[Effect of continuous aerobic training on serum levels of liver injury indices in rats with myocardial infarction]

Introduction: In this study, the effect of continuous aerobic training on serum indices of liver tissue damage enzymes [aspartate aminotransferase [AST], alanine amino transferase [ALT], and alkaline phosphatase [ALP]] in rats with myocardial infarction [MI] were evaluated. Material and Methods: For this purpose, four weeks after MI, 30 male Wistar rats were randomized to the following groups: 1: Sham [n=10]; 2: MI-sedentary [Sed-MI], n=10 and 3: MI-exercise [Ex-MI], n=10 the rats were subjected to aerobic training in the form of treadmill running for 10 weeks [5 days per week] at 17 m/min for 50 min/day. At the end of training program, serum AST, ALT, and ALP were measured by ELISA kits. Results were analyzed by one-way analysis of variance [ANOVA] and P<0.05 was considered as significant level. Results: AST activity, in the MI-sedentary and MI exercise groups was significantly higher at the end of training [p=0.01], there was however no significant difference between MI-sedentary and MI-exercise [p=0.93]. Alanine amino transferase was also significantly increased after MI [p=0.02], there was howere no significant difference between MI-exercise and the MI-sedentary groups [p=0.55]. ALP activity was comparable between groups [p=0.9]. Conclusion: Ten weeks continues aerobic exercise training with moderate intensity had no effect on liver function in rats with MI. To better evaluate the effect of exercise training on liver pathological indices immunohistochemical analyses are needed

[ comparison of the effect of food sources of saturated and unsaturated fatty acids on ovarian activity of holstein dairy cows in close up period]

Background: Application of different sources of fatty acids and their effect on ovarian performance is a current issue in animal science and research centers

Objectives: The purpose of this study was to determine the effect of different fatty acids in close-up period on population and size of follicles and measuring blood parameters related to the energy state of the body after calving of lactating dairy cows

Methods: In this study 15 Holstein cows were selected by expected date of parturition [around 30 days before calving] and assigned them randomly within treatments diets. The diets were formulated to be isonitrogenous. Cows were fed 1] control [carbohydrate source], 2] Rumen-protected fat [RF] [saturated fatty acids] and 3] Roasted Soybean [RS] [unsaturated fatty acids]. Blood sample was collected at 7 day intervals in -21, -14, -7, 1, 7, 14, 21 periods of calving. Also dry matter intake and body condition score cows were recorded. Ovarian activity was monitored by daily transrectal ultrasound scanning from 30 to 40 and 61 to 70 DIM

Results: Average plasma glucose and cholesterol concentration were significantly different among treatment groups. Numerically, follicular classes were higher in cows, fed with fat diet compared with control group

Conclusions: According to the results of this experiment, it seems that application of polyunsaturated fatty acids, to improve the energy and ultimately the function of the ovaries, has more advantage than saturated fatty acids

[Comparison of color change of silorane and methacrylate-based composites due to bleaching]

Bleaching treatments may alter the color stability of composite restorations. Silorane-based composites have shown similar or superior physical and mechanical properties compared to other types of composites. Furthermore, studies have shown variable and sometimes contradictory results regarding the effect of bleaching agents on the color stability of composite restorations. This study aimed to assess the effect of two Iranian bleaching agents on color stability of a Silorane-based [P90] composite compared with two methacrylate-based composites [nanofiller[Z350] and microhybrid. [Z250]. In this in vitro study, a total of 18 disc-shaped specimens [10 x 2 mm] of Z250, Z350 and P90 composites [A3 shade] were fabricated and randomly divided into 3 groups [n=6] and subjected to bleaching treatment with 16 % carbamide peroxide, 35% carbamide peroxide and distilled water as the control group. Color parameters were measured using CIE-L*a*b* system and a spectrophotometer before and after bleaching. The factors were statistically analyzed by means of two-sided ANOVA [repeated measures ANOVA] and Tukey's multiple comparisons tests.The mean +/- standard deviation of total color change [delta E] in control, 16% carbamide peroxide and 35% carbamide peroxide groups was 3.48 +/- 1.43,4.55 +/- 1.7 and 4.17 +/- 1.9, for Z250, 4.33 +/- 2.41, 4.94 +/- 2.23 and 4.25 +/- 1.65, for Z350 and 4.97 +/- 2.47, 5.28 +/- 1.67 and 3.4U2.26 for P90, respectively. delta E was clinically perceptible after bleaching treatments of all composite materials [delta E>3.3]

[Determination and comparison of estimated menopausal age based on serum anti-mullerian hormone in women with and without polycystic ovarian syndrome]

Menopause is defined as 12 months of constant amenorrhea in the absence of any pathology. Right now there is no definite test to predict menopause age and the ovarian reserve evaluations are mainly implemented on the basis of sonographic and hormonal measurements. The present study was conducted to determine and compare the menopausal age in women with polycystic ovarian syndrome [PCOS] and non PCOS women based on anti-mullerian hormone [AMH]. The present study is an epidemiologic case- control research in which from among 1019 women aged 20-40 years, 208 PCOS women and 811 normo-ovulatory controls were selected as the case and control groups respectively. Data collection was done through completing questionnaire, clinical examination and lab test measurements. After age and body mass index [BMI] matching, AMH levels in relation to age were displayed in an interactive graph and SPSS software version 21 was used for statistical analysis. Findings showed the mean age and BMI for case and control groups were 29.75 years - 27.1 [kg/m[2]] and 31.62 years - 26.1 [Kg/m[2]] respectively. Our results indicated significantly higher AMH levels in PCOS cases than in normal controls [P<0.0001]. The estimated menopausal age for PCOS and non PCOS women was 51 and 49 years respectively. To conclude PCOS patients reach menopause two years later than healthy women. If the length of reproductive period in these patients is higher than that the healthy women, it may be possible to use this period for increasing the fertility likelihood

[Infertility, the most adverse outcome among sexual function outcome affecting of Iranian women with polycystic ovarian syndrome]

The physical and apparent changes caused by PCOS such as hirsutism, obesity, acnea, hair loss and outcomes like infertility can cause decreased sexual function in the women affected. In the present study we aimed to evaluate the impact of PCOS clinical signs on the sexual function of married Iranian women. This cross-sectional study was carried out on 600 reproductive aged married women with PCOS selected using simple sampling from among women referring to gynecologists at private clinics. Clinical examinations and antropomethric measurements were done and a questionnaire including demographic, reproductive history, diseases and Persian version of Female Sexual Function Index were completed for all participants. Analysis was done using SPSS version 15. Approximately two third of participants had sexual dysfunction. Infertility is was found to be the most influential clinical sign of PCOS on sexual function of affected women. Subgroup analysis demonstrated that PCOS women with infertility had significantly more sexual dysfunction compared to fertile PCOS women [71 vs 61%]. Seventy-two percent of infertile women had sexual dysfunction in lubrication and arousal, while these values for fertile women were 54 and 52% respectively. Among Iranian women with PCOS, infertility affects their sexual function more than any other clinical sign, and these women experience orgasm and sexual satisfaction less than their fertile counterparts. It seems that infertility should be carefully considered during sexual consultation visits for PCOS women

Residential segregation and infant mortality: a multilevel study using Iranian census data

There is a great amount of literature concerning the effect of racial segregation on health outcomes but few papers have discussed the effect of segregation on the basis of social, demographic and economic characteristics on health. We estimated the independent effect of segregation of determinants of socioeconomic status on infant mortality in Iranian population. For measuring segregation, we used generalized dissimilarity index for two group and multi group nominal variables and ordinal information theory index for ordinal variables. Sample data was obtained from Iranian latest national census and multilevel modeling with individual variables at level one and segregation indices measured at province level for socioeconomic status variables at level two were used to assess the effect of segregation on infant mortality. Among individual factors, mother activity was a risk factor for infant mortality. Segregated provinces in regard to size of the house, ownership of a house and motorcycle, number of literate individual in the family and use of natural gas for cooking and heating had higher infant mortality. Segregation indices measured for education level, migration history, activity, marital status and existence of bathroom were negatively associated with infant mortality. Segregation of different contextual characteristics of neighborhood had different effects on health outcomes. Studying segregation of social, economic, and demographic factors, especially in communities, which are racially homogenous, might reveal new insights into dissimilarities in health

[Associations between hormonal profiles of urban Iranian women of reproductive age: a community based study of four provinces]

Differences in prevalences of metabolic and cardiovascular disease [CVD] between men and women could be a result of differences in their hormonal profiles. In this study we aimed to examine the association between hormonal profiles and metabolic syndrome parameters in reproductive aged women. From 1126 non-menopause women, aged between 18-45 years, using the stratified, multistage probability cluster sampling method, 423 reproductive aged women, living in urban areas of four selected provinces [Golestan, Hormozgan, Kermanshah and Qazvin], without any hormonal disorder, were enrolled for this study. Clinical examinations, and antropometric, biochemical and hormonal parameters were assessed to determine associations between the hormonal profiles and metabolic syndrome parameters, using Spearman and Pearson correlation tests and Logistic regression. Our analysis revealed that diastolic blood pressure, high density lipoprotein cholesterol, fasting blood sugar and waist circumference were differed significantly between quartiles 1 and 4 of thyroid stimulating hormone concentration. Also, fasting blood sugar and waist circumference differed in the two groups of Sex Hormone Binding Globulin concentration values. Central obesity was associated with reduced Sex Hormone Binding Globulin, a relationship observed after adjustment for age and body mass index. Hormonal variation even with normal limits could be associated with metabolic syndrome parameters and cardiovascular disease, making it necessary to identify individuals in high risk categories

Prevalence of odontogenic deep head and neck spaces infection and its correlation with length of hospital stay

Statement of Problem: As the duration of hospital stay could be an indicator of the severity of infection [Including odontogenic sources]; defining related variables could be very helpful in the treatment process. All clinical and paraclinical variables related to sever head and neck infections of odontogenic origin have not been fully evaluated

Purpose: This study was designed to identify the potential risk factors associated with increasing hospital stay in patients with deep head and neck spaces infections of odontogenic origin

Materials and Method: A total of 297 patients admitted to Shiraz Khalili hospital [1996-2006] with head and neck spaces infection were retrospectively identified by a medical chart view. Data concerning patient demographics, source and location of infection, culture results, and treatment modalities were evaluated. Linear regression techniques were used to explain the relationship between patient admission characteristics and duration of hospitalization

Results: A total of 34.3% [n=102] of the patients had head and neck spaces infections of odontogenic origin. The most common location of infection was submandibular space [32%], followed by masseter space [22%] and Ludwig's angina [20%]. Culture results showed non-hemolytic streptococcus as the most common microorganism with the prevalence of 61.6%.The most frequent signs and symptoms were swelling and pain. The results showed a higher percentage of hospital admissions for the middle socioeconomic status [58.8%]. Variables such as high weight, blood sodium level less than 135, preexisting disease and increasing in blood mean cell volume [MCV] were associated with longer hospital stay. Only 1 [0.9%] death was reported as the result of these infections

Conclusion: Odontogenic infections were a common source of deep head and neck spaces infection resulted in longer hospital stay. Paying particular attention to the variables that lead to longer hospital stay could be very important in formulating the treatment plan and reducing complications

[Association of serum cortisol with critical illness scoring and prognosis in intensive care unit]

Background: The prevalence of adrenal insufficiency and association of serum cortisol with prognosis in intensive care unit patients is controversial. Some studies have shown a direct association between serum cortisol and bad prognosis while in other studies no such association has been made

Objective: This study was designed to evaluate the association between serum cortisol and prognosis of patients in intensive care unit

Methods: This was a cross-sectional study performed on intensive care unit patients of Bou-Ali teaching hospital in Qazvin [Iran] in 2009. Serum cortisol levels were measured before and after injection of cosyntropin. Basal cortisol level below 441 nmol/l was interpreted as adrenal insufficiency. In patients with serum cortisol between 441 and 938 nmol/l following injection of cosyntropin the level of serum cortisol was re-measured after 60 min. Patients with serum cortisol response less than 255 nmol/l were interpreted as having partial adrenal insufficiency. Later, patients were divided into 4 groups based on APACHE scoring system. Association of serum cortisol with APACHE score, hypotension, intubation, and mortality was evaluated

Findings: Of 60 patients under study, none found to have adrenal insufficiency. Serum cortisol was independently associated with mortality, hypotension, and intubation

Conclusion: Based on results found through this study, Adrenal insufficiency was not common in ICU patients and serum cortisol could be used as a predictor of prognosis

Utility of filter paper for preserving insects, bacteria, and host reservoir DNA for molecular testing

Appropriate methodology for storage biological materials, extraction of DNA, and proper DNA preservation is vital for studies involving genetic analysis of insects, bacteria, and reservoir hosts as well as for molecular diagnostics of pathogens carried by vectors and reservoirs. Here we tried to evaluate the utility of a simple filter paper-based for storage of insects, bacteria, rodent, and human DNAs using PCR assays. Total body or haemolymph of individual mosquitoes, sand flies or cockroaches squashed or placed on the paper respectively. Extracted DNA of five different bacteria species as well as blood specimens of human and great gerbil Rhombomys opimus was pipetted directly onto filter paper. The papers were stored in room temperature up to 12 months during 2009 until 2011. At monthly intervals, PCR was conducted using a 1-mm disk from the DNA impregnated filter paper as target DNA. PCR amplification was performed against different target genes of the organisms including the ITS2-rDNA of mosquitoes, mtDNA-COI of the sand flies and cockroaches, 16SrRNA gene of the bacteria, and the mtDNA-CytB of the vertebrates. Successful PCR amplification was observed for all of the specimens regardless of the loci, taxon, or time of storage. The PCR amplification were ranged from 462 to 1500 bp and worked well for the specified target gene/s. Time of storage did not affect the amplification up to one year. The filter paper method is a simple and economical way to store, to preserve, and to distribute DNA samples for PCR analysis

Metabolic disorders in women with previous gestational diabetes mellitus, Tehran Lipid and Glucose Study

Gestationai diabetes mellitus [GDM] is a common complication of pregnancy that is associated with fetal and maternal adverse outcomes. These women are at higher risk for development of type 2 diabetes mellitus [T2DM] and metabolic and cardiovascular disease. Various results have been presented on the long term consequences of GDM. We aimed to compare the incidence of these metabolic disorders between women with previous GDM and those without any history of GDM. Three groups of non-diabetic women, aged 15-45 y who participated in first phase of Tehran Lipid and Glucose Study [TLGS] were selected; 1] women with previous GDM, 2] women with previous still birth or macrosomia and without any history of GDM, and 3] normal age-BMI matched controls. They were followed for an average of 9 years, for developing of type 2 diabetes mellitus, hypertension and dislipidemia. Cumulative incidence of T2DM in the GDM group was 3-fold higher than the control. Incidence rates of T2DM were not significantly different between women in MC-ST group and their controls; however the serum concentrations of FBS were significantly different between these two groups. There was no significant difference in the cumulative incidence of hypertension and dislipidemia between the case and control groups. Women with previous GDM are at an increased risk of developing T2DM later in life. It seems that GDM screening in pregnancy could identify women at risk of metabolic disease

[In vitro evaluation of antibacterial activity of extract of Salvia officinalis and Carum copticum against cariogenic microorganisms]

Based on the attraction of the world society to traditional treatment and the importance of drug extraction of natural material and plants, in this in vitro study the effect of hydroalcoholic extract of Salvia officinalis and Carum copticum which are very useful in the traditional treatment of mouth and teeth disease have been determined against cariogenic bacteria. In this experimental study, hydroalcoholic extracts have been prepared after sterilization of the extracts by special filter from Salvia officinalis and Carum copticum using the maceration method [serial dilution of the sample by the method]. Their antibacterial activity against Streptococcus mutans, Lactobacillus rhamnosus and Actinomyces viscosus have been evaluated by the broth macrodilution method. Results have been analyzed with Mann-Whitney test. MIC [Minimum Inhibitory Concentration] of Salvia officinalis and Carum copticum for Streptococcus mutans were 6.25 and 12.5 micro gram per milliliter, respectively, These figures were 1.56 and 6.25 micro gram per milliliter for Lactobacillus rhamnosus and 12.5 and 25 micro gram per milliliter for Actinomyces viscosus. Both extracts had inhibitory effects on growth in all three bacterial species. Salvia officinalis had a greater effect on inhibition of growth in all three bacterial species. Salvia officinalis also had a bactericidal effect in the range of concentration

[Comparison of nested case-control and cohort analysis methodologies using a district TB registry data]

The nested case-control study has become popular as an efficient alternative to the full-cohort design. This study compares the results of a nested case-control analysis approach with the full cohort analysis. A cohort of 276 subjects [new cases from a TB registry] was used for this study. Cox Regression model was used for the full cohort analysis. In order to do the nested case-control analysis, for each death, three random controls were selected from those who did not suffer from the outcome at the time of the outcome took place. Case control data was analyzed by the conditional logistic regression model. Results from both cohort and nested case-control analyses show that treatment group is the only variable that affects on the outcome. Gender, place of residence, and age has no effect on the outcome. For binary exposure variables with trivial effects [e.g. Gender and place of residence], the relative efficiency of nested case-control study design is approximately 75%. Results of this study show that nested case-control study is not only an easy and cost-effective method for data analysis but also is as robust as cohort analysis in rate ratio and its variance estimation

Impact of preconception health education on health locus of control and self-efficacy in women

The preconception period is an ideal opportunity to optimize women's health. This study of women attending premarital clinics in the Islamic Republic of Iran aimed to evaluate the impact of a health education workshop on their health locus of control and self-efficacy in physical activity. The design was a randomized controlled trial with a questionnaire before and after the intervention. At post-intervention, there were significant increases in scores of internal health locus of control and self-efficacy in the experimental group [n = 109] compared to the control group [n = 101]. It was concluded that a short-term health education may empower women to adopt healthy lifestyles

[Antibacterial activity of hydroalcoholic extract of Salvia officinalis and Achillea millefolium against cariogenic microorganisms: an in vitro investigation]

There is an increasing global tendency to use traditional medicines and drug-extracts from natural plant materials. This in-vitro study was conducted in order to evaluate the cariostatic effect of hydroalcoholic extract of Salvia officinalis and Achillea millefolium. In this experimental study, hydroalcoholic extracts were prepared from Salvia officinalis and Achillea millefolium using maceration method. The antibacterial activity of these two extracts against Streptococcus mutans, Lactobacillus rhamnosus, and Actinomyces viscosus were evaluated through broth macrodilution method. Data was analyzed with Mann-Whitney test. The Minimum Inhibitory Concentration [MIC] of Salvia officinalis and Achillea millefolium for streptococcus mutans were 6.25 and 50 micro gram per milli liter, respectively. The corresponding figures for Lactobacillus rhamnosus were 1.56 and 12.5 micro gram per milli liter; and for Actinomyces viscosus the value were 12.5 and 50 micro gram per milli liter, respectively. The differences between the two extracts were statistically significant. Both extracts had growth inhibitory effect on all three bacteria. Salvia officinalis showed greater inhibitory effect on growth of all three bacteria. Both extracts had bactericidal effect in the considered concentration range

[Use of rat estrus serum for in vitro maturation of bovine oocytes]

Superovulation produces complications in some patients, so in vitro maturation of oocyles is used to decrease or eliminate these complications and improve IVF. Moreover, IVM is used for different aspects of reproductive researches. Slaughterhouse ovaries are the main source of oocytes for IVM and IVF studies. Different media has been introduced and experimented for in vitro maturation of oocytes. Animal's serum at estrus stage contains different hormones and proteins which are essential for oocyte maturation. The aim of this study was to compare three culture media for in vitro maturation [IVM] of bovine oocytes; 1][control]TCM-l99, 2]HCG and follicular fluid [FF] and 3] antibiotic. Rat estrus serum [RSS] or fetal bovine serum [FBS] was added to control medium. Total of 1789 compact cumulus oocyte complexes [COCs] were aspirated from ovaries of slaughtered animals. Oocytes were randomly cultured in mentioned media and incubated in 38.5°C, 5% CO2 and 95% humidity for 24 hours. The maturation of oocytes was judged according to cumulus cell expansion or randomly orcein stained oocytes and observation of polar bodies. The results showed that maturation rate was significantly higher in second and third group [90.2%, 78.7%] as compared to the control group [p<0.001]. There was no significant difference between second and third groups [90.2% vs. 86.6%]. RSS is as effective as FBS for IVM of bovine oocytes and can be used as an alternative

[ serum levels of Th1 and Th2 cytokine profiles in patients with different stages of chronic kidney disease]

Various abnormalities of the immune system have been demonstrated in patients with chronic kidney disease [CKD]. Patients with CKD commonly present with abnormalities of immune function related with impaired kidney function and the accumulation of uremic toxins. Th1 and Th2 cells produce predominantly some cytokine profiles. The aim of the present study was the determination of the levels of IL-13 and IFN-gamma in sera of end-stage renal disease. The correlations of IL-13 and IFN-gamma levels with clinical presentation of the disease were assessed. In this case-control study the serum levels of IL-13 and IFN-gamma were determined by a sandwich enzyme-linked immunosorbent assay in 30 patients on hemodialysis [HD], 30 patients with chronic renal failure [CRF], and 60 healthy individuals. Renal function was evaluated by measuring serum levels of creatinin, albumin and urea. The serum levels of IL-13 and IFN-gamma were differed significantly between patients and healthy controls. The serum levels of IL-13 was significantly increased in the HD group than in the CRF and control groups [13.7 +/- 3.9, 6.7 +/- 3.4, 4.5 +/- 3.3 pg/ml, respectively] [P=0.001]. On the other hand, the IFN-gamma plasma levels were significantly higher in CRF patients than HD patients and controls [38.8 +/- 18.8, 17.4 +/- 8.78, 12.5 +/- 8.9 pg/ml, respectively]. In the HD patients, low production of IFN-gamma in line with upregulation of IL-13 indicates that Th1/Th2 balance may shift towards Th2 dominance. It is possible that this imbalance contributes to the abnormality of the immune system in HD patients

Malignant salivary glands tumors in Kerman province: a retrospective study

Malignant salivary glands tumors [MSGTs] are uncommon cancers. The most common site of these cancers is the parotid gland. Some investigations show these cancers preference for males than females. The majority of MSGTs arise in sixth decade of human life. According to the literature review for the present work, there is a few epidemiological researches about MSGTs in Iran and especially there isn't any study in Kerman province. So the aim of this study was investigation the incidence, sex, age, histological types, and site distribution of MSGTs in the Kerman province during the time period from March 1991 to March 2002. Documents and records of 70 patients with MSGTs diagnosed from March 1991 to March 2002 were reviewed. The patients' records were analyzed based on gender, age, location, and histopathological type of the tumor. Data were analyzed by SPSS-13.5 statistical software using t-test, chi-square, and ANOVA tests. During this period of time, 70 cases [43men, 27 women] of MSGTs had been diagnosed. Mucoepidermoid carcinoma was the most common cancer [30%] and the parotid was the most affected site [70%]. The age range was 10-86 years old with the overall mean age of 50.18 +/- 17.97. Despite a considerable volume of literatures written about MSGTs in many countries, the incidence of these cancers haven't as yet been thoroughly documented or analyzed in Iran. However, comparison between the findings of this study with the results of other investigations showed a relative consistency

Nosocomial blood stream infections in Imam Khomeini Hospital, Urmia, Islamic Republic of Iran, 1999-2001

In a 2-year retrospective study, the database of the microbiology laboratory of the Imam Khomeini Hospital was reviewed to identify patients who had nosocomial bacteraemia between 1 May 1999 and 31 May 2001 and identify the pathogen responsible and its resisitance to antibiotics. Of 6492 patients in various wards, 593 [9.1%] had positive blood cultures; 85 of those [14.3%] had signs of potential skin contamination. Gram-positive cocci, including coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus pneumoniae and other Gram-positive cocci, accounted for 42.3% of isolates. Gram-negative bacilli were responsible for another 42.3% of isolates; Pseudomonas aeruginosa was the predominant isolate. Patterns of drug resistance varied according to species of bacteria but were generally quite high

[Comparison of efficacy of nortryptiline with fluoxetine in the treatment of major depression in depressed patients referred to Yasuj psychiatry clinic]

Introduction and Objective: depression is the most common mood disorder between psychiatric diseases. This research was performed on depressed patients referred to Yasuj psychiatry clinic to compare the efficacy of nortryptiline and fluoxetine in the treatment of major depression

Materials and Methods: among patients that referred to Yasuj psychiatry clinic [since 1.11.81 till 15.5.82] 117 patient on the basis of interview, physical examination and Beck test, were recognized as depressed patient. The safety and efficacy of nortryptiline and fluoxetine were compared in a double-blind, randomized study in 117 patients with relatively moderate to sever depression. forty-nine nortryptiline and forty-eight fluoxetine patients completed 6 month of medication and we included them in the efficacy analysis

Results: at the end of 6 methods treatment, 85.4% of patients with fluoxetine and 81.6% of patients with nortryptiline were much improved. There was significance statistical difference between them [p < 0.05].The average of Beck test results for fluoxetine patients at the end of 6 months was 16.16 and for nortyitiline patients was 19.71. Fluoxetine was associated more frequently with nausea and vomiting [p<0.05], while nortryptiline was more frequently with malaise, hypersomnia, constipation and headache [p < 0.05]. In this study, there was no statistical significance difference between sex, age, and efficacy of nortryptiline and fluoxetine

Conclusion: although the changes in depressive symptoms over 6 month treament were comparable between fluoxetine and nortryptiline, however fluoxetine is superior to nortryptiline