for serotyping of isolated Shigella and their antibiotic resistance patterns were determined by standard Kirby-Bauer method. Of the 147 studied Shigella strains, 102 (69.3%) belonged to S. flexneri, 32 (21.7 %) to S. dysenteriae, 11 (7.4%) to S. boydii, and 2 (1.36%) to S. sonnei species. The isolated strains showed resistance to ampicillin (99.3%), trimethoprim-sulfamethoxazole (52%) and nalidixic acid (1.3%), but there was no resistance against ciprofloxacin and ceftriaxone. According to the findings, it is suggested that antibiotics should not be used without laboratory testing (antibiogram).

Objectives: Epstein-Barr virus has been recently associated with the onset of multiple sclerosis, yet understanding how it elicits autoimmunity remains elusive. We investigated the relation between Epstein-Barr virus reactivation and disease development in different subtypes of multiple sclerosis. Methods: In the present research, we have determined the Epstein-Barr virus-DNA load by quantitative real-time polymerase chain reaction and Epstein-Barr virus antibody levels by EIA technique in both multiple sclerosis patients (n = 78) and healthy controls (n = 123). Results: Our results demonstrated increased titer of both anti-Epstein-Barr virus-IgG and IgM antibodies in patients (91.02% vs 82.11% in controls, p