Introduction: Clinical use of the late responses during routine neurophysiological examination has significantly increased the diagnostic yield of the neurophysiological evaluation. The H max to M max RATIO (H/M RATIO) is considered a suitable index for illustrating the level of reflex excitability of the motor pool.Methods: In this study posterior tibial nerve H/M RATIO changes in cerebrovascular accidents (CVA) evaluated. This investigation was carried out in 22 normal subjects aged 40-65 years with mean 52 years, and in 40 patients with CVA aged 42-63 years with mean 57 years.Results: In normal subjects no significant differences were found between the mean values observed between right and left sides. In patients significant increased H/M RATIOs in both sides with more in non-plegic leg (P<0.01) were found. The facilitation of Babinsky sign in patients is significantly associated with low H/M RATIOs (P=0.003). The H/M RATIO changes were not significantly associated with severity of hemiplegia (P=0.3 for lower extremities, P=0.9 for upper extremities). The H/M RATIO was increased in ischemic lesions (P<0.01), but in intracerebral hemorrhages the soleus H/M RATIO increases in non-plegic side the same as the plegic side.Conclusion: The posterior tibial nerve H/M RATIOs are increased in CVA bilaterally due to decreased presynaptic inhibition Ia terminals, thus amplitude of H reflexes increased without increased amplitude of M response.

The method of selection of the study design decides the type of analysis 10 be used. Case-Control studies assess the causes of a particular outcome, comparing a group of individuals who have experienced the outcome under study with a group who have net.Results appear as a two by two table. As these two groups are sampled separately, the rate of the disease in the exposed or unexposed groups can not be calculated. However, the Odds RATIO can be obtained. The Odds RATIO is sometimes referred to as the cross product RATIO.                        Cases                            Controls Exposed            a                                  b Unexposed         c                                  d Odds RATIO (a/b)I (c/d) = ad/bc

Introduction: Adenoid hypertrophy is one of the main common causes of eustachian tube dysfunction and otitis media with effusion. A group of otolaryngologists and pediatrics believe that it is not possible to estimate adenoid size in order to do Adenoidectomy only with clinical evaluation and there is no any acceptable result to show how many patients with OME were satisfied after adenoidectomy. The aim of this study is to determine RATIO between adenoid and nasopharynx in children with adenoid hypertrophy and OME then determine the number of children who will be satisfy after adenoidectomy.Materials and Methods: This descriptive study was performed on 50 patients who had OME and adenoid hypertrophy and came to ENT department of Imam Reza Hospital. The standard lateral neck view for the patients was done and sizes were calculated on lateral neck graphy. The A/N degree RATIO which estimated was compared with the A/N degree RATIO in normal children in the same ages from the other studies and the efficacy of adenoid size on obstructive manifestations was considered.Results: 6 of 50 patients were between 4-6, 37 of them between 6-8 and, 7 of them between 8-10 years old. A/N RATIO on different age groups in OME patients in comparison with normal people has no significant differences (P=0.43). 16(%32) patients did not have any obstructive signs and 54(%44) had obstructive signs and mean RATIO A/N was 0.44 and 0.49 respectively. This study shows in patients with OME, mean RATIO A/N in a group with adenoid hypertrophy is higher than those in asymptomatic group (P<0.001).Conclusions: This study shows in patients with OME and obstructive signs, adenoidectomy can be effective for the treatment of obstructive signs, but in patients with adenoid hypertrophy without obstructive signs, adenoidectomy would not be beneficial.

Introduction: Left ventricular filling pressure (LVFP) determination is a key step in predicting prognosis and making an appropriate therapeutic strategy, especially in patients with heart failure. Left cardiac catheterization allows an accurate and direct evaluation of some hemodynamic variables that estimate LVFP. But, since this method is not completely free from complications, several different methods, especially echocardiographic, were used in order to non invasively evaluate LVFP. The aim of this study was to determine the accuracy of E/E’ RATIO in non-invasive prediction of LVFP in patients with different EF. Materials and Methods: In this study, LVEDP was measured in cardiac catheterization for 50 patients with sinus rhythm under left ventricular catheterization. Also, the mean E/E’ RATIO (early diastolic mitral inflow velocity to annular velocity) was measured by Doppler echocardiography in all patients. At the end, the relationship between echocardiographic measurements and cardiac catheterization measuring LVEDP was evaluated. Results: The mean age of patients was 57. 71 ± 11. 72 years and 37 (61. 7%) were male. The mean E/E’ RATIO was 11. 06 ± 4. 17 cm/s and the mean LVEDP was 12. 9 ± 3. 96 mm Hg. The Pearson correlation between E/E' RATIO and LVEDP was 0. 717 (p <0. 001). Based on different EF values, the strongest correlation between E/E' and LVEDP was observed in the patients with EF <35 and >55%, and the weakest correlation in the EF=35-44. Conclusion: The results of this study show that the evaluation of left ventricular filling pressure using a non-invasive calculation of E/E’ RATIO in echocardiography has high accuracy and can replaced and used instead of invasive methods.

Introduction: Chest X–Ray is one of the most common methods of imaging. Cardio Thoracic RATIO (CTR) is one of the parameters of Chest X–Ray that is used for determining cardiac enlargement. Echocardiogra hy as compared to Chest X–Ray is expensive and all centers dont have it, but it can determine heart size, valvular diseases, Ejection Fraction, Left Ventricular Hypertrophy (LVH), pericardial effusion and diastolic dysfunction very well. So, this research was done in order to compare CTR with Echocardiographic find ngs and precent expensive investigations in the future.Methods: In this cross-sectional analytical study from Sep 2006 to Sep2007, CTR of 172 patients referring to Shohadaye Kargar and Goodarz hospitals was determined from their Chest X–Rays and echocardiography was done later. Data was analyzed with SPSS software and statiscal tests such as Chi-square and Fisher exact tests were used.Results: The results of this research were as follows: 1- The mean age for the patients with increased CTR was higher than patients with normal CTR. 2- Left Ventricular Hypertrophy (LVH) and increases of left and right ventricular diameters increased the CTR. 3- There was no statistical relation between sex, pericardial effusion, left and right atrium diameters and TR. 4- Patients with increased CTR had more valvular heart diseases, systolic and diastolic dysfunction than patients with normal CTR.Conclusion: Increased CTR is one of the signs of cardiac pathologies and therefore echocardiography is advisable for more evaluation of patients with increased CTR.

Background: Adenoid hypertrophy plays an important role in the nasopharyngeal obstruction in children. Given that the symptoms of adenoid hypertrophy often occur at the time of lying down, the radiological evaluation of these patients is more consistent with clinical symptoms of patients. Therefore, the aim of this study was to investigate the relationship between the depths of nasopharynx in adenoid hypertrophy via adenoid graphic evaluation in sitting and lying positions. Methods: In this study, 31 patients referred to the ENT clinic of Tabriz Children's Hospital, who had clinical symptoms of adenoid hypertrophy, were included and considered as the symptom assessment score (SAS). A / N RATIO was measured for the each patients in sitting and resting conditions. Results: 16 females and 15 males with adenoid hypertrophy with mean age of 7/39 ± 1/39 years were enrolled in the study. The results showed that all patients had symptoms of open-mouth breathing, night snapping and permanent nasal congestion, while only 4 patients had sleep apnea. The results showed that the average A / N RATIO in patients in sitting and lying down conditions was 0. 79 ± 0. 016 and 0. 89 ± 0. 015 respectively. The statistical results showed that there is a significant difference between the A / N RATIO in the sitting and lying down situations, and the average A / N RATIO in the lying down state was higher. Conclusion: Based on the results obtained in this study lateral cephalometric in lying down mode is preferable to sitting position for adenoid hypertrophy investigation.