Tehran University Medical Journal

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This study was performed in order to improve the knowledge about Craniopharyngioma tumors, and tried to present extensive datas about the signs and symptoms, the clinical process and the treatments and their complications of the patients with Craniopharyngioma, admitted in the hospitals of Tehran university during 15 years (1355-70). Ultimately, these datas have been compared with those in the reputable books and new medical papers And the results are present at the end of the discussion. Undoubtedly, this study is not free of the limitations of retrospective studies. Our patients-contrary to the textbooks are predominantly males And also their most common chief complaints are neurological manifestations, and headache (82%) is the most common one. There is only a little difference in the prevalence of some of the endocrinologic and ophthalmic manifestations between our datas and what in the texts, while, in some others, we can see a great diversity between the 2. For instance, decreased libido in men and amenorrhea in women, among our patients are prominently less than what we study in the books And blood pressure disturbances, sensory and motor symptoms and urinary incontinence have not been seen in our patients. In most cases, CT scan leads to diagnosis and its diagnostic accuracy in 2 times higher than that of the simple radiography and it can show the sella enlargement obviously. In a majority of cases (More than 95%), excision a part of the tumor (From just limited to the biopsy area to 90% of tumor mass) was the only therapeutic measure. In only a few patients, tumor excision was followed by radiotherapy, that showed the better results. The most common delayed complication was the recurrence of the disease.

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A case-control study was performed by the Research Center of Isfahan University, to determine the predisposing factors of early atherosclerosis. Children of cases admitted to a university hospital in Isfahan with early myocardial infarction (MI) were considered for the study. The affeckted cases (n=116), had 120 children aged 2-14 years. The control group were selected from children of the neighbors of the cases. The two groups were similar in age of parents, children and socio-economic status. Mean cholesterol and triglyceride levels and the frequency of hypercholesterolemia and hypertriglyceridemia were significantly higher in the children of MI cases. The mean lipid concentration of the controls was significantly higher than standard levels. These results emphasize the importance of evaluating children of high risk cases for risk factors of MI.

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The main purpose of this study was to evaluate the prevalence of overweight and obesity among guidance-and high school students and its relation to modifiable environmental factors.
Materials and Methods: The subjects have been 1000 girls and 1000 boys aged between 11-18 years, selected by multi-stage random sampling, their parents (2000 subjects) and their school staffs (500 subjects) in urban and rural areas of two provinces in Iran. Data have been analyzed by SPSSV10/ Win software.
Results: The prevalence of 85th < BMI<95th percentile and BMI>95th percentile in girls was significantly higher than boys (10.67±1.1%, 2.9±0.1% VS. 7.37±0.9%, 1.87±0.1% respectively, p<0.05). The mean BMI value was significantly different between urban and rural area (25.38±5.2 VS. 23.25±7.1, P< 0.05). BMI > 85th percentile was more prevalent in those with lower educated mothers (9.2+2.1 vs. 11.5+2.4 years of mothers education respectively). The mean of the total energy intake was not different between overweight or obese and normal- weight subjects (1825±90Kcal VS. 1815±85Kcal, P>0.05) but the percent of energy derived from carbohydrates was significantly higher in former than the latter (69.4% VS. 63.2%, P<0.05). Regular out-school sport activities were significantly lower and the time spent on television watching was significantly higher in overweight or obese than non-obese subjects (300±20 VS. 240±30 minutes/day, P<0.05). Significant linear association was shown between the consumption frequency of rice, bread, pasta, fast foods and fat/salty snack and BMI (p=0.05-0.06, p<0.05). A significant correlation was shown between BMI percentiles with serum triglyceride, high density lipoprotein-cholesterol and systolic blood pressure (Pearson r=0.38,-0.32 and 0.47 respectively).

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Morphine is the most important alkaloid of opium family which is found as much as ten percent in opium, and is in two types the sulfate morphine and the hydrochloride morphine.
Materials and Methods: In this study morphological changes of uterus of surri mice due to oral consumption of sulfate morphine were studied. It was shown that, female surri mice following gradually increasing of morphine to water (0.1 and 0.01) mg/ml were depended to morphine. Female surri mice were classified in two age groups before puberty and depended to morphine during puberty. Each age group took morphine for 21 days. After finishing the period, the mice anesthetizing were weighted, then were anesthetizing and uterus was studied the length, width and apparent features.
Results&ConcIusion: In this study it was distinguished that length and width of uterine horn, between experimental and control groups, were significant (P< 0.01). Morphological changes such as anemia, the thinness and fragitidily walls of uterus and filiformity of uterine horns were observed.

 

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Background: We aimed to demonstrate the mechanism of fracture and functional outcome of patients with hip injury in our clinical setting.
Methods: In a historical cohort, all women 50 years of age and older admitted to three university hospitals of Tehran University of Medical Sciences (Shariati, Imam Khomeini and Sina) with the diagnosis of hip fracture from 21 March 2003 to 21 March 2004 were included in this study (n=115). Follow up was conducted via telephone post and even home visit to record the functional status of the patients at the time of study (5 Jan 2005) measured with Barthel index in addition to the exact mechanism of injuries.
Results: The mean and standard deviation of age were 76.3 ± 10.6 years. About 88.7% of injuries had occurred at home (65.2% on the carpet), the remaining happening in the streets. Mean length of hospitalization was 11 ± 7.9 days. Among our patients, 71% could mobilize spontaneously without aids before injuries. This had reduced to 20% at the time of follow-up. The mean Barthel index was 97.2 ± 8.2 before fracture and 75 ± 21.1 at the present. Among our patients, five cases died during hospitalization and 29 of them died afterwards (total: 34 or 29.6%).
Conclusion: The most common external cause of injuries in our cases was stumbling at home especially on carpeted surfaces. This necessitates preventive measures aimed at physical standards of houses and education of elderly on healthy locomotion, indoors.

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Background: A plan for management of infected arterial pseudoaneurysm has evolved from our experience with forty two cases of such aneurysms treated between 1378 and 1382.
Methods: Clinical data of 42 patients with femoral pseudoaneurysm resulting from addictive drug injection who presented in emergency department of Sina Hospital between 1378 and 1383 were retrospectively reviewed.
Results: All patients were men with the mean age of 36.9 years. Twenty eight patients were referred from other medical centers. The mean time of delay in presentation was 17.3 days. The mean duration of drug injection was 14 months. Primary repair and emergent vascular bypass were performed in 3(7.1%) and 2(4.8%) patients, respectively. 5(11.9%) patients undergone delayed revascularization. Thirty two (76.2%) patients returned to their normal lifestyle without any vascular bypass. One patient required amputation and one patient died due to sepsis and acute renal insufficiency.
Conclusion: Management of infected femoral pseudoaneurysms is simple ligation of the external iliac or femoral artery. When Doppler is not available “Operation Room and postoperative Direct Observation” is recommended in such patients to avoid unnecessary revascularization surgery.

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Background: Malaria is still one of the main health problems in south and southeast provinces of Iran and recently on average 10,000-30,000 malaria cases were reported annually. Mosquitoes of Anopheles superpictus are one of the main malaria vectors in Iran and have been reported from all areas of the country including central plateau and plains of Alborz and Zagrous Mountains chains, and with low numbers in shore plains of the Persian Gulf and Caspian Sea. There are variations in larval and adult morphological characters and also in vectorial capacity of this species in different areas of Iran.
Methods: This study has been conducted to investigate rate of mtDNA variation among various populations of this species in Iran. The sequence variation of an 1512 bp length of mitochondrial DNA (mtDNA) cytochrome oxidase subunits 1 and 2 (COI-COII) and an 708 bp sequences of COI gene were analyzed by PCR-RFLP and PCR-direct sequencing respectively.
Results: This study showed that there are considerable variations between and within populations. Rate of variation was 12.3 % between populations and this was 2-5% for within Baluchistan population. Totally 4 haplotypes were observed between populations where 3 occur in Baluchistan and one in other places.
Conclusion: This is the first report on existence of various haplotypes in An. superpictus in science, and presumably this species comprising siblings and is a species complex. Further studies need to confirm this result and to determine the relationship between mtDNA haplotypes and their role in malaria transmission in each locality.

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Background: Anopheles superpictus is one of the main malaria vectors in Iran. The mosquitoes of this species are found throughout the Iranian plateau up to 2000 meters above sea level in the Alborz Mountains, south of the Zagros Mountains, and in the plains near the Caspian Sea and Persian Gulf. It has been reported that different geographical populations of An. superpictus play different roles in malaria transmission. Based on the presence or absence of a black spot/band on the apical segment of the female maxillary palpi, two morphological forms have been reported in this species. This work has been conducted to study other morphological features as well as the genetic structure of these two forms of An. superpictus in Iran.

Methods: The different morphological characteristics of 35 different populations were observed and recorded. An 887 bp portion of the mitochondrial DNA (mtDNA) cytochrome oxidase subunit I (COI) was amplified and assayed by restriction fragment length polymorphism (RFLP) using 18 enzymes and PCR-direct sequencing techniques.

Results: Among the morphological characteristics studied, there are significant differences between the two forms with regard to the length of the palp light band (p<0.01), wing length (p<0.5), and the distance from the branching point of the II/IV veins to the tip of the wing (p<0.05). Results also revealed that these two forms are sympatric in most localities of Iran. RFLP analysis and sequences of about 710 bp of the gene showed that there was great variation between and/or within the populations, but these variations were not associated with the morphological forms.

Conclusion: This is the first comprehensive study on the morphological and molecular characteristics of An. superpictus in the literature. To determine the role of these morphological forms or genetic haplotypes in malaria transmission, further molecular, cytological, morphological, and epidemiological studies are necessary.

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Background: The risk of atherosclerosis and cancer is high in hemodialysis (HD) patients. There is evidence that HD causes oxidative stress. However, the causative factors of oxidative stress are unknown. It has been suggested that HD imposes an additional oxidative stress on patients with chronic renal failure by activation of granulocytes on dialyzer membranes resulting in an imbalance between oxidants and antioxidants. In this regard, a number of reports, either measuring specific analytes or enzymes, or estimating the total antioxidant activity of the plasma have given contradictory and inconclusive results. To investigate the oxidative stress status in Iranian HD patients, in this study, we evaluated GSH and FRAP levels along with Ca and pH in the blood of these patients.

Methods: Along with 20 healthy age and gender matched control subjects, 24 patients underwent dialysis, three times per week, for four hours in each session. Before and after dialysis, blood was taken for biochemical and liver function tests and to evaluate oxidative stress markers and measure Ca and pH levels.

Results: There was a significant decrease in FRAP and GSH levels after dialysis compared to those before treatment. Dialysis caused an increase in pH and Ca levels compared to levels in control subjects after dialysis.

Conclusion: In general, before dialysis, there is a balance between oxidants and antioxidants however, due to higher levels of oxidants as well as the possible binding of antioxidants to the dialyzer membrane during dialysis, an imbalance occurs. The instability in the balance of oxidants and antioxidants may be the major cause of cellular oxidative damage found in HD patients. This study indicates that there is a significant level of oxidative stress in renal chronic patients and this stress is augmented by dialysis. Antioxidant therapy should be considered in these patients.

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Background: Data mining as a multidisciplinary field is rooted in the fields such as statistics, mathematics, computer science and artificial intelligence and has been gaining momentum in scientific, managerial, and executive applications in health care. Data mining can be defined as the automated extraction of valuable, practical and hidden knowledge and information from large data. Applying data mining in medical records and data is of utmost importance for health care givers and providers and brings vital and valuable outcomes. Data mining can help doctors come up with better recommendations and plans for treatment which actually in many respects have significant impact on patients’ life and satisfaction In this paper we have proposed and utilized data mining methods to extract hidden information in medical records of pelvis stone patients with ureteral stone. We have tried to design a decision support system model to be applicable for selecting type of treatment for these groups of patients.
Methods: We gathered needed information from Shahid Hashemi Nejad hospital. In this research we have used decision tree as a data mining tool, for selecting suitable treatment for patients with ureteral stone. This model can predict probability of success of each treatment. 
Results: In this research we extracted effective attributes in selecting type of treatment for patients with ureteral stone.
Conclusions: By using this model we can have eight percent improvement in number of patients who have stone free output after treating. In fact, this model has a better functionality than expert system of hospitals.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Identification of the determatophytosis species and superficial mycosis agents may be useful in directing the survey for environmental and animal sources of infection to educate the danger of acquiring infections from infected persons and other animals. Based on this background the identification of cutaneous mycosis distribution was the main purpose.
Methods: From March 2005 to Feb 2009 we examined 5500 patients suspected to superficial and cutaneous mycosis referred to medical mycology labs in Tehran, Iran for Medical Mycology examination. Skin, hair and nail sampling were taken by scraping from patients and collected for diagnosis. Diagnosis was confirmed by direct microscopy and culture according to the mycology routine laboratory methods.
Results: A total of 2271 cases (41.3%) suffered from superficial and cutaneous mycosis. The most common infections were dermatophytosis 1279 cases (56.31%), Tinea Versicolor 356 cases (15.47%), Erythersma 283 cases (12.46%), cutaneous candidiosis 243 cases (10.7%) and sacrophytic cutaneous mycosis 110 cases (4.83%). Tichophyton mentagrophytes was the most common etiological agent with 198 cases (41.56%). The most common clinical type of cutaneous candidiasis was onychomycosis and Candida albicans was the most common etiological agent. The common sites of involvement of tinea versicolor were neck and trunk and Malassezia globosa was most common etiologic agent.
Conclusion: This study highlights a common problem (Antropophilic species) in Tehran and suggests that further measures regarding public health and especially personal hygiene should be undertaken to reduce the risk of superficial and cutaneous mycoses.

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Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with presumed autoimmune origin. T cells are considered to play a pivotal role in orchestrating the self-reactive immune responses in multiple sclerosis (MS). This study was performed to investigate the role of polymorphisms of the programmed cell death 1 (PD-1) gene on susceptibility to ankylosing spondylitis.This gene codes an immunoreceptor named PD-1, which has a cytoplasmic domain containing two tyrosine residues located within immunoreceptor tyrosine-based inhibitory and switch motifs (ITIM and ITSM), suggesting that PD-1 is predominantly inhibitory which responsible for the negative regulation in T cell activation and peripheral tolerance. We investigated whether PD-1 gene polymorphism is a genetic modifier for risk and progression of MS.Methods: Blood samples from 150 Iranian Relapsing-Remitting MS patients (mean age, 34.98 years) and 202 healthy controls (mean age, 30 years) were enrolled in this study.The PD-1.3 (7146 G/A Intron 4) and PD-1.9 (7625 C/T Exon 5) polymorphisms were detected by Polymerase Chain Reaction and Restriction Enzyme digestion or Restriction Fragment Length Polymorphism (PCR-RFLP). Results: No significant association of the mutated alleles with the disease were detected. Because of the ethnic group genetic variation, our data is not like some of Asian population such as Korea and China.Conclusions: Our data suggest that PD-1 polymorphisms are not act as genetic modifiers of the progression of MS, possibly these polymorphisms don't induce a partial defect in PD-1 mediated inhibition of T-cell activation.

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Background: Uterine environment and fetal period can profoundly affect health of the neonat. Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that regulates cellular stress responses and its activity is essential in both embryogenesis and postnatal life. The aim of the present study was to investigate the effects of maternal swimming on rat pups' HIF-1α levels as a key regulator of oxygen in lungs.

Methods: Sixteen female Wistar rats weighing 180- 200 grams were acclimated to a new environment consisting of equal light-darkness cycle and ad lib access to chow and adapted to the stress caused by water for two weeks. The rats were divided into two swimming and control groups. Swimming training began on the first day of pregnancy in a pool and continued for 3 weeks (1 h/day, 5 days/wk). Pups' lungs were removed two days after birth and their HIF-1α concentration was determined with enzyme-linked immunosorbent assay (ELISA). Statistical analysis of the data was done using independent t-test. A p-value smaller than 0.05 was considered statistically significant.

Results: Swimming lead to a significant (P<0.001) increase in the pups' lung HIF-1α levels compared with the control group. Although 3-wk period of swimming training, showed no significant increase in weight and also lung weight of newborns. Thus it can be concluded that swimming endurance training in pregnancy, can be considered as appropriate alternative in order to embryos development.

Conclusion: Our research suggests that HIF-1α level is an essential element for the development of the lungs of embryos. Moreover, further studies on the lung HIF-1α levels at post-natal period with different modes of exercise will provide more clear insight into the mechanisms of the findings resulting from this study.

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Background: Epidemiological studies have reported positive, negative, U-shaped or J-shaped association between high blood pressure and cognitive function as well as dementia whereas other studies have not reported any significant association. The aim of this study was to examine the association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation (KCF).

Methods: This cross sectional study was done in Kahrizak Charity Foundation in suburban areas of Tehran, Iran during 2008. The data were collected over one week. Among the 850 elderly residents of the Foundation who were ≥ 65 years old, 185 individuals were chosen randomly. The Mini-Mental State Examination (MMSE) was completed for all. Mean of all blood pressure readings were recorded while anthropometric and biochemical measurements were performed.

Results: The findings indicated that in participants with cognitive impairment, systolic blood pressure, diastolic and mean blood pressures were higher than people with normal cognitive function but the differences were not significant statistically. The odds ratio of cognitive impairment in patients with and without hypertension was 1.52 and 1.58, respectively (P>0.05).

Conclusion: This study did not show any significant association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation.

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Background: Anti-Müllerian Hormone (AMH) is secreted from granulosa cells of growing follicles and is a useful marker of ovarian reserve. Fertility in women is determined by the quality and quantity of follicle pool and ovarian follicular reserve positively correlates with AMH. In this study we aimed to determine if AMH can predict ovarian response in IVF treatments.
Methods: In this retrospective observational study undertaken in Mehr Institute during 2010 to 2011, we studied the medical records of 101 patients and recorded the concentrations of AMH, day two or three FSH, LH, basal estradiol (E2), E2 on day of HCG administration and the number of metaphase II oocytes. Having undergone ovarian hyperstimulation, the women were divided into three groups: poor responders (retrieved oocytes ?3), normal responders (retrieved oocytes 4 to 15) and high responders (retrieved oocytes ?16).
Results: Overall, 20% of patients were defined as poor responders, 71% as average responders and 10% as high responders. There were significant differences in the concentration of AMH, E2 on day of HCG administration, FSH, the number of metaphase II oocytes and age between the three groups. MII oocyte count correlated positively with AMH (r=0.487), basal E2 (r=0.275) and LH (r=0.07) but it did negatively with FSH (r=-0.26) and age (r=-0.04). The areas under curve for AMH, FSH, LH, E2 and age were 0.799, 0.32, 0.429, 0.558 and 0.304, respectively. We determined the 0.85 ng/ml AMH concentration as the cut-off point with 71% specificity and 79% sensitivity for the prediction of poor responders. 
Conclusion: anti-müllerian hormone is an appropriate predicator of ovarian response following induction of ovulation.

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Background: Amphotericin B Deoxycholate (ABD) has been the best therapeutic agent for treatment of most systemic fungal infections. However, untoward adverse effects like nephrotoxicity may limit its appropriate therapeutic use. We studied administration of fat emulsion early after infusion of ABD to evaluate its effects on ABD-associated nephrotoxicity.
Methods: This study was a randomized clinical trial. Patients with fungal infections admitted in Amir-Alam and Imam-Khomeini University Hospitals, Tehran, Iran, entered the study during 1390- 1391. The patients were randomized to intervention and control groups. In both groups, patients received 1mg/kg/day ABD in dextrose 5%. In intervention arm, the patients additionally received intralipid 10% daily that was started as soon as possible within one hour after infusion of ABD. ABD-associated nephrotoxicity (a minimum 50% increase in baseline serum creatinine to a minimum of 2mg/dl), daily serum creatinine changes during first two weeks of treatment and some other relevant indices of renal function were compared between groups. ABD-related hypokalemia was also compared as an additional target.
Results: Thirty one patients entered the study. ABD-associated nephrotoxicity and values of other relevant indices of renal function were not different between intervention and control groups (P>0.05). Daily changes in serum creatinine level within first two weeks of treatment in both groups were not also statistically different (P=0.62). Furthermore, ABD-related hypokalemia was not significantly different between groups (P=0.47).
Conclusion: Administration of intralipid 10% early after infusion of ABD in dextrose 5% does not have any effect in decreasing ABD-associated nephrotoxicity. Moreover, it does not have any significant effect on ABD-related hypokalemia.

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Background: Ischaemic pain counts among the most difficult to treat pains in palliative care. Ischemic pain is frequently severe, and usually resistant to available analgesics. Treatment of this condition is difficult, especially when the condition is inoperable.
Case presentation: A 36-year-old woman with the diagnosis of systemic lupus erythematosus with severe ischemic pain in the lower leg due to vascular problems presented to Akhtar Hospital. The patient was arranged for lumbar sympathetic block which was performed in two stages with one week interval. In the procedure, a long needle with No. 22 gauge and the length of 15 cm was used. Under view of fluoroscopy guide, 10 cc marcaine 0.125% was injected. In the second stage, 5 cc of marcaine 0.25% and 5 cc of phenol 0.6% were used. Pain improvement was observed immediately after neurolytic lumbar sympathetic block. Three-month follow up period revealed improvement of quality of life.
Conclusion: Lumbar sympathetic block is considered as a safe and useful technique. Clinically, the technique is effective for pain relief in patients who develop lower leg pain due to vasculitis.

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Background: The aim of this study was to assess the association of serum adiponectin and a set of traditional cardiovascular risk factors with carotid artery intimal-medial thickness (CIMT) and coronary artery calcium score (CACS), as markers of subclinical atherosclerosis in subjects with early type 2 diabetes mellitus.

Methods: Carotid artery intima- media thickness (measured by B-mode ultrsonography), coronary artery calcium score (determined by high resolution computed tomography), serum adiponectin, Fasting blood sugar, serum lipids, body mass index (BMI), systolic blood pressure, diastolic blood pressure and mean arterial pressure were measured in 123 asymptomatic newly diagnosed cases of type 2 diabetes mellituss and 152 age and sex matched healthy control subjects.

Results: Serum adiponectin and lipids were significantly lower in those with type 2 diabetes mellitus (P<0.01). Left, right and mean carotid artery intima- media thickness, coronary artery calcium score, fasting blood sugar, systolic blood pressure, diastolic blood pressure and mean arterial pressure were significantly higher among diabetic patients compared to healthy controls (P<0.05). Mean carotid artery intima- media thickness was positively and independently related to age (P<0.001) and triglyceride (P=0.01) in diabetic group. Coronary artery calcium score was associated positively with age (P=0.004) and inversely with high density lipoprotein (HDL) cholesterol (P=0.002) among diabetics.

Conclusion: Although adiponectin was lower in diabetics compared to controls, it had no significant association with carotid artery intima- media thickness and coronary artery calcium score as markers of subclinical atherosclerosis. In patients with type 2 diabetes in addition to age, serum triglyceride levels are correlated with carotid artery intima- media thickness, while HDL cholesterol is inversely correlated with coronary artery calcium score.

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Background: Nocardia species are Gram-positive, partially acid fast, non-motile, catalase positive, aerobic and saprophytic actinomycetes found all around the world. They invade the human body from the environment via trauma and respiratory tract and cause cutaneous, pulmonary and systemic diseases. They are able to grow in various media.The organisms opportunistically infect both immunocompromised and immunocompetent individuals. Behcet's disease is an autoimmune disease and immunocompromised patient which may suitable host for Nocardia bacterium. The present study is the first case report of isolation of Nocardia from the thigh abscess in a patient with behcet’s disease from Iran.
Case Presentation: A 39-year-old man with Behcet’s disease in August 2011 was admitted to Shariati hospital Tehran, with swelling and pain in the left flank and left thigh. Microscopic identification from direct microbiological slide of thigh abscess discharge demonstrated number of lymphocytes, neutrophils and macrophages foamy and white blood cells together with filamentous bacteria. Further microbiological characterization using phenotypic and antibiogram tests with disk diffusion method, demonstrated that the isolated bacterium is Nocardia asteroides complex. The bacteria were sensitive to ampicillin, vancomycin, ceftriaxone, amikacin and cotrimoxazole but it was resistant to clindamycin, erythromycin, penicillin G, cephalothin and gentamicin. The patient was treated with cotrimoxazole.
Conclusion: Because of the high incidence and high mortality of Nocardia infection in immunocompromised cases, rapid detection and timely treatment for these patients is necessary.

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Background: One of the main reasons of hemorrhagic fevers is Ebola. The high rate of mortality and lack of definite treatment have been caused this infection to be a serious problem in the world. Ebola, especially in the early stages, when causes symptoms such as fever, anorexia and nausea, can be confused with malaria infection and conversely, severe malaria with Ebola. Plasmodium falciparum is an important cause of severe malaria that more than other types of plasmodium confused with Ebola. Case presentation: The patient is a 54-year-old man who had gone to Sudan about 8 months ago. The patient reported that fever, chills and headache had been started one week before traveling from Sudan to Iran and hematuria was added to his symptoms in third week of illness in Iran. He was referred to the emergency department with probable diagnosis of Ebola. Plasmodium falciparum gametocytes were revealed in his peripheral blood smear. Finally, he was treated with Coartem (artemether/lumefantrine) for malaria and after clinical improvement discharged to home with good condition. Conclusion: Ebola should be suspected in every patient with fever and a history of traveling to endemic areas. Considering the fact that in most areas where Ebola is endemic also malaria is common, lack of clinical suspicion to malaria causes that clinicians mistake malaria with Ebola. Necessary laboratory tests to rule out important differential diagnoses in patients with suspected Ebola virus contains: Peripheral blood smear for malarial parasite and blood culture and blood cell counts to investigate typhoid fever and other bacterial infections. Therefore, malaria should be considered as an important differential diagnosis in every patient suspected with Ebola.