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Abstract Background Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disorder characterized by inflammatory assaults on the central nervous system (CNS), particularly on the optic nerves and spinal cord. In recent years, a wider range of clinical manifestations of this complex disease have been observed, emphasizing the importance of gaining a more profound understanding beyond optic neuritis (ON) and transverse myelitis (TM). Current knowledge This study explores the many clinical symptoms of NMOSD, including common and uncommon presentations. Distinctive aspects of ON, TM, and diencephalic/brainstem syndromes are examined, highlighting their unique characteristics in contrast to conditions such as multiple sclerosis. We also discuss extra‐CNS involvement, such as unusual signs, including muscle involvement, retinal injury, auditory impairment, and rhinological symptoms. Aims and objectives Our study intends to highlight the wide range and complexity of NMOSD presentations, emphasizing the significance of identifying unusual symptoms for precise diagnosis and prompt management. The specific processes that contribute to the varied clinical presentation of NMOSD are not well understood despite existing information. This emphasizes the necessity for more study to clarify the mechanisms that cause different symptoms and discover new treatment targets for this complex autoimmune disorder. Conclusion It is essential to acknowledge the complex and varied clinical manifestations of NMOSD to enhance diagnosis, treatment, and patient results. By enhancing our comprehension of the fundamental processes and investigating innovative therapeutic approaches, we may aim to enhance the quality of life for persons impacted by this illness.

Background and Aim: Considering the importance of sepsis and its complications in the mortality of the patients admitted to different parts of hospital and the importance of early diagnosis and timely and appropriate treatment in the patientschr('39') survival, we investigated the value of procalcitonin serum level for the differential diagnosis between infectious and non-infectious SIRS in the patients referring to Tohid Hospital in Sanandaj. Material and Methods: In this descriptive analytical (case-control) study, we measured procalcitonin level in SIRS positive patients who had been referring to Tohid Hospital in Sanandaj. After obtaing the results of the lab.tests the patients were divided into two groups of infectious SIRS (case group) and non-infectious (control group) based on the final diagnosis made by our infectious diseases specialist. Patients with history of antibiotic intake within the last 48 hours, mechanical trauma, heat stroke, recent surgery, cancer and severe burn were excluded from the study. Each group consisted of 30 patients. Using SPSS software, data were analyzed by independent T-test to compare the quantitative data between the two groups. We also used Pearson correlation test to investigate the relationship between procalcitonin serum level and variables related to vital signs and blood markers. P

Metastatic breast cancer is a disease of early breast cancer that usually occurs several years after the early breast cancer. Breast cancer is the most common cancer among Iranian women. According to the new statistics in Iran 6160 breast cancers are diagnosed in the country each year and 1063 cases lead to death. In this paper, epidemiology, diagnosis and treatment have been investigated. In this study, case–control clinical trials and open studies with adequate data were collected. Due to the higher risk of age group 40–49 years and the advent of advanced breast cancer in Iranian women, the early diagnosis and determination of the exact size of the tumor before surgery is important in choosing a therapy plan. The decision on the therapy of invasive breast cancer depends on several factors such as cancer stage, tumor size and type, pathological and cytological status of the tumor, the patient's opinion, the presence or absence of estrogen and progesterone receptors in the cytoplasm of tumor cells and so on.

This research, one of the most covering rainfall times (from1381/8/6 to 1381/10/5) in Iran study and then synoptic and dynamic analysis of it's the heaviest rainfall cluster (from 1381/9/15 to 1381/9/20) explain using environmental to circulation pattern method. In this time more than 60% of Iran stations experienced rainfall and also, the number of heavy rainfall events were recorded in the southern coastal Caspian see. After drawing of Isorain maps in studied days, rain maximum points and its gravity centers calculated. Then, pressure surface patterns, geopotential, humidity advection, front, jet stream and Q-vector maps were drawn in different levels. Analysis of pressure of see level maps showed that pressure gradient reinforcement between Black see high pressure and Mediterranean low pressure and between Black see high pressure and the eastern north of Caspian sea low pressure are effective to produce these heavy rainfalls in west, southern west of Iran and the southern coastal Caspian sea. Maps geopotential showed that there are two main patterns in this studied time, as role of the eastern north of Caspian Sea trough (part of long through of Mediterranean) is very important. Analysis of humidity advection maps showed that Mediterranean sea and Red sea in upper levels and Persian Golf and Oman sea in lower levels are sources of humidity for heavy rainfalls, as them role in different days aren’t alike. However, heavy rainfall events in the southern coastal Caspian sea were provided via Mediterranean sea in 500(ha) level, Mediterranean sea and Red sea in 600 and 700 (ha) levels and all of main sources of humidity (Black sea, Mediterranean sea, Persian Golf, Red sea and Caspian sea). Polar front, north of Red sea-north of Persian Golf front and composition of subtropical jet stream and polar front jet steam in the east of Iraq can be from reasons of producing and strengthening of vertical movements. Also, analysis of Q-vector maps with point of convergence regions shows the important role Caspian sea, Mediterranean sea, Black sea, Persian Golf and Oman sea to producing of raising movements in different levels and times and its follow to forming of heavy rainfall events in the southern coastal Caspian sea and Iran.

This study has been performed in order to determination of optimum refining of paper made of recovered Kraft liner. Recovered Kraft liner has been prepared from anzali city. After shredding into 5 centimeter pieces, the papers were soaked in distillated water in pail. After 7 days fibers was separated of each other by disintegrator and freeness for each pulp before and after refining were measured. They were refined in revolutions of 3000, 6000, 9000, 12000 by PFI mill. Hand sheets were made from each revolution in order to TAPPI standard T 205om-95 number, and then were compared with control sample. Analysis of variance of waste papers were conducted using completely randomized design, then mean values were compared, using Duncan’s test, and finally the normalization equations were used to determine the best sample. Results showed that increasing of refining revolution increased strength of burst, tensile and brightness but decrease freeness, thickness and tear strength at product. Normalization equations showed that the best papers made from refining revolution of 9000.