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Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived.

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Diabetes mellitus is a common metabolic disorder that is associated with long-term complications of various organs, such as cardiovascular system. This study is about evaluation of myocardial function and determination of related cardiovascular factor in type 2 diabetic patients who referred to diabetes clinic of 5th Azar Hospital from 200 patients who referred to the clinic, 48.5% had diastolic and 29.5% had systolic dysfunction. Related factors with both diastolic and systolic dysfunction of diabetic patients are: HbA1c level (Control of diabetes), duration of diabetes and hypertension. This investigation shows that: Incidence and severity of systolic and diastolic dysfunction in type 2 diabetic patients are related to metabolic state and quality of diabetic control. Incidence of hypertension increase in diabetic patients, and hypertension is an important risk factor in diastolic and systolic dysfunction. Diastolic dysfunction is more common than systolic dysfunction in diabetic patients. Intensive control of blood Glucose level lead to decreasing the incidence of coronary artery disease in diabetic patients. We suggest, intensive control of blood Glucose level, treatment of hypertension, regular cardiovascular evaluation in diabetic patients and screening test for early diagnosis of diabetes in high-risk population should be taken under consideration.

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Background and Objective: Heart failure is the end stage of cardiac disease after that myocardium has used all its reserve and compensatory mechanism. This is a descriptive survey for determine underlying and precipitating etiology of congestive heart failure among patients who admitted on CCU and cardiac department of 5th Azar Hospital of Gorgan. Materials and Methods: In this study 145 patients aged between 19-87 years have participated by data collection using questionnaire and analysis by SPSS-10. Results: The results indicated. The most common underlying causes are myocardial ischemia (57.3%) and the most common precipitating factors is inappropriate drug therapy (75.8%). Orthopnea (86.2%) and ralls (82.8%) are the most symptoms and physical exam findings. AF rhythm with 24.1% is the most common arrhythmia and cardiothoracic ratio more than 0.5 is the most abnormal finding in CXR-PA. The average ejection fraction (EF) in male patients was 32.3% and in women it was 35.7%. There was meaningful relationship between male sex and EF (P<0.05). Conclusion: This study indicated that good control of HTN and preventing of (CAD) incidence are the most important factor to avoid from CHF and appropriating drug therapy has the essential role to maintain compensated state in heart failure.

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Background&Objective: High blood pressure (BP) is one of the most important health problem world-wide (2005), and risk factor of cardiovascular diseases. This study was determine the prevalence of high blood pressure (BP) among urban subjects in Golestan of province, during 2005. Materials&Methods: This cross sectional study was done on 5000 subjects of 17-70 years old in different towns of Golestan province during 2005. Two equal ratios of both sexes were selected on random clustering sampling in the morning and afternoon. A questionnaire consisting of demographic data and clinical information such as electronic presser gauge filled by trained persons. All of the data analyzed using spss-11.5 and descriptive statistics. Results: The result showed that 2500 male (50%) and 2500 (50%) female, ethenicity were (4.6%) Torkaman, (18.9%), and Sistani (76.4%) Fars group from age of 17 to 70 years old. This study on this basis criterion JNC-5 (46.4%) all of studied subjects had blood pressure normal, (22.6%) blood pressure high normal (21.4%), blood pressure light (7.4%), blood pressure medium and (2.2%) blood pressure severe. Conclusion: The prevalence high blood pressure among the urban population in this province in this province was 31%. Which is slightly higher than other regions in Iran and other part of the world. This issue can be considered in the health planing and theraputic programs in the region.

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Background & Objective: Ureteroscopic lithotripsy is a prevalent and minimally invasive modality for the management of ureteral calculi. This study was done evaluate to the incidence and management of major complications in 3900 cases of ureteroscopic lithotripsy. Materials & Methods: This descriptive – cross sectional study was done on 3900 cases of ureteroscopic lithotripsy in Isfahan – Iran, during 1994-2006. All complications and treatment of patients recorded. Results: Major complications occurred in 29 cases either intraoperatively or postoperatively (1 to 30 days), including ureteral perforation in 16 cases, ureteral avulsion in 7, urinoma in 4 and perinephric abcess in 2. Two cases of uretral avulsion at the ureterovesical junction underwent ureteroneocystostomy. The other 5 cases were managed by psoas hitch together with Boari flap, transureteroureterostomy, open placement of double J stent with omental wrap, and ureteroscopic placement of double J stent and ileal substitution. Urinomas were managed by percutaneous drainage of the urinoma and placement of double J stent (3 cases) and open surgery (1case). Two cases of perinephric abscess were managed by open surgical procedure and double J placement. Fourteen cases of ureteral perforation were managed by ureteroscopic double J placement and in 2 cases by open surgery. Conclusion: Ureteroscopic lithotripsy is an excellent and minimally invasive modality for the management of ureteral calculi. Major complications may occur, emphasizing the need for constant vigilance and precautionary measures.

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Background & Objective: The atherosclerosis of left anterior descending (LAD) coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting for treatment of proximal LAD disease. Materials & Methods: In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing (ETT) by Bruce protocol was performed before angioplasty and at the end of follow up period as well. Results: There were 44 (58.7%) males, and 31 (41.3%) females. The mean age of patients was 59.4 (range, 39 to 83 yrs). Clinical outcomes of 73 (97.3%) patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. Conclusion: This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome.

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Background and Objective: In particular medical situation administration of muscle relaxants following intravenous anesthetics for tracheal intubation may be unnecessary or hazardous. The aim of this study was the comparison of larengoscopy and intubation conditions after induction of anesthesia with propofol or thiopental with remifentanil in the absence of muscle relaxants. Materials and Methods: In a randomized, and double – blind clinical trails, 42 ASA class 1 and 2 patients assigned randomly to propofol 2mg/kg group or thiopental 5mg/kg group. All patients received lidocaine 1.5mg/kg and remifentanil 2.5 µg/kg 30 second before anesthetics administration. Ninety second after administration of the hypnotic agent's, larengoscopy and intubation were attempted. Intubating conditions were assessed as excellent, good, suitable or poor on the basis of mask ventilation, jaw relaxation, vocal cords position and patient's response to intubations and indotracheal tube cuff inflation. The mean arterial pressure and heart rate were measured before and after anesthetic administration, and immidately, 2 and 5 minutes after intubations. Results: 40% of patients in thiopental group and 80% of patients in propofol group showed either excellent or good conditions for larengoscopy and tracheal intubation (P<0.05). Mean arterial pressure and heart rate were decreased more significantly in propofol group in respect to thiopental group (P<0.05). Conclusion: This investigation showed that propofol in combination with remifentanil is better than thiopental for tracheal intubation without muscle relaxants. However, it induces more homodynamic changes.

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Background and Objective: Constraint induced movement therapy is an approach that with limitation of the healthy upper limb movement of a person with hemiplegia obligate to use the affected limb. This study was done to determine the modified constraint induced movement therapy on quality of upper extremity skills in affected limb in children with hemiplegic cerebral palsy. Materials and Methods: This single blind randomized clinical trial was carried out on 21 children with hemiplegic cerebral palsy referred to rehabilitation centers in Tehran-Iran during 2008. Samples randomly were divided into experimental (n=11) and control (n=10). Common therapeutic physical practice was carried out for 6 weeks in both groups equally. In treatment group intervention was practiced by constrain induced movement therapy methods for 3 hours daily. Quality of upper extremity skills pre and post intervention based on the quality of upper extremity skills test (QUEST) was evaluated. Data were analyzed by SPSS-16 software, Kolmogrov-Smirnoff, chi-square, T student and repeated measurement tests. Results: Mean age of children in the experimental group (7 girls, 4 boys) and control group children (5 female, 5 male) were 46.55±17.5 and 48.10±19.2 months respectively. Internal analysis of all items in interventional group were significant after 6 weeks of treatment (P<0.05). but in control group only grasp item was significant (P<0.05). Analysis between two groups did not show any significant difference in total and subtitle score including dissociated movement, weight bearing and protective extension. But only grasp subtitle showed significant difference between two groups (P<0.05). Conclusion: This study showed that modified constraint induced movement therapy only affect in quality of grasp.

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Background and Objective: Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran.

Materials and Methods: In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index (BMI), cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests.

Results: In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects (58.8% males, 41.2% females). Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure (47.7%) has been found in left anterior descending artery.

Conclusion: Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders.

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Background and Objective: Hypertension is considered as a major public health problem in most countries due to its association with ischemic heart disease. The aim of this study was to determine people awareness of hypertension in Golestan province of Northern Iran.

Materials and Methods: This cross sectional population based study carried out on 2497 subjects (15-65 years old) including 1500 men and 1247 women in Golestan province- Northern Iran during 2006. The subjects were chosen by proportional-cluster sampling based on sex and age groups. The subjects were interviewed, antropometric indexes and serum biochemical factors were evaluated. Blood pressure was measured three times with 5 minutes interval and defined based on JNC-7 classification. Serum cholesterol and fast blood sugar (FBS) were determined using laboratory kits (enzymatic methods), and spectrophotometery technique. Data was analyzed by SPSS-16 software and Chi-Square test.

Results: In general, the prevalence of hypertension in this region was 23.9%. with higher rate among women urban area by 3.3% and 5% respectively. Only 48.7% of hypertensive patients were aware of their disease and that was significantly more in women than men (P<0.001). Low physical activity, chronical age, diabetes, hypercholesterolemia, general obesity, central obesity and illiteracy were the risk factor for hypertension morbidity (P<0.05).

Conclusion: This study showed, in spite of prevalency of hypertension among 20% of subjects in this area only 48.7% of them were aware about their disorder.

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Background and Objective: Abdominal operations as gynaecological procedures result in gastrointestinal dysmotility. Early feeding and ambulation are nonpharmacologic interventions which can be useful in re-initiation of bowel function. This study was done to evaluate the effect of early oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women.

Materials and Methods: In this randomized clinical trial, 120 primiparous women undergone elective cesarean section were assigned to control and intervention groups in Hajar hospital, Shahrekord, Iran during 2007. In the interventional group, oral hydration with liquids was started 4 hours after surgery regardless of presence of bowel sounds and solid food was started after bowel sounds appeared. The control group recieved liquid diet 12 hours after the operation if it was tolerated, they were given soft diet and regular food at the next meal. The return of bowel activity, time of ambulating, satisfaction, discharge from the hospital and complications were compared in two groups. The data were analyzed using SPSS-15, Chi-Square, T and one way ANOVA tests.

Results: The mean postoperative time interval to first hearing of normal intestinal sounds in interventional versus control groups were (9.5±1.38 and 12.5±2.5 hours) the first passage of flatus (15.7±3.61 vs.22.4±4.1 hours), time to first sensation of bowel movement (10.8±1.99 versus 15.7±3.4 hours) and defecation (18.9±3.65 versus 23.4±4.85 hours). These differences were significant (P<0.05). Also discharge from the hospital (0.96±0.18 versus 1.1±34 days) were significantly shorter in interventional group (P<0.05). The women in the early feeding group got out of bed (patient mobilisation) earlier than their interventional group (14.1 hours versus 18.8 hours (P<0.05). Maternal satisfaction was significantly higher among the early fed women (P<0.05).

Conclusion: Early oral hydration after elective cesarean section associated with rapid resumption of intestinal motility and increased woman’s satisfaction.

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Background and Objective: Nausea and vomiting are the most frequent complications in the first trimester of pregnancy. Herbal medicine is among the traditional effective treatments. Ginger and Chamomile are hypothesized to be useful in decreasing the signs. This study was done to determine the effect of Ginger and Chamomile capsules on nausea and vomiting in pregnancy.

Materials and Methods: This triple-blind randomized placebo-controlled trial was carried out on 105 pregnant women in 6-16 weeks of gestational age with a mild to moderate nausea and vomiting, whome referred to the prenatal care clinic in Dezyani hospital and health centers, Gorgan, Northern Iran during 2009-10. Rhodes index questionnaire had been given to all participants to be completed before bed-time for two weeks. In the first week no intervention was done and prescribing the capsules was started the following week. Subjects randomly divided into 3 groups: In group 1, ginger capsules were consumped twice a day for one week, in group 2 twice daily chamomile capsule and in placebo group, glucose capsule was prescribed. Scores were calculated and all data were entered into the SPSS-16 software, analysis was done using variance analysis, Will-Cockson, paired T and Fisher-exact tests.

Results: The mean of Rhodes index before intervention in plasbo, Ginger and Chamomile groups were 12.71±5.88, 10.42±0.76 and 11.19±5.51, respectively. Also, the mean of Rhodes index after intervention in plasbo, Ginger and Chamomile groups were 11.47±6.43, 7.28±3.74 and 5.73±4.32, respectively (P<0.05). Bonferroni test indicated that there is no difference about scor chang (after and before) between Ginger and Chamomile and Ginger and plasbo, but this difference was significant between Chamomile and plasbo group (P<0.05).

Conclusion: This study showed that Chamomile capsule was more effective on nausea and vomiting during pregnancy compared to Ginger.

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Background and Objective: The silent brain infarctions are common in first-ever stroke. Some recent studies show the possible role of silent brain infarction in ischemic stroke. The aim of this study was to evaluate the frequency of silent brain infarction in acute first-ever ischemic stroke and its association with stroke risk factors. Materials and Methods: This descriptive - analytical study was carried out on 203 (94 males, 109 females) patients with acute first-ever ischemic stroke in Shafa hospital in Kerman, Iran during 2010. The diagnosis of ischemic stroke was made by physical examination and was confirmed by MRI and CT Scan. A questionnaire containing demographic information and risk factors including hypertension, diabetes, hyperlipidemia, cigarette smoking, ischemic and non-ischemic heart disease for stroke as well as presence of silent stroke was completed for each patient. Data were analyzed using SPSS-16 and logistic regression test. Results: The mean age of patients was 62.56±17.35 years. Among our patients history of hypertension, hyperlipidemia, cigarette smoking, diabetes, history of ischemic heart disease, history of other cardiac disease and silent stroke were observed in 66 (32.5%), 26 (12.8%), 16 (7.9%), 40 (19.7%), 27 (13.3%), 16 (7.9%) and 31 (15.3%), respectively. The probability of silent stroke among patient with hyperlipidemia, was 3.7 times more than those without hyperlipidemia (95%CI: 1.556-12.780, P<0.05). There was no significant correlation between silent stroke and the above risk factors. Conclusion: Silent stroke was found in 15% of patients with ischemic stroke. Control of hyperlipidemia can have a vital role in the prevention of silent stroke.

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Background and Objective: Menopausal symptoms influence mental, physical and emotional health, as well as social performance and family relationships. Due to the undesirable side effects of alternated hormone-therapy, tendency toward alternative treatments in relieving these symptoms have been increased, and the use of herbs like phytoestrogens seem preferable. This study was conducted to determine the effect of red clover Isoflavones extract on menopausal symptoms. Materials and Methods: This clinical randomized, triple-blind trial was conducted on 72 menopausal women who referred to Navab Safavi health care center, Isfahan, Iran during Oct-Apr 2011. After two weeks of monitoring and determination of the baseline symptoms score including hot flushes and sweating, paresthesia, insomnia, nervousness, depression, vertigo, weakness and fatigue, arthralgia and myalgia, headache, palpitation and formication, the women were randomly divided into two groups of 36 subjects: placebo and intervention (taking 45 mg of red clover Isoflavones extract capsules). The subjects were given one capsule daily for eight weeks and menopausal symptoms were recorded weekly. Data were analyzed using SPSS-18, independent t-test, ANOVA, chi-square and Mann–Whitney tests. Results: 55 women completed the study: 27 subjects in the placebo and 28 in the intervention group. The mean age of subjects in placebo and intervention group was 53.923.21 and 52.963.07 years, respectively. The mean age of menopause in the placebo and intervention groups was 51.382.63 and 50.051.17 years, respectively. The mean elapsed time since menopause was determined as 2.691.47 years in placebo and 2.661.65 years in intervention group. The average score of menopausal symptoms at the end of the 10th week was 13.877.22 and 16.4411.59 in intervention and placebo groups, this reduction was significant (P<0.05). Conclusion: This study showed that consumption of capsules containing red clover Isoflavones extract for 8 weeks, reduces menopausal symptoms in postmenopausal women.

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Background and Objective: Ferula gummosa Boiss. (Barije.) contain medical and antimicrobial properties. This study was done to determine the effect of aqueous and alcoholic extracts of roots of Ferula gummosa Boiss. on the growth of Pseudomonas aeruginosa. Materials and Methods: In this laboratory study, the plant was dried in dark place and aqueous, alcoholic extracts of Barije's root, powder were prepared using Soxhlet method. The efficacy of 0.1 dilution of different values of extracts of Ferula gummosa Boiss. on the strain of Pseudomonas aeruginosa (PTCC 1430) were evaluated by disk diffusion, Agar-well diffusion, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. Results: Pseudomonas aeruginosa was completely resistant to the aqueous extract, and the MIC for the methanol and ethanol extracts was 1.25×10⁴ μg/ml and 6.25×10³ μg/ml, respectively. Conclusion: Methanolic and ethanolic extracts of Ferula gummosa Boiss. have antimicrobial activity against Pseudomonas aeruginosa in in-vitro model.

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Background and Objective: Glycodelin expression in normal and cancerous human breast tissue and its relation with age, tumor type, microscopic grade and metastasis to axillary lymph nodes recently were noticed. This study was done to evaluate the glycodelin expression in breast cancer. Methods: In this descriptive study, 96 Paraffin-embedded blocks of malignant breast cancer by immunohistochemistry method were considered to evaluate the expression of glycodelin. Patients age,tumor size, tumor type, microscopic grade and metastasis to axillary lymph nodes were recorded for each subject. Results: Glycodelin was found in 30.45% of invasive carcinoma of the breast with axillary lymph node metastasis. Glycodelin was expressed in 72.7% of carcinoma of the breast without lymph nodes metastasis (P<0.05). There was a significant relation between glycodelin expression with microscopic grade 1 of tumor and metastasis to less than 4 of lymph nodes (P<0.05). Conclusion: Glycodelin expression can be evidence for lack of axillary lymph node metastasis of breast cancer.

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Background and Objective: Thalassemias is the most common inherited disease in the world. This study was designed to assess general health of patients with beta-thalassemia major in Gorgan, northern Iran. Materials and Methods: This descriptive study was performed on 163 patients with beta-thalassemia major whom referred to Thalghani hospital in Gorgan, northern Iran. Socio-Psychosocial status of patients was assessed by using general health questionnaire-28 (GHQ-28). Results: Socio-Psychosocial status of 44.2%, 46% and 9.8% of patients was normal, suspected and suffered from psychosocial disorders, respectively. Social dysfunction (12.9%) and depression (10.4%) were the most prevalent and anxiety was the less prevalent (4.9%) in the patients. There were significant correlations between psychosocial status and mother’s ocupation (P<0.05), patients level of education (P<0.05) and history of associated diseases (P<0.05). Conclusion: Social dysfunction and depression were the two major general health complications in beta-thalassemia patients in this region.

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Background and Objective: Methadone is a synthetic opioid which is used in opium addiction therapy and relief of acute and chronic pain. Side effects of Methadone were reported on heart and induction of Torsade De Pointes disease and increase QTc interval in electrocardiogram. This study was conducted to determine the effect of Methadone therapy on QTc interval in electrocardiogram and its relationship with dosage and duration of Methadone therapy. Method: This cohort study was conducted on 60 opium addicted patients (57 males, 3 females) whom referred to “Methadone Therapy Clinic” in 5 Azar teaching hospital in Gorgan, northern Iran during 2009-10. Patients were divided to three groups based on the dosage of methadone: 0-35 mg (27 cases), 35-55 mg (27 cases) and 55-120 mg (26 cases) per day. QTc interval in electrocardiogram was measured at the beginning of study, one month and 5 months afterward. Results: The mean±SD of QTc interval in patients at the beginning, one month and 5 months afterward of study was 0.42±0.027, 0.43±0.029 and 0.43±0.041 seconds, respectively. There was a significant increase in QTc interval after one month of methadone therapy, compared to the beginning of study. There was no significant difference in QTc interval between 1 month and 5 months following methadone therapy. There was no significant difference between QTc interval and different dosage of methadone. Conclusion: Methadone therapy increase QTc interval but there is not any relationship between dosage and duration of methadone therapy and QTc interval.

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Background and Objective: Due to high prevalence of pre-menstrual syndrome (PMS) and pre-menstrual dysphoric disorder (PMDD) and its effect on the educational, professional activities and familial behaviors, this study was conducted to determine the prevalence of clinical manifestations of pre-menstrual syndrome and pre-menstrual dysphoric disorder in medical students. Methods: This descriptive-analytic study was done on 162 female medical students of Golestan University of Medical Sciences in Gorgan, Iran during 2010. Demographic characteristics and PMS and PMDD clinical manifestations questionnaire based on DSM-IV-TR and ACOG criteria was filled for each subject. Results: Mean age and menarche age of subjects was 22.2±2.5 and 13.3±1.2 years, respectively. 145 students (89.5%) were single. 57.4% and 22.8% of participants fulfilled the criteria of PMS and PMDD, respectively. The most frequent affective and somatic symptom was lethargy and fatigability (57.4%) followed by sensation of bloating and weight gain (45.7%). The lowest frequent somatic and affective symptoms were dyspnea (8%) and insomnia (1.2%), respectively. There was significant correlation between the prevalence of PMDD and chronical and menarche age (P<0.05). Conclusion: Pre-menstrual syndrome is a prevalent disorder in medical students of Golestan University of medical sciences in Iran.

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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.