2 1016-1430 Iran University of Medical Sciences 591 Clinical Biochemistry THE STUDY OF CLASS I HLA TYPES IN PATIENTS WITH ULCERATIVE COLITIS AND ITS COMPARISON WITH HEALTHY PERSONS EBRAHIMZADEH MOHAMMAD EBRAIDM b b Department of Clinical Biochemistry, Faculty of Medical Sciences, Tabriz University of Medical Sciences, 1 11 2005 19 3 279 280 10 09 2012
590 Pathology PRIMARY LIPOSARCOMA OF THE STOMACH: A RARE MESENCHYMAL TUMOR AFSHAR MOGHADDAM NOUSHIN c SAFAEI MANSOUR c Pathology Department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, l.R. Iran. 1 11 2005 19 3 275 278 10 09 2012 Gastric liposarcoma is very rare such that only a few cases have been reported to date. We present a case of a 62 - year - old diabetic man who presented with epigastric pain, vomiting, constipation and melena. The physical examination was unremarkable. By computed tomography (CT), a large mass with low attenuation value was seen in the left abdominal cavity. Histologic examination of a gastric biopsy was nondiagnostic. The patient underwent subtotal gastrectomy. On microscopic examination, the tumor showed features of a benign lipoma but with a distinctive capillary network and dense fibrotic areas. In immunohistochemial staining, positive S 100 and negative CD 117 reactions were seen, and less than 1 % Ki67 positive cells could be found. These findings suggested a highly differentiated gastric liposarcoma. 589 Vascular & Trauma Surgery CELIAC ARTERY ANEURYSM: A NEW METHOD IN THE MANAGEMENT OF AN OLD PROBLEM KALANTAR MOTAMEDI M.R e AGHAEE MEYBODI F MALEKPOUR GHORBANI F SASANI S e Department of Trauma and Vascular Surgery, Shohada Tajrish Medical Center, Shahid Beheshti 1 11 2005 19 3 271 274 10 09 2012 Celiac artery aneurysm is a rare visceral aneurysm, comparising only 4 % of them. In this article, an innovative surgical method is presented for the treatment o f such aneurysms. A 53 year old female referred to our center with epigastric pain and a mass in the region, which was diagnosed as a case of celiac artery aneurysm by using different imaging techniques. During the operation, according to the firm adherence of the mass to the aorta and a short celiac artery stump, we omitted aortic clamping and took control of entrance and exit sites to the aneurysm using a Foley and a Fogarthy catheter respectively. Using the normal part of the aneurysm's wall, the damaged part was trimmed and patched with a PTFE vascular patch. The patient was discharged satisfactorily in two days and did not have any problem in her follow-up. There was no need for extracorporeal oxygenation and total time of the procedure and vascularization was shortened. This surgical method obviates extracorporeal oxygenation due to reduction of aortic clamping time. Total procedure time and revascularization time will be shortened. It is proposed as an alternate method in cases when a short stump restricts proximal clamping, and also since there is little risk of renal and visceral ischemia. 587 Microbiology and Anatomy PREVALENCE OF ROTAVIRALDIARRHEA IN AHVAZ ABUZAR HOSPITAL SAMARBAF-ZADEH A.R i MAZAHERI-TEHRANI E i Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapoor University of Medical 1 11 2005 19 3 267 270 10 09 2012 Introduction: In developing countries, rotaviral diarrhea is the cause of death of many children, and is the main etiology of gastroenteritis in children under 2 years old. Determination of the prevalence of rotaviral infection can reveal the impact of this infection in this group of the population and provides clues as to the strategies for prevention and treatment protocols for children suffering from diarrhea. The aim of this study was to determine the prevalence of group A rotavirus in diarrheic children in Ahvaz, Iran. Methods: For this purpose, 200 stool samples were collected from diarrheic children under 2 years old who were referred to Ahvaz Abuzar Hospital. The samples were examined by electron microscope and the electropherotype of extracted RNA of the virus were also studied. Results: The results showed that 59 samples (29.5%) were rotavirus positive. Conclusion: These results suggest that the prevalence of this virus in diarrheic children is moderately high in comparison with some reports from other developing countries. 584 Immunology IDENTIFICATION, ISOLATION, CLONING AND SEQUENCING APARTIALANNEXIN GENE FROM AUREOBASIDIUM PULLULANS KAZEMI A k ROBSON G.D DENNING D.W k Immunology and Parasitology Department , School of Medicine, Tabriz University of Medical Sciences, Tabriz, I.R. Iran 1 11 2005 19 3 255 265 10 09 2012 Background and Objectives: Annexin is the common name for genes and proteins that were identified as calcium-dependent phospholipid-binding proteins. Recently a more complex set of functions has been recognized for this superfamily of proteins including in vesicle trafficking, cell division, apoptosis, calcium signalling, mineralization, crystal nucleation inside the extracellular organelles-matrix vesicles (MY s) and growth regulation. Methods: In the present work Aureobasidium pullulans strain PRAFS8 genomic DNA was extracted. Using designed primers from a highly conserved region of annexin genes of Aspergillus Jumigatus and Aspergillus niger a 800 bp PCR product was obtained from degenerated PCR. The 800 bp PCR product was gel purified and cloned into E. coli using the suitable plasmid and standard cloning procedures. From grown transformed E. coli, plasmid was extracted and the presence of expected insert in the plasmid, was confirmed by digestion of plasmid by Eco RI restriction enzyme. Results: Gel purified 800 bp band was sequenced and submitted at NCBI gene bank with accession No.: AY848856. A phylogenetic tree for obtained partial gene of annexin was drawn using bioinformatic software in order to understand the evolutionary relationship of annexin genes between some microrganisms. Also southern analysis of800 bp PCR product using digoxigenin (DIG) labeled probe demonstrated the probability of two copies of annexin genes existence in the A. pullulans genome. Conclusion: This study for the first time presented the presence of annexin gene in yeast-like fungi and this result is important due to the existence of this superfamily of genes in moulds but not in yeasts. We emphasize for future additional work to clone and sequence the full length of annexin gene(s) from A. pullulans and also additional studies for this gene expression and annexin mRNA transcription to understand the effective factors for expression of annexin. 583 Medical Physics and Radiation Therapy SYNERGISM BETWEEN 1-MEGAHERTZ THERAPEUTIC ULTRASOUND PL US CEFTAZ-IDIME ON GROWTH OF PSEUDOMONASAERUGINOSA KASHEF NASIM n BEHZADIAN NEJAD QORBAN n Department of Bacteriology and the 2Department of Medical Physics, Tarbiat Modares 1 11 2005 19 3 251 254 10 09 2012 Objective: The effect of ceftazidime on Pseudomonas aeruginosa, with or without application of 1 MHz therapeutic ultrasound, was studied. Method: An aqueous suspension of microorganisms in a sterile, sealed plate was placed in an ultrasonic tank operating at 1 MHz. Different power outputs were used. After desired time of exposure to the ultrasound, each sample was plated separately and after incubation, the number of colonies was counted. Results: Results showed that ultrasound in combination with sMICs of ceftazidime was much more lethal to this bacterium than either of the treatments alone. The mechanism by which ultrasound enhances antibiotic action is due to the induction of uptake of antibiotic by perturbing or stressing the membrane. Conclusion: This application of ultrasound may be useful for expanding the number of drugs available for treating localized infections by rendering bacteria susceptible to normally ineffective antibiotics. 581 Neurology EVALUATION OF PATIENTS WITH HEMIPLEGIC MIGRAINE IN MACKENZIE HEADACHE CLINIC GHANDEHARI KAVIAN p SHUAIB ASHFAQ p Department of Neurology, Southern Khorasan University of Medical Sciences, Birjand, Iran 1 11 2005 19 3 247 250 10 09 2012 Background: The sporadic type of Hemiplegic Migraine (HM) is sometimes observed among migrainous patients (MP) and mimics ischemic strokes. Methods: In an evaluation of two-hundred consecutive adult MP in the Mackenzie headache clinic, Canada during 2004 , 9% of the patients met the criteria established by the International Headache Society for sporadic HM. Female to male sex ratio, family history of migraine, frequency of epileptic seizures, migraine status and migraine aura without headache were investigated in the HM group and compared with other MP. The relationship between side of hemiplegia and distribution of head pain was also evaluated. Results: All of these clinical dimensions were significantly more common in the HM group than in the other MP. All of the patients with HM had other types of aura. Hemiplegia was often ipsilateral to the side of the headache. These results highlight the importance of documenting the side of hemiplegia in relation to the headache side, as well as determining the history of seizures in HM patients. Conclusion: This study supports the argument that migraine is a disease which may appear with different or mixed presentations in each episode. 580 Pediatric CEREBROSPINAL FLUID FINDINGS IN NEONATAL BACTERIAL MENINGITIS ZAMANI Ali ZAMANI FATEMEH Pediatric Department, Vali-Asr Hospital, Valises Reproductive Health Research Center, Tehran, I.R. Iran. 1 11 2005 19 3 241 245 10 09 2012 Background : Meningitis is more common during the neonatal period than other periods of life and has a prevalence of one in 1000 live births. The similarity of its clinical manifestations with other infectious diseases makes it difficult to diagnose. The aim of the current study was to determine the relationship between age, sex, clinical signs and symptoms and laboratory test results of newborns in which bacterial meningitis had been confirmed by positive CSF culture. Methods: This cross-sectional study was performed by a non-randomized simple sampling method, in which the medical files of neonates hospitalized between March 1994 and Oct. 1999 were reviewed. Results: A total of294 files (16 boys, 127 girls 54 preterm, 240 full-term infants) were reviewed. Fifteen newborns (8 girls, 7 boys) had positive CSF culture results. A significant statistical relationship was not found between sex and pre-term cases with meningitis. The most common results in newborns with positive CSF culture were poor feeding, lethargy and hyperthermia, followed by seizures, jitteriness, hypothermia and vomiting. Blood culture was positive in only 6 (40%) of the 15 neonates with positive CSF cultures. Leukocytosis (3 cases, 20%), thrombocytopenia (2 cases, 13 .3%) and positive direct CSF smear (9 cases, 60%) were also present. Group B Streptococcus (GBS), E. coli and gram-negative bacteria were the leading causes of neonatal sepsis and meningitis. A significant difference was found in the WBC count, CSF protein and glucose levels with bacterial meningitis. A significant relationship was also found to exist between CSF glucose-simultaneous blood glucose ratio and neonatal meningitis. Conclusion: There was a significant difference between CSF protein and glucose, WBC count and bacterial meningitis. A significant relationship was also found between CSF and blood glucose ratio ( CG ) and neonatal bacterial meningitis 579 Gynecology & Obstetrics LAPAROSCOPIC OVARIAN DRILLING INCLOMIPHENE RESISTANT PCO PATIENTS: A PREFERRED METHOD OF TREATMENT ZOLGHADRI J MOTAZEDIAN S DEHBASHI S TAVANA Z Gynecology Endoscopy Ward, Shiraz University of Medical Sciences, Shiraz, Iran. 1 11 2005 19 3 237 240 10 09 2012 Objective: To determine the efficacy of ovarian drilling in PCO patients who failed to achieve pregnancy with medical treatment. Methods and Main Results: 75 patients with a diagnosis of PCO of whom 48(64%) were primary infertile and 27(36%) were secondary infertile were clomiphene resistant. The other methods like bromocriptin, gonadotropins, GnRH -a and metformin had been given to these patients for infertility treatment without benefit. After ovarian drilling, pregnancy was achieved in 41 patients (54.6%), 30(40%) in group I (primary infertile group) and 11 (14.6%) in group II (secondary infertile group). During the operation adhesiolysis was necessary in 14( 18.6%) and removal of endometriotic lesions was indicated in 5(6.6%) in both groups. Conclusion: Ovarian drilling is an ideal technique in PCO patients with failure of medical treatment, considering the benefit of also performing other necessary surgical interventions. 578 Neurosurgery EVALUATION OF CRANIALIZATION TECHNIQUE IN T HE TREATMENT OF FRONTAL SINUS FRACTU RES LOTFINIA I SHOKOUHI G SALEHPOOR F BABOLI S TOTONGEE J Departments of Neurosurgery and Otolaryngology, Tabriz University 0f Medical Sciences, 1 11 2005 19 3 231 236 10 09 2012 Frontal sinus fractures are of surgical importance because of the microbial flora covering the frontal air sinus and it's proximity with the duramater and brain. There is an increased risk of meningitis when fracture of the posterior wall of the frontal sinus is associated with a dural tear. In this condition, communication occurs between the contaminated space of the air sinus and the intracranial space, which may be concurrent with cerebrospinal fluid (CSF) leakage. Non-depressed fracture of the posterior wall of the frontal sinus per se generally doesn't warrant surgical repair, but in some cases when conservative therapy fails to manage CSF leakage and when there is severe injury to the posterior wall of the sinus or to the sinus drainage duct, surgical treatment is warranted. Cranialization is the surgical procedure for such patients in whom communication between the frontal air sinus and outside space is cut off and the air sinus space is integrated with the intracranial space. In this study, we evaluated 29 patients with frontal region fracture who underwent cranialization performed by a single surgery team. Of these patients, 89.7% were male and 10.3 % were female. The most common cause of injury was found to be vehicle accident trauma (65.5%). These patients were also seen to have concurrent iJ1iuries involving the brain parenchyma, cranial nerves (II and III), and pneumocephalus. Post-operative complications included rhinorrhea, CSF leakage from the wound, meningitis and superficial infection of the site of surgery. All these complications improved with conservative therapy. In general, in cases of severe injuries to the posterior wall of the frontal air sinus with nasofrontal duct injury, cranialization is an appropriate procedure. In these patients, in order to reduce complications it is essential that particular attention be paid to the repair of the damaged duramater and to the closure of the nasofrontal duct. 577 Heart ANGIOPLASTY AND STENTING OF CAROTID ARTERY STENOSIS WITH EMBOLIC PROTECTION DEVICES HAJI ZEINALI ALI MOHAMMAD KAZEMI SALEH DAVOOD Interventional Department of Tehran Heart Center; Tehran University of Medical Sciences, Tehran, Iran. 1 11 2005 19 3 223 230 10 09 2012 Background: Carotid artery stenting (CAS) has recently been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. Objective: This study was designed to evaluate the success rate and in-hospital and 30-day adverse events in our first experiences in Iran for CAS with protection devices, to document our results and guide further use of CAS. Methods: From December 2003 to December 2004 we performed 21 consecutive CAS procedures. 16 were men and 5 were women with mean age of 62 years (range 46-78 years). Indications for CAS included primary lesions in all patients with stenosis >50% in symptomatic and stenosis >80% in asymptomatic patients. Results: CAS was technically successful in a1l 21 patients. Mean severity of stenosis before CAS was 85%+14% compared with 15%+10% after CAS. No periprocedural death occurred. No in-hospital and 30-days minor or major stroke/ death was seen. Conclusion: Our data suggest that percutaneous stenting of the carotid artery when a cerebral protection device is used is feasible and effective but not without technical difficulties and potential complications. We recommended CAS for high-risk patients for carotid endarterectomy, but this technique has a learning curve for those willing to perform the procedure with a low rate of complications. 575 Rheumatology RELATIONSHIP BETWEEN KNEE MALALIGNMENT AND QANGLE WITH AGE AT ONSET OF DISEASE IN 260 CHONDROMALACIA PATELLA PATIENTS SALEHI I JAMALI R KHAZAELI S JAMSHIDI A AKBARIAN M GHARIBDOOST F DAVATCHI F Rheumatology Research Center, Amir A 'lam Hospital, Tehran University of Medical Sciences, 1 11 2005 19 3 219 221 10 09 2012 Background: Chondromalacia patella is the most common cause of mechanical knee pain in young women. Q angle and knee alignment are important clinical parameters for biomechanics of the patellofemoral joint. Objective: To identify the prevalence of knee malalignment and to find out if there is a correlation between knee mal alignment and Q angle with age at onset of disease. Methods: All patients under 40 years old complaining of mechanical knee pain with positive shrug sign and normal knee radiography who were referred to Amir A'lam Rheumatology Clinic during the period of September 2000 to September 2002 were included in this study. The patients were examined by a rheumatologist for measuring Q angle and detection of knee malalignment. Age at onset of disease was defined as initiation of knee pain according to the patient's history. Results: The cases were 260 with 189 females. Prevalence of knee mal alignment was 32.4%. The mean age at onset of disease was 22.8 ± 7.08 years. The mean age at onset in patients with knee mal alignment (21.41 ± 5.66 years) was significantly lower than the mean age at onset in those without knee malalignment (23.6 ± 7.43 years) (p= 0.002). There was a positive correlation between Q angle and age at onset of disease (r=0.17,p= 0.006). Conclusion: It seems reasonable to identify knee malalignment in chondromalacia patella patients and perform proper management to postpone progression of disease. There are many other factors that influence age at onset of disease, so further investigation is recommended. 574 Orthopedic Surgery A COMPARATIVE STUDY OF LATERAL APPROACH VERSUS P OSTERIOR APPROACH FOR THE SURGICAL TRE ATMENT OF SUPRACONDYLAR FRACTURES OF THE HUMERUS IN CHILDREN ENSAFDARAN A EMAMI M.J BORGHEI M Department of Orthopedic Surgery, Shiraz University of Medical Sciences, Shiraz, I.R. Iran 1 11 2005 19 3 213 217 10 09 2012 Background: Supracondylar fracture of the humerus is the second most common fracture in children. For most cases closed reduction and percutaneous crossed pinning is recommended. Those patients who had previously undergone an unsuccessful closed reduction trial need open reduction and pin fixation, but the best surgical approach is questionable. Most surgeons apply the technique of posterior or lateral approach. Methods: To compare the results of these two classical techniques, in a prospective study, 40 pure closed noncomplicated supracondylar fractures of the humerus (under 10 years old ), after failure of closed reduction, were randomized into 2 groups, 20 cases in each series, and operated by a single surgeon. The first group was operated by posterior approach. There were 12 boys and 8 girls, with average age of 5 years (range 3-10). Their fractures were reduced and fixed by two crossed pins. The second group was operated by lateral approach. There were 14 boys and 6 girls, with average age of 6 years (range 4-10), whose fractures were reduced and fixed by two lateral pins. Both groups were immobilized in a long arm posterior slab in 80 degrees of elbow flexion. The sutures were removed after 2 weeks, and the pins were removed after 3 weeks and active motion begun. Then after 6 months follow up, the results were determined according to Lagrange - Rigault range of motion. Results: In group 1: 70% (14 patients) were excellent, 20% (4 patients) good, 10% (2 patients) poor results. In group 2: 85% (17 patients) were excellent, 15% (3 patients) good, and no poor or bad results. There was a significant difference between groups 1 and 2 (p<0.05) for post-operation range of motion. There was no deep infection, myositis ossificans or compartment syndrome. Conclusion: The lateral approach appears to provide good long-term functional results. 573 Anesthesia EFFECTS OF EPIDURAL ANALGESI A WITH LOW-DOSE BUPIVACAINE AND FENTANYL ON THE PROGRESS OF LABOR AND MODE OF DELIVERY ATASHKHOII S JAFARI SHOBEIRI M NEGARGAR S Departments of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, l.R. Iran. 1 11 2005 19 3 207 211 10 09 2012 Background and Objective: Epidural analgesia (EA) has been used to relieve labor pain in many obstetric units, yet controversy persists about its effect on progress and outcome in labor. The purpose of the current study was to evaluate the effect of EA on the rate of cervical dilation and myometrial contractility. Methods: In a 6-month period, 36 women who received standardized EA were matched with the next two delivering women of72 patients of the same parity who did not receive EA. The outcome variables were uterine activity, rate of cervical dilation, oxytocin therapy, and operative deliveries. Results: Intermittent EA with bupivacaine and fentanyl did not result in a change in myometrial contractility and the rate of cervical dilation. Oxytocin therapy was significantly higher in the epidural group than in the nonepidural group (p0.0S). Conclusion: After intermittent low-dose bupivacaine and fentanyl EA, myometrial contractility and the ability of the uterus to dilate the cervix are maintained with oxytocin. Despite prolongation of the second stage of labor, cesarean delivery was not common in the epidural group. 570 Gastroenterology and Liver Disease PYOGENIC LIVER ABSCESS: REVIEW OF 54 CASES GHAEMI MOHAMMAD Department of Surgery, Imam Reza Hospital, Mashad University of 1 11 2005 19 3 201 206 09 09 2012 Background: Historically open surgical drainage has been the treatment of choice for pyogenic liver abscess. The records of 54 patients with pyogenic liver abscess were reviewed to determine whether earlier diagnosis with current imaging tests and definitive treatment with antibiotics and aspiration drainage was an effective alternative to surgery. Methods: The clinical features, laboratory tests, imaging, and microbiologic findings, management strategy and final outcome were studied. Results: Twenty-nine patients were treated with broad-spectrum antibiotics and diagnostic aspiration. Twenty-three (79%) recovered uneventfully, and six required catheter or operative drainage. Twenty-three patients (including five who failed aspiration) underwent drainage with percutaneusly placed catheters. Nineteen (83%) recovered, four required open drainage, and of seven patients who required open drainage, six recovered. One (2%) of the 54 patients died following failed aspiration and catheter and surgical drainage. Four patients were successfully treated with antibiotics alone without aspiration. Conclusion: This study confirms that pyogenic liver abscess can be successfully treated with broad spectrum antibiotics and aspiration or percutaneous catheter drainage. Open surgical drainage is reserved for patients in whom treatment fails or who require celiotomy for concurrent disease. 569 Pediatric ENDOSCOPIC NODULAR GASTRITIS: AN INDICATOR OF HELICOBACTER PYLORI INFECTION IN CHILDREN NAJAFI SANI MEHRI KIANIFAR HAMID REZA KHODADAD AHMAD AHMADI MAHMOUD FALSAFI TAHEREH KHATAMI GHOLAMREZA the Departments of Pediatric Gastroenterology and Pathology, The Children's Medical Center; 1 11 2005 19 3 195 199 09 09 2012 Objective: To investigate the importance of endoscopic nodular gastritis associated With Helicobacter pylori infection in children. Methods: In this prospective study, 220 consecutive patients (age range 2 to 15 years, mean age 9. 02 ±3 .3 ), 118 of them males (53. 6%) underwent upper endoscopy during evaluation of chronic abdominal pain. The appearance of nodular gastritis was observed during endoscopy by the author. Culture, rapid urease test and staining were carried out on gastric mucosal biopsies. With histological examination the presence of Helicobacter pylori and the nature of inflammation was assessed. Results: H. pylori infection was identified in 110 (50%) patients. Endoscopic nodular gastritis was seen in 100 patients ( 45.5% ), and was significantly associated with active chronic gastritis. Nodularity in the stomach showed a sensitivity of72. 7% and a specificity of81.8% and a ppv of 80% for the diagnosis of H. pylori infection and was observed in 80 (72. 7% of) H. pylori positive cases. Antral nodularity was associated with increasing risk of infection with H. pylori (OR=12, 95% CI: 6.3-22.7). Conclusion: Endoscopic findings of antral nodularity in children may suggest the presence of H. pylori infection. 567 Gynecology & Obstetrics THE EFFECT OF ENDOMETRIAL PATTERN AND THICKNESS ON PREGNANCY RATE IN CONTROLLED OVARIAN HYPERSTIMULATION-INTRAUTERINE INSEMINATION ALBORZI S MOMTAHAN M ZOLGHADRI J PARSANEZHAD M.E The Division of Infertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 1 11 2005 19 3 189 193 09 09 2012 Objective: In order to evaluate the endometrium by ultrasound in patients undergoing controlled ovarian hyperstimulation (COH) with clomiphene citrate (CC) and human menopausal gonadotropin (HMG) with intrauterine insemination (IUI) to determine the relationship between endometrial pattern and thickness on pregnancy rate (PR). Methods: In this prospective study, 108 infertile couples underwent COH with CC and HMG. The patients were categorized in 4 groups according to etiology. Overall261 COH -IUI cycles with CC-HMG were evaluated. Thickness of the endometrium was measured and its pattern was classified according to its echogenicity. Results: In the homogenous group the pregnancy rate (PR)/cycle was 16. 7%, and in the trilaminar group it was 15 .5%. This difference was not statistically significant (p>0.05). The mean endometrial thickness in trilaminar and homogenous groups was 8.92+ 1.18 mm, and 8. 72+ 1.56 rnrn respectively. In cycles in which conception occurred, the mean endometrial thickness was significantly higher in trilaminar and homogenous groups (p<0.001). In patients with a trilaminar pattern, the pregnancy was equal with those who had a homogenous pattern. The endometrial thickness was a major factor in determining PRs. There was no significant difference between PRs in cycles with trilaminar and homogenous patterns according to the etiology of infertility