Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Effects of nicotine on sperm motility in male mice under methylphenidate treatment 1 6 FA simin fazelipour Islamic Azad University, Tehran, Iran Simin_fazelipour@yahoo.com Y Mahsa Hadipour-Jahromy Islamic Azad University, Tehran, Iran N Zahra Tootian University of Tehran, Tehran, Iran N Ladan Babaei Tehran Medical University, Tehran, Iran N Seyed Babak Kiaei University of Tehran, Tehran, Iran N Background: Nicotine is an important part of cigarette smoke with strong physical and psychological effects on smokers. Methylphenidate (mph) is a medicine that has been prescribed widely for treatment of attention deficit hyperactivity disorder (ADHD). In the present study, effects of both mph and nicotine on sperm motility which is one of the most effective factors in male fertility genital tract have been evaluated. Materials and methods: In this experimental study, one hundred and twenty male mice divided in 11 treated and one control groups. In treated groups, mph with doses of 2 and 10 mg/kg and nicotine with doses of 100, 200 and 400 microgr/kg were prescribed separately and in combinations orally for 40 days. At the final day, mice were killed and percent of sperm motility was calculated by counting gametes present in vasodeferan. Data were analyzed using Kruskal-wallis, Post-Hoc (Scheffe) and student’s t-test. P<0.05 was considered significant. Results: The sperm motility has been reduced significantly in groups that received both mph and nicotine. Conclusion: it can be concluded that even in light smokers, mph administration at high amount can reduce sperm motility. Keywords: Methylphenidate, Nicotine, Sperm motility, Mice Methylphenidate, Nicotine, Sperm motility, Mice http://tmuj.iautmu.ac.ir/article-1-417-en.html http://tmuj.iautmu.ac.ir/article-1-417-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Production and physicochemical evaluation of Neisseria meningitidis serogroup A outer vesicle as a vaccine candidate 7 13 FA Seyed Ali Delbaz Islamic Azad University, Karaj, Iran d.siadat@gmail.com N Seyed Davar Siadat Pasteur Institute of Iran, Tehran, Iran Y Mohammad Reza Aghasadeghi Pasteur Institute of Iran, Tehran, Iran N Mehrangiz Zangeneh Islamic Azad University, Tehran, Iran N Seyed Mehdi sadat Pasteur Institute of Iran, Tehran, Iran N Jalal Solati Islamic Azad University, Karaj, Iran N reza Ghorbani Islamic Azad University, Tehran, Iran N Arfa Moshiri , Tehran University of Medical Sciences, Tehran, Iran N Background: Neisseria meningitidis serogroup A Polysaccharides vaccines have been available for many years, but these vaccines have many disadvantages due to their induction of T-Cell independent responses. To overcome these problems, many researches have been focused on other parts of bacterial cell component such as OMV (Outer membrane vesicle). In this study, OMV containing PorA were extracted and evaluated by biological and immunological methods. Materials and methods: OMV were extracted by siadat, et al method. Physicochemical properties of extracted OMV were analyzed by electron microscopy and SDS-page. The toxicity of LPS content in OMV was assayed by LAL test. The Presence of PorA was confirmed by western blot. Antibodies synthesis after immunization by OMV was evaluated using ELISA method. Results: The content of extracted protein was 0.1 mg/ml. Size of OMV was between 50 and 150 nanometer. SDS-PAGE showed that PorA was located in 35-40 kDa. LAL test showed that the endotoxin activity was ranged in 126EU/ml which is safe for using. The ELISA test showed that the total IgG titer was elevated after first injection. Conclusion: The results showed that the conformation of extracted OMV was stable, and there were no progeny determinants in OMV. Also, OMV elicited high level of specific antibodies against Neisseria meningitidis serogroup A. These results indicate that the OMV can be used as a meningococcal vaccine after further investigations. Keywords: Outer membrane vesicle (OMV), PorA, Neisseria meningitidis serogroup A. Outer membrane vesicle (OMV), PorA, Neisseria meningitidis serogroup A. http://tmuj.iautmu.ac.ir/article-1-418-en.html http://tmuj.iautmu.ac.ir/article-1-418-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Association of Cag A positive Helicobacter pylori with bacterial colonization and epithelial immune response 14 17 FA mehran Ragha Islamic Azad University, Najafabad N mina Rezaei Islamic Azad University, Najafabad, Iran N zahra Poormoghaddas Islamic Azad University, Najafabad, Iran zahrapormoghadas@yahoo.com Y Keyvan Shirneshan Dr. Ali Shariati Hospital, Isfahan N mahmood Jannatipoor Isfahan University of Medical Sciences, Isfahan, Iran N Background: This study was conducted to assess the association of CagA (Cytotoxin associated gene A) positive Helicobacter pylori (H. pylori) with bacterial colonization and immune response in gastric epithelial cells. Materials and methods: Gastric biopsy specimens of angulus, antrum, and lesser and greater curvatures were obtained from 138 patients with dyspeptic symptoms referred for endoscopy to Shariati Hospital, Isfahan. Specimens were evaluated for H. pylori and in positive ones, serum samples were investigated for anti-CagA IgG antibody. Immune response to Helicobacter pylori was classified according to Sydney system. Results: Of138 patients, 97 (70.3%) were infected with H. pylori from which CagA antibody was positive in 83.5%. No association was found between CagA positive antibody and age or gender (P>0.05). Also, no association was found between CagA status and bacterial colonization or epithelial immune response (P>0/05). Conclusion: The presence of CagA positive H. pylori is not related to bacterial colonization or gastric epithelial immune response in dyspeptic patients. However, according to evidence on the association of CagA positive H. pylori with increased of gastric cancers, strict follow-up of patients with this type of H. pylori is recommended even in the absence of severe epithelial immune response. Keywords: Helicobacter pylori, CagA antibody, Colonization, Immune response. Helicobacter pylori, CagA antibody, Colonization, Immune response http://tmuj.iautmu.ac.ir/article-1-419-en.html http://tmuj.iautmu.ac.ir/article-1-419-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Frequency of TNFα-244GàA, TNFα-308GàA and TNFα-238GàA polymorphisms in healthy and malaria infected patients of Kerman and Hormozgan provinces 18 23 FA Parisa Atef Vahid Islamic Azad University, Tehran, Iran N Mohammad Reza Alivand Institute of Genetic Engineering and Biotechnology, Tehran, Iran N Feyzollah Hashemi Gorji Islamic Azad University, Tehran, Iran N Mehrdad Hashemi Islamic Azad University, Tehran, Iran N Mohammad Reza Noori Dalooi Tehran Medical University, Tehran, Iran nooridaloii@sina.tums.ac.ir Y Background: Tumor necrosis factor-alpha (TNFα) is one of the key cytokines that affects on pathology of microbial infections. It is suggested that genetic susceptibility to severe form of malaria is associated with TNFα promoter polymorphisms. The aim of present study was to investigate frequency of -308GàA, -244GàA and -238GàA polymorphism in 174 samples of Hormozgan and Kerman provinces. Material and methods: In case- control study, we investigated the prevalence of TNFα-244GàA, TNFα-308GàA and TNFα-238GàA polymorphism in 174 (154 healthy and 20 patients) individuals from Kerman and Hormozgan provinces of Iran. DNA extraction performed, and then PCR-RFLP was used to detect polymorphisms in -308,-244 and -238 loci. Results: In these three regions, 82.2% of healthy samples showed GG genotype, 14.26% AG and 0.19% AA. All samples of patients showed GG genotype in these three regions. Conclusion: It seems that evolutionary effect of malaria causes increased genotypes which related with protection against malaria or reduction of risk of cerebral malaria and death, although, there was no association between frequency of these genotypes and protection against malaria. Malaria, polymorphism, TNFα, PCR-RFLP http://tmuj.iautmu.ac.ir/article-1-420-en.html http://tmuj.iautmu.ac.ir/article-1-420-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Identification of polymorphism in rpoB gene (a marker of gene resistance to rifampin drug) in mycobacterium tuberculosis isolated from patients in Tehran 24 31 FA Fahimeh Ostadzadeh Islamic Azad University, Tehran, Iran fahimeh84@yahoo.com Y mehran Hashemi Islamic Azad University, Tehran, Iran N saied Zakerbostanabad Islamic Azad University, Tehran, Iran N Mohammad karim Rahimi Islamic Azad University, Tehran, Iran N Sajjad Nouri Islamic Azad University, Tehran, Iran N Mostafa Ghalami Masood Laboratory N Background: One of the most important causes of death due to tuberculosis is drug resistant Mycobacterium tuberculosis. Rifampin is one of the most important drugs that are commonly used for treatment of tuberculosis. Mutations in rpoB gene of Mycobacterium tuberculosis cause rifampin drug resistant. The aim of this study was to investigate the type and frequencies of the mutation in this region in Mycobacterium tuberculosis isolated from patients in Tehran. Materials and methods: In this experimental study, 50 patients who did not respond to 6- month chemotherapy with anti- tuberculosis drugs were selected and tested for resistance to this drug. Patients’ sputum were obtained and cultured on Lowenstein-Jensen solid medium. After susceptibility testing, DNA of resistant strains was extracted and rpoB gene was amplified with PCR. Results were analyzed by computer using DNAMAN program. Results: 14 cases had mutations in this region of Mycobacterium tubrculosis. However, 6 isolates (30%) had no mutation in this part of the genome. The most frequent mutations occurred in codons 531(40%) and 515 (20%). We report mutation of codon 515 for the first time. Mutations in codons 526 (10%) and 510 (15%) were found. Conclusion: Mutation in codon 515 probably shows the different pattern of mutation in Tehran. Our data indicate 6 isolates without mutation in the 81bp region. According to this study, resistance to rifampin may have non genetic and genetic causes on genes outside of 81bp region. Mycobacterium tuberculosis, Drug resistance, rpoB gene mutation, Rifampin http://tmuj.iautmu.ac.ir/article-1-423-en.html http://tmuj.iautmu.ac.ir/article-1-423-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Diagnostic value of PCR method for detection of Salmonella enteritidis contamination in poultry products in Karaj 32 37 FA Negar Nayebi Islamic Azad University, Tehran, Iran Y Seyed Ali Ghorashi National Institute of Genetic Engineering and Biotechnology, Tehran, Iran N Naser Harzandi Karaj Branch, Islamic Azad University, Tehran, Iran N Mehdi Shamsara National Institute of Genetic Engineering and Biotechnology, Tehran, Iran N Bahman Tabarai Vaccination Center, Pasteur Institute of Iran N Amir Bakhtiari Islamic Azad University, Tehran, Iran N Background: Salmonella enterica serovar Enteritidis which involves poultry is transmitted by food. The aim of this survey was to optimize PCR method in order to detect Salmonella enteritidis in poultry products. Materials and methods: In this basic research, 80 samples (40 broiler meat and 40 egg samples) were obtained from distribution centers in Karaj and suburb. Following the DNA extraction of the samples, PCR was optimized and performed using standard strain of Salmonella enteritidis (RTCC1621) as positive control and primers against the flagella coding sequence of Salmonella Enteritidis genome. Results: The analysis of the PCR products by agarose gel electrophoresis indicated the amplification of 250 bp segments in 16 out of 40 (40%) broiler meat and 9 out of 40 (23%) egg samples. The sensitivity of the PCR at the DNA level was found to be 1pg and the specificity of the PCR was determined using 6 other entric Gram negative bacteria and found to be positive only for Salmonella enteritidis. Conclusion: This study confirmed that PCR provides sensitive, specific and rapid approach for detection of Salmonella enteritidis in food samples. Salmonella enteritidis, PCR, poultry products http://tmuj.iautmu.ac.ir/article-1-425-en.html http://tmuj.iautmu.ac.ir/article-1-425-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Comparison the viewpoint of nursing students and their trainers regarding preventing and facilitating factors of effective clinical teaching in Islamic Azad University, Marageh Branch 38 43 FA Mohammad Sahebzamani Tehran Medical Branch, Islamic Aazd University, Tehran, Iran m_szamani@yahoo.com Y Asiyeh Salahshooran Fard Tehran Medical Branch, Islamic Aazd University, Tehran, Iran N Alireza Akbarzadeh , Shahid Beheshti University, Tehran, Iran N Robab Mohammadian Islamic Aazd University, Maragheh, Iran N Background: There is few studies in Iran investigated the viewpoint of nursing students and their trainers regarding preventing and facilitating factors of effective clinical teaching in Islamic Azad University. The aim of the present study was to compare the viewpoint of nursing students and their trainers regarding preventing and facilitating factors of effective clinical teaching. Materials and methods: In a descriptive-comparative study, all nursing students (n= 121) and clinical trainers (n= 21) of Islamic Azad University, Maragheh Branch were participated. Data were gathered by a questionnaire. Validity and reliability of questionnaire was determined by content validity and internal consistency (Cronbach’s alpha), respectively. Questionnaires were completed with self-report method. Data analysis was conducted with SPSS,13 software by Mann- Whitney U test. Results: 21 trainer and 121 students considered facilitating and preventing factors as important factors for effective clinical teaching. There were statistical differences between nursing students and nursing trainers viewpoints regarding facilitating factors of effective clinical teaching (p= 0.003). In other hand, there were no statistical differences between nursing students and nursing trainers viewpoints regarding preventing factors of effective clinical teaching (p= 0.08). Conclusion: These findings demonstrate the importance of facilitating and preventing factors of effective clinical teaching from the viewpoints of nursing students and trainers of Islamic Azad University. Attention to this factors have important role in improvement of clinical education of nursing students. Nursing education, Clinical education, Effective teaching, Nursing trainers, Nursing student. http://tmuj.iautmu.ac.ir/article-1-426-en.html http://tmuj.iautmu.ac.ir/article-1-426-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 The effects of hemovac on short- term outcome of Lichtenstein herniorrhaphy 44 49 FA Mohammad Reza Sobhiyeh Shahid Beheshti University of Medical Sciences N Hojjat Molaei Shahid Beheshti University of Medical Sciences N Amirhoseyn Jalali Shahid Beheshti University of Medical Sciences, Tehran, Iran N Mohammad Shafiee Shahid Beheshti University of Medical Sciences N Mohammad Mozaffar Shohadaye-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohamad_mozafar@yahoo.com Y Background: Many patients with inguinal hernia are operated and hemovac is used to drain extra fluids from the surgery site. In this study, we compared the results of surgery in patients operated with hemovac vs. who had not hemovac. Materials and methods: In a randomized clinical trial, 86 patients with inguinal hernia were assigned into two groups. Patients were operated by Lichtenstein method and hemovac was used in one group. The short- term outcome was compared between two groups. Results: Severity of pain in hemovac group was mild in 20 cases, moderate in 16 and severe in 5, and in non hemovac group was mild in 19 cases, moderate in 20 and severe in 2. Severity of scar in hemovac group was mild in 21 cases, moderate in 20 and severe in 2, and in non hemovac group was mild in 25 cases, moderate in 16 and severe in 2. Inflammation in hemovac group was mild in 23, moderate in 20 and nobody had severe inflammation, while in non hemovac group was mild in 31 cases, moderate in 11 and severe in 1. Conclusion: There were no significant differences in pain, scar and inflammation among groups with and without hemovac. Using hemovac in inguinal hernia repair does not have effect on the healing of surgery site. Inguinal hernia, Hemovac, Surgery complications. http://tmuj.iautmu.ac.ir/article-1-427-en.html http://tmuj.iautmu.ac.ir/article-1-427-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Evaluation of antibiotic resistance of gonococcal infections in women referred to Azad University hospitals 50 54 FA Mohammad Karim Rahimi Islamic Azad University, Tehran, Iran mohammadkrahimi@yahoo.com Y Saeid Zakerbostanabadi Islamic Azad University, Tehran, Iran N Mina Mirfakhraei Islamic Azad University, Tehran, Iran N Parvaneh Adimi Naghan Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Mohammad Bossak Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Mojgan Masoomi Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Zahra Taiebi Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Kasra Behroznasab Science and research Campus, Islamic Azad University, Tehran, Iran N Mahanaz Omidian Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Background: There is high prevalence of pencicllinase producing Neisseria gonorrhoeae and antibiotic resistance in numerous areas of the world. The aim of this study was to investigate drug resistance of gonococci. Material and methods: In this cross-sectional descriptive study, vaginal discharge of 126 patients visited for vaginal discharge or suprapubic pain or admitted for periodic examination in Azad University hospitals were studied. Direct smear and gram stain of vaginal discharge was prepared and it was cultured into Tyer-Marthin media. Sensitivity to antibiotics was evaluated in positive cultures. Results: Direct smear and gram staining of cervical discharge revealed 48 (38.1%) gram negative kidney shaped diplococci, but in selective media, only 12 (9.5%) Nesseria gonorrhoeae was detected. From 12 strains of Neisseria gonorrhoeae, 8 (66.6%) were resistant to penicillin, 8 (66.6%) to spectinomycin and 8 (66.6%) to co-trimoxazol, but neither of specimens were resistant to ceftriaxone. Conclusion: Direct smear of vaginal discharge isn't enough for proper diagnosis of Neisseria gonorrhoeae and it should be confirmed by culture. Ceftriaxone is the best choice for treatment of gonococcal infections, but there is resistance to spectinomycin, co-trimoxazol and penicillin. Drug resistance, Gonococcal infections, Antibiotic http://tmuj.iautmu.ac.ir/article-1-428-en.html http://tmuj.iautmu.ac.ir/article-1-428-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Evaluation of the association between FokI and BsmI polymorphisms of vitamin D receptor gene and risk of colorectal cancer in Iranian patients referred to Taleghani hospital, Tehran 55 60 FA Pedram Azimzadeh Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran Azimzadeh.pedram@yahoo.com Y Mahdi Montazerhaghighi Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Seyed Reza Mohebbi Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Sara Romani , Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Seyed Reza Fatemi Gastroenterologist, Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Mohammad Amin Pourhoseingholi Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Fatemeh Nemati Malek Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Mohammad Reza Zali Gastroenterologist, Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran N Background: There are several studies that have identified relationship between VDR gene polymorphisms and colorectal (CRC) or other kinds of cancers, such as breast and prostate cancers. The aim of our study was to evaluate the association of VDR gene polymorphisms, BsmI and FokI, with colorectal cancer risk among Iranian patients. Materials and methods: In this case-control study, 110 DNA samples from Iranian CRC patients and 110 samples from healthy Iranian people. Genotyping of BsmI and FokI polymorphisms were performed by PCR-RFLP method. To confirm the RFLP results, 5% of samples were sequenced with direct sequencing method. Results: The frequency of the VDR gene polymorphisms at BsmI and FokI restriction sites in CRC patients and healthy controls was almost similar. Allele distribution in patients and controls was same. There was no statistically significant difference in genotype or allele frequency between CRC patients and control group. Conclusion: VDR FokI and BsmI genotypes are not associated with increased risk of colorectal cancer in Iranian patients. However, these data remain to be confirmed by studies with larger sample size in Iran BsmI, FokI, Vitamin D receptor, Colorectal cancer http://tmuj.iautmu.ac.ir/article-1-429-en.html http://tmuj.iautmu.ac.ir/article-1-429-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 Epidemiological survey of Crimean Congo hemorrhagic fever in Khorasan Razavi (2009) 61 66 FA Farid Ebadi of Management of Health Services, Tehran University of Medical Sciences, Tehran, Iran N Ramezan Ali Esmaeil Mashad University of Medical Sciences, Mashad, Iran esmaeiliram@gmail.com Y Alireza Zohoor PhD of Epidemiology, Tehran University of Medical Sciences, Tehran, Iran N Background: Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis disease was reported from different part of world since 1944. This research was conducted to study the epidemiology of CCHF and also confirm the epidemic of disease in the province of Khorasan Razavi in spring and summer 2009. Materials and methods: In this cross-sectional study, all suspected and probable CCHF cases reported to surveillance system in the Spring & Summer of 2009 were studied. Results: In the first 6 months of 2009, 13 people were infected to this virus in the Khorasan razavi province. Compared with previous years, it confirms an outbreak. Four patients (31%) were medical staff of Ghaem hospital, four patients (31%) were butchers and the rest (38%) were farmer or poultry staff. Conclusion: According to our findings, medical staffs, butchers and ranchers are seriously at risk more than others. For prevention of epidemic, case finding, early diagnosis and training of high risk groups are essential in surveillance system CCHF, Zoonosis, Hemorrhagic fever, Tick-borne diseases http://tmuj.iautmu.ac.ir/article-1-430-en.html http://tmuj.iautmu.ac.ir/article-1-430-en.pdf

Islamic Azxad University, Tehran Medical Branch Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch 1023-5922 2008-3386 21 1 2011 6 1 A rare variation in radial artery: a case report 67 69 FA Zahra Nadia Sharifi , Tehran Medical Branch, Islamic Azad University, Tehran, Iran N Shabnam Movassaghi Tehran Medical Branch, Islamic Azad University, Tehran, Iran sm_movassaghi Y Background: Arterial variations can cause many problems in treatment of patients. So, it seems that knowledge about these variations can improve the process of treatments. Case Report: During dissection of a 55 year-old male cadaver, it was seen that radial artery had been separated from the second part of axillary artery and brachial artery had been continued in forearm as ulnar artery. Conclusion: This variation is important because radial artery is used for injection of drugs, catheterization and bypass grafting of coronary arteries. Attention to this variation may facilitate the surgical approaches and decrease the risk of arterial injuries in upper limb. Radial artery, Variation, Axillary artery http://tmuj.iautmu.ac.ir/article-1-431-en.html http://tmuj.iautmu.ac.ir/article-1-431-en.pdf