Vermiform appendix has diverse anatomical positions, lengths, and conditions of mesoappendix. Knowing the exact anatomical position of vermiform appendix is important in view of surgeons for on-time diagnosis and management of acute appendicitis. The aim of present study is determination of these characteristics of vermiform appendix among Iranian population. The present study was conducted on 200 bodies, selected from the dead bodies that had been referred to local bureau of legal medicine, Zenjan province, Iran, for medicolegal autopsy since 21 Mar 2010 to 21 Mar 2011. According to the results, the anatomical positions of the appendix were pelvic, subcecal, retroileal, retrocecal, ectopic, and preileal in 55.8%, 19%, 12.5%, 7%, 4.2%, and 1.5% of the bodies, respectively. The mean length of vermiform appendix was 91.2 mm and 80.3 mm in men and women, respectively. Mesoappendix was complete in 79.5% of the bodies. No association was found between sex and anatomical position of vermiform appendix. Anterior anatomical position was the most common position for vermiform appendix. It is inconsistent with most related reports from western countries. It might be possible that some factors, such as race, geographical changes, and dietary habits, play roles in determining the position of vermiform appendix.

Backgrounds:Vitamin D deficiency is common worldwide, including Iran. It has been suggested that vitamin D deficiency is associated with non-specific musculoskeletal pain. The aim of this study is evaluation of the association of musculoskeletal pain with vitamin D deficiency and the response of the patients to vitamin D supplementation.Materials and Methods:sixty two adult patients with chief complaint of musculoskeletal pain were enrolled in the study. Serum concentrations of 25(OH)D, Calcium, Phosphate, Alkaline Phosphatase and PTH were determined. If there was vitamin D deficiency, oral vitamin D supplementation was given. Assessment of pain and its response to therapy was carried out using Visual Assessment Score (VAS). SPSS software version 15.0 was used for statistical analyses.Findings:Most of the patients (95.4%) had vitamin D deficiency. Pain in 53 patients (85.5%) with responded to the proposed treatment. In responder group post treatment vitamin D concentration was significantly higher than non responder group (60.6±27.6and 39.2±9.6 nmol/l respectively, p<0.01) pretreatment vitamin D and minerals concentrations and pain characteristics did not have significant differences in responder and non responder group.Conclusion:Treatment with vitamin D can relieve the pain in majority of the patients with vitamin D deficiency. Lack of response can be due to insufficient increase in serum vitamin D concentration. Physiologic differences of gastrointestinal vitamin D absorption, differences of body mass indexes, and noncompliance could be potential causes for this issue. Reassessment of serum 25(OH)D concentration is recommended in nonresponsive patients.

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Objectives:Systemic lupus erythematosus has its unique complications which warrant careful examination and assessment during follow/up visits of patients. The present study was conducted to evaluate prevalence of hearing loss in patients with SLE.Materials & Methods:At present a case- control study has been performed on 45 patients with SLE in a clinic of a teaching university hospital, Qazvin city, Iran. The patients were examined and evaluated for auditory and hearing problems as well as parameters related to their disease severity and progression. The control group was selected from the same clinic.Results:Five patients (11.1%) complained from hearing loss, 4 patients (8.9%) complained from otorrhea, 3 patients (6.7%) had tinnitus in research group, moreover twelve patients (26.7%) in case group and 4 patients (8.9%) in control group had sensorineural hearing loss. The difference was found to be statistically significant. No statistical significant relationship was found between severity, age of onset, and duration of the disease, and the lab tests of the patients with hearing loss.Conclusion:The present study implies that patients with systemic lupus erythematosus may develop sensorineural hearing loss during their course of the disease. It is recommended that audiology examination and/or audiometry become a part of routine follow/up studies of the patients.

Objectives:Chronic obstructive pulmonary disease (COPD) is a widespread disease. It produces some night symptoms such as nighttime cough and dyspnea. Then subjective and objective changes in sleep pattern are expected. Present study was conducted to determine frequency of sleepiness and quality of sleep in patients with COPD.Materials & Methods:Present case-control study has been performed on 120 patients with diagnosis of COPD who had been referred to pulmonary disease clinic in a University teaching hospital. One hundred twenty age- and sex- matched healthy individuals were recruited in the study and served as control. Spirometry (PFT) was performed for all patients. Patients were categorized under 3 groups in relation to their PFT as follow: mild COPD (FEV1/FVC<70% and FEV1≥80%), moderate COPD (FEV1/FVC<70% and 50%≤FEV1<80%), and severe COPD (FEV1/FVC<70% and FEV1<50%). Pittsburgh Sleep Quality questionnaire (PSQI) and Epworth Sleepiness Scale (ESS) were used to estimate quality of sleep and daytime sleepiness in the patients and control group. The collected data were analyzed using version 16 SPSS software. Student’s T- test, Chi- square and multiple logistic regressions were used as appropriated.Results:120 patients with COPD (79 males and 41 females) and 120 normal individuals responded to the questionnaires. Mean scores of quality of sleep were 8.03±3.66 and 4.2±2.8 in COPD patients and control group respectively. 32.1% of the patients had good sleep quality (PSQI score less than 5) and 67.9% had poor sleep quality. Daytime sleepiness (ESS≥ 10) was present in 34.8% of the patients and 15% of control people. Multiple logistic regressions showed that the patients reported significantly worse sleep quality and more daytime sleepiness than control group [OR=2.9; 95% CI (1.6-3.7) & OR=3.5; 95% CI (2.5-4.3) respectively].Conclusion:Results of present study confirmed that COPD is associated with daytime sleepiness and poor quality of sleep, possibly attributable to nighttime respiratory difficulties and concomitant sleep apnea. Assessment of the patients for symptoms of sleep apnea, daytime sleepiness should be a part of regular follow up visits of patients with COPD.