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Background and objective: To determine the effects of duration of second stage of labor on the newborn’s Apgar score in primigravida women admitted in Fatemeh Zahra Hospital. Materials and methods: Case control study on the 120 primigravide women (40 women with a duration second stage more than 2 hours and 80 women with a duration second stage less than 2 hours). The criteria such as pregnancy history, quality of prenatal care and socioeconomical status were the same for the both groups. Patients with preterm labor, cesarean section, multiple pregnancy, malpresentation, malformation and receipt sedation of narcotic less than one hours to baby’s birth were excluded. From this study statistically analysis had done by Chi-square and Z-test and person’s coefficient correlation. Results: Statistically significant relationship was observed between the age of the mothers and the duration second stage of labor, so that, the mothers with more than 30 years of age had prolonged duration in second stage of labor (P<0.05). More than half of the sample population had used oxytocin for augmentation of labor, which this difference was significant (P<0.05). Conclusion: The different studies showed that the duration of second stage of labor was significantly associated with fetal lactate and low Apgar score less than 7 at birth, but didn’t have any role in five-minute low Apgar scores and neonate morbidity.

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Background&Objective: The present study was designed to investigate the outcome of pregnancy and delivery in pregnant Iranian women with low and high hematocrit. Materials&Methods: In a cohort control study, 609 pregnant women attending Yahyanejad Hospital for antenatal care and delivery from Dec 2001 to Dec 2003 were randomly selected. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care and 3 cc.blood was sent to the laboratory for CBC. The main outcome measures included birth weight, gestation at delivery, Apgar scone, mode of delivery,the admitted NICU and perinatal death. X2, T-test, Anova and logistic regression models were also applied to analyze the data. Results: Anemia (hematocrit<34%) in the first trimester was associated with a significantly increased risk of low birth weight (<2500g) and preterm delievery (<37 week’s gestation). High hematocrit values (>40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admitted NICU was significantly increased in women with high and low hematocrit adjusting for maternal age, parity, weight gain, inter pregnancy, father and mother education and other confounding factors. Conclusion: Low and high maternal hematocrit in the first trimester can contribute to the adverse pregnancy outcomes, thus pregnant women with abnormal hematocrit are at high risk factor and necessary awareness should be given to them on how to prevent complication and adverse outcome by special clinical care.

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Background and Objective: Stress has been known as an important causative factor in irritable bowel syndrome. Various studies have indicated the relationship between serum leptin levels and stress levels. This study was undertaken to investigate the relationship between serum leptin levels with irritable bowel syndrome. Materials and Methods: In This case-control study, eighty irritable bowel syndrome patients and 80 controls were recruited. All participants were asked to fill in a questionnaire included demographic information and medical history as well as a stress questionnaire. Serum leptin level was measured by ELISA method. Chi-square, student t-test, pearson correlation and logistic regression were used for investigating the relationships between variables. Results: Participants in irritable bowel syndrome group had significantly higher stress levels than controls (p<0.05). In the other hand, Serum leptin levels were significantly lower in irritable bowel syndrome group than the other one (p<0.05). Multivariate logistic regression analysis showed that after adjustment of stress level and body mass index, serum leptin level was still significantly lower in irritable bowel syndrome group (Odds ratio=0.9 CI95%:0.85-0.94). Conclusion: The present study indicated that there is a relationship between leptin and irritable bowel syndrome and serum leptin level is significantly lower in irritable bowel syndrome group than controls. This relationship is independent of other variables such as stress levels, BMI.

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Background and Objective: Diabetes mellitus is the most frequent cause of chronic renal failure. Microalbuminuria is the first clinically important sign of renal impairment in diabetes mellitus. The main pathophysiology of diabetic nephropathy is not understood. This study was done on 100 patients with type 2 diabetes for determination of the prevalence of diabetic nephropathy with urine albumin assay in Sina Hospital in Tabriz, North-West of Iran. Materials and Methods: In this discriptive study, 100 patients with type 2 diabetes whome consecutively referred to Endocrine and Diabetes Clinic of Sina Medical Center in Tabriz were enrolled. At the first visit clinical and biochemical parameters such as systolic and diastolic blood pressure, age, sex, body weight, length, body mass index, FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine were measured. FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine measurements repeated every 2 months up to three times during the study. Patients with confounding factors such as uncontrolled hypertension, urinary tract infection, congestive heart failure and hyperlipidemia were excluded. Results: The prevalence of diabetic nephropathy was 36% in our patients. There were not statistically significant differences in age and sex and diastolic – systolic blood pressure and creatinine between nephropathy and, non-nephropathy groups. There was significant differences in body mass index between two sex groups, females were more obese than males. Mean duration of diabetes in diabetic nephropathy group and in diabetic patients without nephropathy were 12.4±8.1 and 9.1±5.5 respectively (P<0.05). Comparison of HbA1c, FBS and drugs used for diabetes treatment were not significant differences between these groups. Conclusion: This study showed that prevalence of diabetic nephropathy was higher than other studies, although there were not significant differences between FBS, HbA1c and hypertension in patients with and without diabetic nephropathy.

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Background and Objective: Muscle size is considered to be a good indicator of muscle function. Previous studies demonstrated a major role for longus colli muscle in cervical spine stabilization. This study was designed to compare muscle size and shape of cervical longus colli muscle between patients with bilateral chronic neck pain and healthy subjects. Materials and Methods: In this case – control study, bilateral ultrasound images of longus colli muscle, 2 centimeters below the thyroid cartilage were taken in 20 subjects (10 males and 10 females) with bilateral chronic neck pain and in 20 healthy subjects during 2008. Cross sectional area (cm2) and muscle shape ratio (ratio between lateral and anterior posterior dimensions) were measured. T- test was used for comparison of cross sectional area and shape ratio of right and left sides between the two groups. Results: In healthy subjects the cross sectional area of longus colli muscle in right and left sides were 0.85±0.11 and 0.86±0.12 respectively which was greater than that of neck pain patients: 0.76±0.11 and 0.68±0.07 respectively (P<0.05). In addition, longus colli muscle shape ratio of healthy subjects in right and left sides was 1.18±0.17 and 1.16±0.19 respectively which was smaller than that of neck pain patients: 1.50±0.25 and 1.50±0.27 respectively (P<0.05). Conclusion: This study showd that patients with bilateral chronic neck pain had generally smaller cross sectional area and larger shape ratio of longus colli compared to controls.

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Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

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Background and Objective: Gastrointestinal polyps have pre-carcinomatous potential. In regard to increasing rate of gastrointestinal cancers and the relation between polyps with cancers, this study was done to determine the anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran. Materials and Methods: This cross-sectional study was conducted on 290 patients with gastrointestinal polyps were undergoing colonoscopy or endoscopy in 5th Azar teaching hospital in Gorgan, northern Iran during 1999-2008. The diagnosis was confirmed by histopathologic method. Gender and age was recorded for each patient. Results: 56.6% of patients were males 19.3% of polyps was diagnosed in the sixth decade of patient's age. The most frequent pathological type of gastrointestinal polyps was adenoma (54.1%) followed by hyperplastic (19.7%), acute inflammatory (13.8%) and young polyps type (11.4%). Tubular type with 63% was the most common type of adenoma polyp followed by various villouses (19.1%) and tubulovillous (17.9%). 87.2% and 12.8% of polyps were in colon and stomach, respectively. The most frequent anatomical position of polyps was rectum (30%) followed by sigmoid with 26/1%. Conclusion: Adenoma polyp in colon was the most common type in gastrointestinal tract.

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Background and Objective: Due to the increase of incidence of extrapulmonary tuberculosis in Iran, This study was conducted to determine the epidemiological pattern of extrapulmonary tuberculosis in the Mazandaran province, northern Iran. Methods: This descriptive-analytic study was carried out on medical record of 3313 tuberculosis patients in Mazandaran province, northern Iran during 2001-11. Age, gender, affected year, area and affected organ were gathered for each patient. Results: 843 (25.4%) of subjects were diagnosed with extrapulmonary tuberculosis. The incidence of extrapulmonary tuberculosis increased by 4% for every unit increase in incidence year (P<0.05). The mean age of patients with extrapulmonary tuberculosis was significantly less than patients with pulmonary tuberculosis (42.8±20.6 years vs. 48.7±21.2, P<0.05). Extrapulmonary tuberculosis was significantly higher in women (P<0.05). The chance of extrapulmonary tuberculosis in women was 1.7 times of men. Lymph node (33%) was the most common affected organ followed by pleura (18.9%) and bone (17.7%). Conclusion: The trend of incidence of extrapulmonary tuberculosis was ascending during 2001 to 2011. The most affected organ in extra pulmonary tuberculosis was lymph nodes.

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Background and Objective: Colonoscopy is the best method for management of patients with Hematochezia or lower gastrointestinal bleeding (LGIB). This study was conducted to assess the endoscopic and histopathologic findings in patients with hematochezia. Methods: This descriptive –analytical study was done on 117 (50 males, 67 females) patients whom referred to 5th Azar hospital in Gorgan, northern Iran during 2010. Demographic characteristics, medical history and colonoscopic and histopathologic findings were recorded for each patient. Results: Hemorrhoid was the most common finding in colonoscopic examination. Inflammatory bowel disease (IBD) and cancer were the most common feature in the under and higher than 43 age old patients, respectively (P<0.05). Ulcerative colitis (22.2%) was the most common finding in histopathological examination. Rectosigmoid was the most common anatomical location of involvement in IBD cases. Cancer and IBD were occurred in the left colon. Conclusion: Flexible sigmoidoscopy can be a selected procedure for evaluation of hematochezia in the <43 age old patients but in >43 age old subjects sigmoidoscopy or colonoscopy should be made based on patients' status.

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Background and Objective: Some problems such as low viability and apoptosis after injection to the body because of exposure to toxic factors such as hypoxia, thermal stress, oxidative stress and food deprivation are encountered with stem cell application. It is suggested that preconditioning of the cells with cytotoxic factors before injection could enhance their efficiency. This study was done to determine the mesenchymal stem cell proliferation exposed to hypoxia by cobalt chloride. Methods: In this experimental study, Mesenchymal stem cells were isolated from rat bone marrow and cultured at least for four times. The cells were cultured in 96 well plates and treated with different concentration (0, 5, 10, 20, 50, 70, 90, 100, 120, 150 and 200 µM) of cobalt chloride for 6, 12, 24 and 46 hours. Cell proliferation was detected by MTT assay [3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide]. Results: The cells isolated from bone marrow were propagated easily in culture condition. The cells morphology was not altered after exposure to cobalt chloride. Preconditioning of mesenchymal stem cells with 120 µM for 6 hours, 20µM for 12 and 24 hours and 5µM for 48 hours significantly improved cell proliferation after hypoxia in cell culture (P<0.05). Conclusion: Hypoxia preconditioning increases proliferation of mesenchymal stem cell.

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Background and Objective: Diazinon is an organophosphate insecticide. , which inhibits the enzyme acetylcholinesterase. This study was done to evaluate the effect of Diazinon on pituitary-gonadal axis and histological alteration of seminferous tubules in adult rat testis. Methods: In this experimental study, 40 adult male Wistar rats were randomly allocated into five groups including control, sham and experimental 1, 2 and 3. Animals in experimental group 1, 2 and 3 were received 50, 100 and 150 mg/kg/bw of diazinon for 28 days, orally, respectively. Animals in control group did not receive any substance. Animals in sham group were received an equivalent amount of normal saline. The animals were euthanized after 28 days and a blood sample was collected via heart puncture and testes were removed for histological studies. Results: Diazinon significantly reduced serum testosterone concentration, sertoli cell, leydig cell count, primary spermatocyte and spermatid (P<0.05). Diazinon had no significant effect on the body and testis weight in the experimental groups compared to controls. Conclusion: Diazinon reduces the concentration of testosterone and cells in seminferous tubule in adult rat.

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Background and Objective: Several methods are available for measuring fever in children. This study was done to compare the accuracy of three method of measuring body temperature using left and right tympanic, axillary and rectal methods in three months to five years old children.

Methods: This descriptive-analytic study was done on 126 children (63 without fever and 63 children with fever) with 3 months to 5 years age in Mofid hospital, Tehran, Iran. Rectal temperature lower than 38°C was considered as Gold standard to determine fever. Body temperature was also recorded for subjects through right and left tympanic and axilary methods.

Results: Body temperature was recorded in axillary method 37.1°C (sensitivity: 92.1%, specificity: 90.5%), right tympanic 36.9°C (sensitivity: 74.6%, specificity: 84.13%) and left tympanic 37.3°C (sensitivity: 93.65%, specificity: 84.13%). The mean temperature in the axillary method 0.77°C, right tympanic 1.02°C and left tympanic 0.48°C was lower than the mean rectal method (P<0.05). The correlation between right, left tympanic and axillary with rectal method was 0.84, 0.894 and 0.925, respectively (P<0.05). The area under the receiver operating characteristic (ROC) curve for left and right tympanic and axillary were 0.95, 0.87, 0.965, respectively.

Conclusion: The difference between rectal and left tympanic method was at the lowest level due to the ease of measuring temperature through tympanic membrane in three months to five years old children.

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Background and Objective: Breast cancer and related treatments induce various physical symptoms. One of suggested method for preventing or reducing physical symptoms is exercise training. This study was done to evaluate the effect of 8 weeks Pilates exercises physical fitness indices in breast cancer patients.
Methods: In this randomized clinical trial study 30 female breast cancer patients were divided into intervention (n=15) and control (n=15) groups by block randomization method. Pilates exercise for 8 weeks, 3 days a week for 60 min in every session was performed in Patients in interventional group but patients in control group did not participate in any regular physical activity. Flexibility, coordination, back and hand strength and muscular strength were determined using Wells, alternate hand wall toss, one leg –stance, back and handgrip dynamometer, sit up tests, respectively.
Results: Pilates exercises significantly increased flexibility, balance, coordination, back and hand strength, muscular endurance and sit up in interventional group in compared to controls (P<0.05).
Conclusion: Pilates exercise improves physical fitness indices in women with breast cancer.

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Background and Objective: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that can be time-consuming and cause considerable disruption to routine activities, occupational functioning, social activities, and relationships with others. This study aimed to determine the prevalence of obsessive-compulsive disorder among high school girl students.
Methods: This descriptive cross-sectional study was done on 342 high school female students in Amol city, northern Iran in the academic year of 2018-19. Cluster random sampling mehod was applied in this study. The Maudsley OCD Questionnaire was used for screening and the Yale-Brown Obsessive-Compulsive Questionnaire was used to confirm obsessive-compulsive disorder.
Results: 98 students (28.7 %) had positive symptoms. The highest frequency was related to slowness and repetition (37 cases), followed by doubting (36 cases), repetitive checking (35 cases), cleaning (31 cases), and finally rumination (12 cases). Among the 98 screened individuals, 67 were positive based on the Yale-Brown questionnaire. Severity of the obsessive compulsive disorder was mild in 37 cases (55.2 %), moderate in 21 cases (31.34%) and severe in 9 cases (13.43%).
Conclusion: The prevalence of obsessive-compulsive disorder observed in one-third of high school students in the area.

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Background and Objective: Reaction time measures have considerable potential to aid neuropsychological assessment in a variety of healthcare settings. One such measure, the intra-individual reaction time variability is of particular interest as it is thought to reflect neurobiological disturbance. The present study aimed to investigate the intra-individual changes in reaction time to visual stimuli in dominant or non-dominant binocular and monocular vision.
Methods: This descriptive-analytical study was conducted on 12 volunteers with an average age of 30.08±1.448 years in 2021. The subjects consisted of the students and staff of Golestan University of Medical Sciences (5 female and 7 male). The reaction time was recorded automatically by the hand reaction time device of Danesh Salar Iranian Company based on the time of presentation of visual stimulation on the computer screen and the person's reaction, i.e. pressing the buttons of the handles by each of the two hands. All experiments were performed between 10 and 11 am and following at least 2 hours of fasting. Data collection was done following training trials for correct performance of the 2-choice reaction time test. After completing the reaction time tests for each volunteer, the dominant eye was determined by the hole-in-card method.
Results: In 4 volunteers, the dominant eye was left and in the rest of the volunteers, the dominant eye was right. The dominant eye did not differ between men and women. The number of reaction times recorded in right monocular vision left monocular vision and binocular vision were 902, 911 and 893, respectively. The mean reaction time in right monocular vision, left monocular vision and binocular vision was 306.81±3.310, 304.28±3.339 and 312.95±4.569, respectively, and the range of reaction times in these three states was between 194-1750, 178-1587, and 155-1797 ms, respectively. Intra-individual reaction time variability in the dominant left eye and left hand were significantly lower compared to the dominant right eye and right hand, respectively (P<0.05). No difference was observed between the reaction time of the right monocular vision, left monocular vision, and binocular vision.
Conclusion: The alignment of the dominant left side in the eye and hand reacts faster than the dominant right side in the eye and hand. The mechanism of this phenomenon may be related to the overall process that determines the dominant left hemisphere in approximately 90% of the population.
 

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Background and Objective: The diagnosis of inflammatory bowel disease (IBD) is performed by colonoscopy, sampling, and histopathology. Stool calprotectin is a test showing the presence of inflammation in the gastrointestinal tract. This study was done to determine the relationship between the calprotectin level in the feces and endoscopic findings in ulcerative colitis patients referred to the gastroenterology clinic in Gorgan, Iran.
Methods: This descriptive-analytical study was performed on 100 patients with ulcerative colitis referred to the gastroenterology clinic of Sayad Shirazi Hospital, Gorgan, north of Iran during 2020. The patients were asked to collect their stool samples one day before the procedure (just after taking the drug for bowel cleansing). Bowel cleansing was done by administering polyethylene glycol solution dissolved in water. The activity of ulcerative colitis was measured using the disease activity score. According to this criterion, a score greater than or equal to 5 is considered an active disease. Patients were classified into two groups: extensive or pan-colitis and left-sided colitis. Stool samples were evaluated for calprotectin in a single laboratory using a commercially available kit (Calprest- EuorociationspA. Trieste) at normal values of less than 50mg/g. The relationship between stool calprotectin with colonoscopic findings was evaluated.
Results: The average duration of infection was 4±3.1 years in the time range of 1-14 years. The calprotectin level was less than 50 μg/g in 16 patients. Stool calprotectin less than 50 µg/g was seen in only 16 patients. There was no significant relationship between the level of calprotectin and the either age or gender of patients. Most patients (84%) had active disease based on colonoscopic findings. Left-sided involvement was seen in 60% of patients. Fecal calprotectin level was significantly higher in those with acute phase and those with severe disease (P<0.05). Additionally, the calprotectin level had no significant relationship with the location of bowel involvement, extension, and disease duration.
Conclusion: This study showed that the fecal calprotectin level in patients with ulcerative colitis had a significant relationship with the severity and activity of the disease in north of Iran.

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Renal cavernous hemangioma is a rare benign tumor. This case report describes a 44-year-old male who was incidentally found to have a renal mass during an abdominal and pelvic ultrasound. The patient's abdominal ultrasound revealed a mass, which was further evaluated with a CT scan. The CT findings suggested renal cell carcinoma. Suspecting malignancy, the patient underwent radical nephrectomy. Histopathological and immunohistochemical examinations ultimately diagnosed the mass as a cavernous hemangioma. Despite its benign nature, the patient was followed up with a control ultrasound three months post-surgery. This case is presented due to the significant clinical and radiological resemblance of this tumor to renal carcinomas, highlighting the importance of considering benign tumors in differential diagnoses.