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Background and objective: The south of littoral of Caspian sea is located on the Asian belt of oesophageal carcinoma, where has the highest incidence in the world. The objective of this study was to determine the epidemiologic aspects of patients with oesophageal carcinoma in the north of Iran. Materials and methods: Based on the existing data of medical charts, we conducted a descriptive study of 668 patients with oesophageal carcinoma who referred to Shahid Rajaei Radiotherapy Center in Babolsar during 1993 to 1999. The data was included age, sex, occupation, residence area, and history of alcohol, smoking, drug consumption, anatomic location and histologic type of tumor. We used T-test and Chi-square test in statistical analysis. Results: The mean (±SD) age of 668 patients was 62.8 (±11) years and the modal age group 60-69 years. The mean age of males was significantly greater than females (63.8 vs. 61.2 years, P<0.05) 54.5% of patients were male and 62.1% of males were farmers, 14.5% clerk, and 7% workers whereas 92.4% of females were housewives. Roughly, 0.7% of patients had a history of alcohol consumption, 19.3% smoker and 7.9% drug users and 50.3% of patients were residence of urban area. The most common histologic type of tumor was squamous cell carcinoma (91.3%) and 7% of tumors were adenocarcinoma. The ratio of men to women of adenocarcinoma was 3 to 1 Also squamous cell carcinoma was more common among men than women The relation between the histologic type of tumor and gender was significant (P<0.05). The most common location of squamous cell carcinoma was the upper third of oesophageal (47.1%) and for adenocarcinoma the lower third (86.4%). Also, we observed a significant relation between occupation and the histologic type of tumor. Conclusion: The results indicated that the frequency of oesophageal carcinoma is increased over the age 50 years. The relation of histologic type of tumor with location and gender are consistent with those reported in the other studies in the western countries, which shows the same pattern of epidemiologic aspects of this neoplasm in the world.

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Background & Objective: Enuresis is a problem in children. In this research the success, rate and recurrence of Imipramine, Desmopresine and conditional therapy has been studied in enuresis treatment of children. Materials & Methods: This study was done on 84 enuresis child between 7-11 years old which were selected by screening at the schools. Patients divided randomly to 3 groups: The 1st group received 25 mg of Imipramine every night. The 2nd group was treated with 20 micg of Desmopresine intranasaly every night. The 3rd group used alarm for conditioning every night. All groups were treated for one month, and 2 weeks without enuresis meaned success. Results: All physical finding and laboratory tests were normal in all patients (FBS, U/A, U/C, kidney and bladder sonography). Patients had in average 8.5 years old. 77.3% of cases were boys and 22.7% were girls. Success rate for therapy was 71.4%, 60% and 50% in-groups 1-3 respectively. Recurrence rate 6 months after therapy was 10%, 55.5% and 25% in-groups 1-3 respectively. Conclusion: Imipramine persists as cheep, available, well-tolerated and effective way of treating enuretic patients. Due to high recurrence rate, Desmopresine is just recommended as a temporary treatment.

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Background & Objective: Although many experimental studies provide convincing evidence, that type II immunity is protective against helminthes, recent data in mice reveal that Th1 are also important in some cestods like Hymenolepis nana. To reveal the role of Th1 and Th2 lymphocyte in immunity against H.nana, the levele of IL12, IFNγ, IL5, IL13 was determined in serum of human infected with H.nana. Materials & Methods: In a case control study in 2006 in Mazandaran Medical Sciences university a total of 31 patients (case) with H.nana infection and 30 clinical healthy people (control) were included in this study. Measurment of IL12, IFNγ, IL13 and IL5 in serum samples were performed by solid-phase sandwich enzyme linked immunosorbant assay. Differential leukocyte count also was done. T test, mannwhitney test and wilcoxan W test were used for data analysis. Results: The mean concentration of IFNγ, IL13, IL12, IL5 in the sera of patient with H.nana infection were higher than control group, but only the difference between concentration of IFNγ (P<0.05) and IL13 (P<0.05) in two groups were significant. There was an increase in percentage of monocytes, Eosinophils and lymphocytes in patient when compared to the control group, but this increase was not significant. Conclusion: Results form the present study are in agreement with experimental study in that both Th1 and Th2 responses occurs in H.nana infection.

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Background & Objective: Preterm infants have less iron storage compared with the term one. Due to rapid growth they need more iron during infancy. This study was designed to evaluate the effect of early iron supplementation on hematologic indices and incidence of iron deficiency anemia in preterm infants. Materials & Methods: This experimental study was done on 20-days-old preterm breast-feed infants referred to the Gorgan-North of Iran primary health care services for vaccination, without any underline disease or growth retardation during 2005. They were divided to two groups (n=15 in each) and a questionnaire was completed for each case. Iron drop (2mg/kg) was given in the interventional group. Iron deficiency anemia was assesed in all sample T-student test and chi-square were used to analyze the independent variables and comparing the hematologic indices, after entering in SPSS-13 software and testing the normal distribution with komologrof-smearnoff test. Relative risk index (RR) was used to compare the two groups. Results: The relative risk of iron deficiency anemia in the interventional group was 0.4 folds [RR=0.4,CI %95 for RR=(0.091,1.749)]. No significant difference was seen between the two groups. Conclusion: The finding of this study showed that iron drop supplementation for preterm infant prevent the iron defeciency anemia, although this observation was not significant.

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Background and Objective: Anthropometric indeces are the best methods for determining of malnutrition and obesity in children and young adulescent worldwide. This study was designed to compare the physical growth status between Turkman and non-Turkman in rural area in Gorgan in North of Iran. Materials and Methods: This cross – sectional descriptive was done on 551 children of 2-5 years of age, Turkman and 895 of non-Turkman in the rural area of Gorgan North of Iran during autumn 2005. Height, weight and personal identification recorded by questioners. BMI percentile and under -1sd ,-2sd and -3sd from NCHS used for comparison. Data were analyzed by using Chi-Square and T-student tests. Results: Mean±SD of height in female Turkman and non-Turkman were 95.3±8.1 and 90.5±8.4 cm respectivly means±SD of height were 96.0±7.6 and 90.9±8.6 cm in Turkman and non-Turkman, respectively. Male childrens mean±SD of weight in were 14.5±2.4 and 14.2±2.9 and in male Turkman and non-Turkman children respectively. Also means±SD of weight were 15.0±2.03 and 14.5±2.3 cm in Turkman and non-Turkman male children, respectively. Turkman children are about 426 gram heavier and 4.9 cm taller than non-Turkman in all of age groups (P<0.05). Stunting and underweight were observed in 13.2% and 1.9% in Turkman group less than non-Turkman respectively by -2sd criterion. There was a significant differences between two groups by stunting (P<0.05). Obesity and overweight exist in Turkman group 24.5% and 2.6% less than in non-Turkman respectively. The difference in obesity statistically was significant between two groups (P<0.05). Underweight was shown in female more than male (7.2% vs 4.2%) and obesity in female less than male (25.6% vs 28.9%). Conclusion: This study showed that secular growth in two groups is incompatible and it is better in Turkman group than non-Turkman group. Malnutrition in Turkmans was less than Non-Turkmans children.

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Background and Objective: Aircraft as a safe means of transportation may cause occupational diseases and hearing loss. Prevention should be implemented for airport employee. This study was done to detemine the scale of hearing loss among Isfahan airport employees in 2005. Materials and Methods: This historical cohort study was conducted among Isfahan International airport employees. 80 employees were selected in four different case groups, the control group consist of two sub-gourps. The sub-group I (18 subjects) including the adminstrative airport employees (low noise exposed) and the sub-group II (32 subjects) including non-airport employees (non-noise exposed). The sound pressure level was measured and equivalent level (Leq) was calculated for all groups. Also the history of participants about past noise exposure and other confounding variables was detrmined by a questionnaire. Pure tone audiometry was carried out on conventional frequencies (0.5-8 KHz). Results: The mean age of subjects was 40.03±9.75 and 37.85±8.15 for exposed and non-exposed groups respectively. Leq (noise equivalent level) for Ramp and traffic workers was estimated more than 95 dBA. 35.7% (n=10) of Ramp workers were suffering in their right ear from noise induced hearing loss (26-40dB) and 32.1% (n=9) of them in their left ear. Relative risks of noise induced hearing loss in Ramp workers in comparison with control group were 9.4 and 7.5 for right and left ears. A siginificant difference was found between the hearing thresholds of exposed and non-exposed groups (P<0.05). Conclusion: This study showed that occupational exposure to noise cause hearing loss among airport employee. It is suggested strategies of noise assessment and prevention should be implemented for airport employees.

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Background and Objective: Hemodynamic alteration and hypotension due to spinal anesthesia can reduce tissue perfusion and increase ischemic risk, myocardial infraction, renal failures spinal damages and even deep veins thrombosis. This study was designed to compare pharmaceutical effects of ephedrine, atropine and mucosal phenilephrin on hemodynamic alteration of women during spinal anesthesia in cesarean section. Materials and Methods: This randomized clinical and double blind study was done on 90 singleton pregnant women with ASA I and II class .the subjects gone elective cesarean section and allocated into three groups. subjects were received 500 ml ringer lactate before spinal anesthesia. Subjects in group I, II and III first received 0.1 mg/kg atropine (IV) 0.01mg/kg ephedrine and 100µgr phenilephrin (mucosal) prior spinal anesthesia, respectively. Hemodaynamic indexes including blood pressure, heart Rate, oxygen saturation and drug side effects were determined every 5 minutes interval through the surgery. Data was analyzed by using SPSS-11.5, Chi-Square and ANOVA tests. Results: Hemodaynamic indexes were changed during study, but three medicine showed similar effect on heart Rate, blood pressure and changes of oxygen saturation (P<0.05). There was a significant differences among three groups for dosage of extra ephedrine to control of blood pressure (P<0.05). This increase dosage of extra ephedrine was 56.7%,20% and in ephedrine, phenilephrin and atropine groups,respectively. Nosia rate was 6.7%, 50% and 46.7% in phenilephrin, atropine and ephedrine groups, respectively (P<0.05). Conclusion: This study showed that to prevent of blood pressure drop following spinal anestasia atropine, phenilephrin and ephedrine can be prescribed, but ephedrine is recommended for lowering the rate of nosia.

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Background and Objective: Electroconvulsive therapy (ECT) is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has a direct relation with the duration of convulsion. This study was conducted to assess the effect of lidocaine on duration of seizure and hemodynamic alterations in electroconvulsive therapy. Materials and Methods: This clinical trial study was conducted on 72 ASA-I, II patients with psychotic disorders in Hajar Medical Center in Shahrekord, Iran during 2010. The patients randomly divided into intervention and control group. The interventional group was received 1.5 mg/kg lidocaine and controls were received normal saline. For induction of anesthesia, all patients were received Sodium Thiopental (2mg/kg), Succinylcholine (1mg/kg) and Atropine (0.5mg) Propofol and Succinylcholine during 72 sessions of ECT. Duration of objective convulsion and hemodynamic alterations including blood pressure and heart rate were recorded (before, immediately and 3, 5 minutes after ECT). Data were analyzed using SPSS-11.5 and t-test. Results: Systolic and diastolic blood pressures and heart rate in 3rd minutes in interventional group following electroconvulsive therapy were 143.38±16 mmHg, 79.86±6.7 mmHg, 91.9±9.9 mmHg, respectively and in controls were 128.88±13.04 mmHg, 87.63±5.79 mmHg and 102.86±13 mmHg, respectively. These difference were significant (P<0.05). The above-mentioned indices for 5th minutes in intervention and controls were as follow: systolic (113.47±9.97 mmHg, 122.36±13 mmHg), diastolic (73.47±4.27 mmHg, 77.63±6.26 mmHg) heart rate (84.41±4.6 in minute, 93.19±12.53 in minute). These differences in above indices were significant (P<0.05). Conclusion: This study showed that lidocaine administration during electroconvulsive therapy increase the duration of convulsion and reduces heart rate and blood pressure.

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Background and Objective: Surgical wound infection is the most common complication following surgery. This study was done to determine the incidence risk factors of surgical wound infection following abdominal hysterectomy. Materials and Methods: This descriptive study was done on 400 patients who underwent abdominal hysterectomy in Babol, North of Iran, during 2008-10. Age, underlying disease, BMI, use of immunosuppressive drugs hospitalization period prior to surgery, shaving and bath time, prophylactic antibiotic, duration of surgery, diagnosis and pathology were recorded for each patient. Evidence of surgical location of infection including surgical discharge, erythema and dehiscence of surgical wound with and without fever during 10 days after surgery were recorded. Results: Surgical wound infection was seen in 26 patients (6.5%) following abdominal hysterectomy. Regression analysis determined, use of immune-suppressive (95% CI: 1.71-480.30, P=0.020, OR:28.70) and emergency operation (95% CI: 1.42-14.39, P=0.011, OR: 4.52), diabetes (95% CI: 1.23-11.26, P=0.020, OR:3.72) were risk factors for surgical wound infection. Conclusion: Immuno-suppressive agents, emergency operation and diabetes increased surgical wound infection in post- abdominal hysterectomy.

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Background and Objective: Attention deficit hyperactive disorder (ADHD) is commnest psychological disorders in children. This study was done to evaluate the effectiveness of rhythmic games on social skills of children with ADHD.

Methods: In this quasi -experimental study with pretest, post test and follow up with control group, 30 boys student with ADHD were non-randomly divided into the two groups. Conners rating scale and social skills checklist were used.

Results: Social skills significantly increased in ADHD students and this effectiveness continued in follow up stage (P<0.05).

Conclusion: Play therapy is effective on social skills of children with ADHD.

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Background and Objective: Managed health care is one of the main components of universal health care systems, which recently has drawn more attentions. Therefore, based on the high costs of health system, poor quality of services, reduce efficiency, it is necessary to study and design a model to distinguish managed form unmanaged systems in Iran. This study was done to evaluate the managed health care in contagious and non-contagious diseases in Golestan province, northern Iran during 2016.

Methods: This descriptive-analytic study was done based on data collected from all urban and rural health centers of Golestan province, north of Iran during 2016 using standard checklists. Data were analyzed according to rural and urban area and type of diseses.

Results: Managed health care of tuberculosis was considerd in first rank following by hypothyroidism, leishmaniasis, hypertension, brucellosis and finally diabetes in a respective manner. In addition, managed cares in rural centers significantly had better condition than those of urban centers (P<0.05).

Conclusion: This study showed that managed care in rural areas is better than urbans and the tuberculosis has well condition according to managed health care.

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Background and Objective: Using chewing tobacco is one of the most important health problems in ports of the southern coast of Iran. The prevention of this problem requires identifying the factors affecting this phenomenon. The aim of this study was to determine the prevalence of chewing tobacco and related factors among adolescents in South- East of Iran (2018).
Methods: This descriptive-analytical study was conducted on 204 male high school students through multistage sampling in two the ports of Konarak and Chabahar located in south - east of Iran during March to June 2018. The data collection tool was a self-administered standardized questionnaire including items about knowledge, attitude and prevalence of chewing tobacco among participants, intimate friends and family members of the study population.
Results: Prevalence of chewing tobacco in life time and current use (pervious 30 days) was 71.8% and 43.1%, respectively. Supari was the main chewing tobacco were used (80.8%) by participants. The negative attitudes about chewing tobacco was a protective factor (OR=0.41) and easy access (OR=6.88), using by family members (OR=2.28), and close friends (OR=3.28) were the most important risk factors.
Conclusion: The prevalence of chewing tobacco was alarming in male high school students in south - east of Iran.