---

Background and Objective: Herbal products consumption is increased worldwide. This study was done to compare the effect of Evening Primrose, Vitex agnus and vitamin E on premenstrual syndrome. Methods: In this clinical trials study, 210 women with premenstrual syndrome were randomly divided eqaly into Evening Primrose (500 mg, 3 times per day), Vitex agnus (40 mg/day) and vitamin E (400 Iu/day) groups. The subjects were received the thraputic regiment for 2 months. Severity of premenstrual syndrome was recorded for each subject using DSR Dickerson questinare, perior and at the end of intervention. Results: After intervention, severity of premenstrual syndrome was reduced in Evening Primrose group (60.58±30.6 to 34.09±19.81), Vitex agnus (61.23±30.54 to 25.25±17.78) and the vitamin E group, (61.24±32.04 to 54.9±19.24). Severity of premenstrual syndrome were reduced in the Evening Primrose and Vitex agnus groups in compared to vitamin E group (P<0.05). Severity of premenstrual syndrome were reduced in Vitex agnus in comparision with Evening Primrose (P<0.05). Conclusion: Vitex agnus, Evening Primrose and vitamin E can reduce severity of premenstrual syndrome, but therapeutic effect of Vitex agnus is more than Evening Primrose and vitamin E.

---

Background and Objective: Helicobacter pylori are one of the most common gastrointestinal bacterium infections. This study was done to compare the urease test with Giemsa staining to detection of Helicobacter pylori infection in patients with gastric ulcer and gastritis.

Methods: This descriptive – analytic study was conducted on 601 patients' diagnosed with gastric ulcer and gastritis, whom under went endoscopy in 5th Azar hospital, Gorgan, Iran during 2008-12. Rapid urease test was immediately taken during endoscopy. Pathological examination, Giemsa staining on paraffin blocks and haematoxylin and eosin stain were done to assess either presence or absence of Helicobacter pylori.

Results: Based on biopsy results, Gastritis and gastric ulcer were diagnosed in 80.69% and 19.3%, respectively. In gastritis and gastric ulcer patients, there was a significant differences between urease test (91.5% and 90%, respectively) in comparison with Giemsa staining (91.5% and 90%, respectively) (P<0.05).

Conclusion: The study revealed that in primary diagnosis and screening of role of Helicobacter pylori in patients with gastric ulcer and gastritis, urease test is suitable than giemsa staining.

---

Background and Objective: Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.
Methods: This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.
Results: The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.
Conclusion: The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.

---

Background and Objective: Perinatal mortality rate (PMR) is one of the main indicators in evaluation of health community and healthcare systems. This study was performed to determine the perinatal mortality rate in the referral third level of maternal and infant care center affiliated to Babol University of Medical Sciences.
Methods: This descriptive-analytical study was performed on by cross-sectional method and 19234 births (9751 male and 9483 female) from 22 weeks gestation to 29 days after delivery Ayatollah Rouhani Hospital in Babol, northern Iran during 2011-18. Data on the cause of neonatal death, maternal age, type of delivery, malformations, maternal underlying disease, maternal pregnancy-related conditions, and diseases at the time of death in neonate were collected from website of the Ministry of Health. Then each of the indicators was calculated per 1000 live births.
Results: In this study, the PMR was calculated per 1000 live births which was 29.01 (boys 16.17 and girls 12.84). The portion of vaginal delivery was 9.67 and cesarean section was 19.34. Out of 558 perinatal deaths, 59.9% died due to intrauterine death with an index of 17.37 and 40.1% of deaths were due to infant death with an index of 11.63. Most neonatal deaths (74%) occurred within the first 24 hours of birth and in terms of gestational age 86.02% were <37 weeks of gestation with an index of 24.95, and low birth weight were 83.8% with an index of 24.31. Underlying disease was found in 25.6% of mothers and pregnancy-related conditions in 74.4% of cases. Fetal distress in 14.4% with an index of 4.20 was the most common disease associated with infant death or cause of death in preterm infants. Other causes of perinatal death were specific disorders of perinatal origin, birth defects, chromosomal abnormalities, and accidents were 10.09, 4.06, and 0.58 per 1000 live births, respectively.
Conclusion: The most and important factors of prenatal mortality wrer prematurity and low birth weight that major causes include maternal pregnancy-related conditions and maternal underlying disease, Therefore, emphasis on adequate prenatal care, identification and follow-up of mothers with underlying diseases can be effective in reducing perinatal mortality.

---

Background and Objective: Multiple sclerosis (MS) is an autoimmune disease that targets the central nervous system. Various studies have shown that several factors influence this disease’s occurrence and prevent its progress. Multiple studies have shown that several factors affect this disease’s occurrence and prevent its progress. Helicobacter pylori can be mentioned among these factors. This study was conducted to determine Helicobacter pylori infection in MS patients and healthy individuals.
Methods: This case-control study was conducted on 100 patients with MS (mean age: 36.99±9.87 years) and 100 healthy subjects (mean age: 38.05±11.38 years) in Golestan province, north of Iran during 2021. The case group included eighty relapsing-remitting cases and twenty secondary progressive cases. Blood samples were taken from both groups, and after separating the serum using the ELISA test, anti-Helicobacter pylori antibody (IgG) was detected by determining the antibody titer.
Results: Helicobacter pylori IgG in the MS and control groups was 21% and 44%, respectively (P<0.05). The mean concentration of IgG in the case group was significantly lower than the control group (13.48±10.83 versus 19.78±16.14 AU/ml). The percentage of positive cases of IgG antibody against Helicobacter pylori in the relapsing-remitting and secondary progressive group of patients with MS was determined as 21.2% and 20%, respectively, and the difference between these two groups was not statistically significant.
Conclusion: The history of Helicobacter pylori infection is less than two times in patients with MS compared to healthy people probably indicate the protective role of this bacterium against this disease.