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In order to determine the relationship between breast feeding and growth pattern, the information about anthropometric measurement and feeding pattern in first 4-6 months of life and after that of 324 hospitalized children were recorded and analyzed results are as follow: 67.3% were exclusively breast-fed, 61.3% were breast-fed accompanied with non-maternal milk (Cow milk, formula, pasteurized cow milk) and 11.4% were fed with non-maternal milk only. 44.8% of the total patients had weight for the age under 5th percentile, 53.7% had height for the under 5th percentile and 26.9% had head circumference (HC) for age under 5th percentile of NCHS standard. 77.8% of infants under 6 months of age who had weight for age under 5th percentile never have been fed with breast milk. In the other hand 72.2% of patients with weight for age between 5-100th percentile fed exclusively with breast milk in first 4-6 months of life (P<0.03). 63.2% of infants aged 6-12 months with weight for age under 5th percentile have never been fed with breast milk in first 4-6 months or did not commence supplementary food on time. This study suggest that exclusively breast-feeding in first 4-6 months of life and continuation of breast milk beside supplementary food on proper time can provide better growth potential relative to other options.

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Urinary tract infection is one of the most common bacteria infections. The incidence of urinary tract infections in school age is more common in girls than in boys. Children have to be screened for asymptomatic bacteriuria before they reach to the state of renal damage. In our district no such study has been made to determine the prevalence of bacteriuria. Urine samples were collected from 642 school girls aged between 6-11 years, and were investigated by doing urine analysis and urine culture. 15 girls had significant bacteriuria, (>10^5 bacteria/ml). 11 children had pyuria (WBC>5), and 6 samples had both significant bacteriuria and pyuria. At the same time there were 5 cases with sterile pyuria. 6 girls had nitrite in their urine samples. All of the urine samples with positive nitrite test had significant bacteriuria. The study shows that there is a positive correlation between pyuria of nitrite and significant bacteriuria. Escherichia-coli is the most common microorganism in schoolgirls with significant bacteriuria. The incidence of screening bacteriuria was 2.3% which most of them were asymptomatic.

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In this case-control study, 58 transfusion-dependent Thalassemic patients compared with 46 normal healthy persons on study of their thyroid size & function. In this study, thalassemia patients divided in two groups: Group one 31 patients with (Ferritin<1500) and group two 27 patients with (Ferritin>1500) and 3rd one was named control group (46 healthy persons). These groups were compared to achieve the best possible results and conclusion out of 31 patients. From first group 26 people had normal thyroid function test only 5 patients (16%) had goiter. From 27 patients in second group, 5 people (19%) had normal thyroid and 22 patients had goiter, in 3rd group 29% had normal thyroid, the difference between second and third groups were significant (P<0.01). In second group T4 level were lower than control, instead the TSH level were more than control group. The difference in second and third group were significant. The mean of T3 and T4 in group one and three don’t have significant differences. Conclusion: The goiter incidence and hypothyroidism in major Thalassemia with poor control (Ferritin>1500) are high.

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Cryptorchidism means undersecending testes, it is one of the most disorder in boy’s urogenital system. The aim of this research is to study the cryptorchidism prevalency in newborn boys in Gorgan. This research is a descriptive and cross-sectional study and the population under examination are those newborn boys that are given birth in Dizyani Hospital during 1377. 2318 newborn boys examined by standard physical method and the relation between this disorder and the following parameters has been the main concerns of this study, these are as follow: Either bilateral or unilateral cryptorchidism, mother’s age, parity, birth weight, maturating as birth, and race. The results of this study show, that from 2318 newborn boys 89 infant (3.8%) have cryptorchidism at birth. From those latter figures 2.3% are unilateral and 1.5% are bilateral. Our result indicate that there is a significant correlation between cryptorchidism gestational age (P<0.0001) and birth weight (P<0.0001) but there is no relation between cryptorchidism with mother age and parity. The present research also indicate that cryptorchidism prevalency in under-weight newborn and premature infant is considerably increased. The conclusion of our study indicate that cryptorchidism prevalency has got no significant differences from previous investigations.

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Low birth weight (LBW) is the main known determinant mortality in under 1 year old children particularly in neonates. The aim of this research is to study the rate of LBW and evaluation of some effective factors in LBW, such as: Difference races, residential conditions, maternal age, parity. This research is analytic-descriptive and cross-sectional study. The study population consists of 2183 newborns that are given birth in Dezyani Hospital during 1996. These samples were chosen by systemic randomized technic (3:1). Information was gathered by a questionnaire. The findings show that LBW rate was 6.3% in population under study, which in male and female newborns were 5.7% and 6.9% respectively. The LBW rates in newborns with mothers age?18 years old and those with ?35 years were 1.8% and 1.4% folds higher than LBW rates for newborns with mothers age 19-35 years. The LBW percentage for primiparous women were 1.9 folds to multiparous who had 2-4 deliveries. LBW rates for newborns with Systanie race were approximately 1.8 folds higher than newborns with Torkman ethnic. The results of this study indicate factors such as: Maternal age, race, parity, affect on LBW rates.

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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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Streptococcal pharyngitis and rheumatic fever/rheumatic heart disease are among the major public health problems in children. In this study we assay the frequency of group A Beta hemolytic Streptococcus in nasopharynex of 1588 healthy 6-12 years children in Gorgan in north of Iran. The sample obtained during February to March 1998, using sterile soap. The prevalence of this bacteria were 11% (175 strains) the rate of colonization in girls and boys were 10.8 and 11.2% respectively. Our study shows that the carrier of this bacteria in Town’s school children are more than the villages.

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Pain is a symptom of disease and most diseases accompanied with pain, specially among hospitalized post-operative patients. Several drugs and routes of administrations have used for post operative pain control. We compared post op analgesic effects of Diclofenac suppository to intramuscular Pethedine in post op inguinal herniorrhaphy patients. This study is a clinical trial on 40 patients who were operated due to unilateral inguinal herniorrhaphy. They divided into two groups incidentally. In Diclofenac Na group each patient received 100 mg Diclofenac Na supp every 8 hours. In Pethedine group each patient received 0.5 mg/kg Pethedine, intramuscularly. Pain severity of the patients controlled for 24 hours with visual comparation method and mean pain severity compared among 2 groups in the first 24 hours. Mean pain severity difference of Pethedine groups patients compared to Diclofenac Na group was 6.10 with standard error of 3.57 with (P<0.212) had no meaningful difference during first post operative phase. We concluded that Diclofenac Na is a suitable substitute of 24 hours intramuscular Pethedine for post op pain relief.

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Anthropometric dimensions are basis for evaluation of newborns’ health. In respect of importance of anthropometric indices of head and face in forensic medicine, surgery, pediatrics, medical imaging, … . We achieved this study. Determining range of head and face dimensions in normal one-day old female newborns on Fars and Turkman races. This descriptive and cross-sectional study is achieved on 423 normal one-day old newborns (Turkman group: N=211, Fars group: N=212) by classic cephalometry method. Mean and standard deviation of cephalic and prosopic indices in Fars group were 78.63±4.7, 74.3±11.5 and in Turkman group were 77.85±8.7, 81.6±9.8 respectively. Dominant and rare types of heads in Fars group were mesocephalic (42%) and hyperbrachycephalic (9%) and in Turkman group were mesocephalic (39%) and hyperbrachycephalic (8%) respectively. Dominant and rare types of face in Fars group was hypereuriprosopic (71%) and hyperleptoprosopic (4.24%) and in Turkman group were mesoprosopic (39%) and hyperleptoprosopic (1.89%) respectively. This study determines the types of head and face in normal female newborns in Fars and Turkman groups and determines the effects of racial factor on the diversity of head and face shapes in normal newborns.

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Recent publications have questioned the efficacy of massage. It is acknowledged that critical care environment are stressful for patients in term of invasive medical, and nursing procedures. Continuous brighting and excessive noise prohibits the potential relaxation and sleep. In this article, which is a research study, the physiologic response during and following a five minutes administration of back massage are described. This study is a semi-experimental research in which a 5 minutes back massage was offered to 25 patients as stress reduction intervention. Physiological data (Heart rate, mean arterial blood pressure, respiration and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Results indicated there was significant effect from the intervention on peripheral oxygen saturation (P<0.002). However, a significant decrease in heart rate (P<0.001), blood pressure (P<0.001) and respiration rate (P<0.001) was observed during the back massage intervention. Results indicated back massage had the potential effect of increasing relaxation as evidenced by physiological change during the intervention administration to critically ill patient in intensive care unit massage was found to be a useful therapy to enhance relaxation and sleep in critically ill patient.

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Urinary tract infection is common disease in pregnancy and most symptomatic infection with grate danger for fetus and mother’s. This study has been done to determine the prevalency of asymptomatic bacteriuria in pregnant women in Gorgan in 2000. Mid-stream urine from 900 pregnant women was obtained. Urine analysis and culture for all of them have been done and positive cultured (Isolated bacteria with 100000-colony count) was antibiogramed by Kerby Buer method. Out of 900 urine specimen 3.7% of samples had positive urinary tract infection. The common organism isolated was E.coli (33.3%), Coagulase negative, Staphylococci (30.3%) and Klebsiella (15.2%). There was not a significant correlation between age, pariety, pregnancy age, fresh urinary infection and asymptomatic bacteriuria but there was a significant and correlation kidney stone between bacteriuria. Anti-microbial sensitivity pattern demonstrates more sensitivity of strain with Amikacin and Gentamycin. Although prevalence of bacteriuria in this (3.7%) lower than other studies in this country but for their severe sequele. This phenomen should be taken into more consideration further investigation in other part of the country should be done to face the probable difficulties.

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The goal of this research is to study of the rate of depression and its relation to type of free time activities, among the medical students at Gorgan University of Medical Sciences in 1999-2000. In this study, 238 medical students (122 male & 116 female) were selected by non-randomized and easy sampling. They were tested by the Beck depression inventory, and a questionnaire due to incomplete information, 32 medical students (15 male & 17 female) were omitted. In general, the average of depressed females was lower than male students (BDI score of 10.2 against 10.9 respectively), but this difference wasn’t statistically significant. Based on this information, medical students had the lowest rate of leisure activities. 52.2% of males and 65.2% of females had not any special leisure activity. The results from this investigation indicate that there are some differences of free-time activities between male and female students. Mental relaxation was the main item among the list of free-time activities of medical students. Finally, we could not find any significant correlation between depression and the kind of leisure activities, which was the main concept in this study.

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It is reported that the rate of congenital malformations is about 2-3% at birth. They are one of the major causes of morbidity, mortality and disability in childhood are later in adulthood. The aim of this study was to determine the rate of gross congenital malformations that were preset at birth. The other factors studied were anatomic locations of anomalies, neonatal sex, race, maternal age and race. This study was a cross-sectional descriptive study, and the sample population was 10000 births. The rate of congenital malformations was 10.1/1000 in our sample 11.8/1000 in male and 7.5/1000 in female neonates. The rate of malformations in musculoskeletal system were 3.8 In CNS 2.8 and in urogenital system 2.5 per 1000 births. It was concluded that the most frequent malformations in CNS, musculoskeletal and urogenital system were cystic spina bifida, clubfoot and hypospadias respectively. The rate of malformations newborns were 14.5 per 1000, 8.5 per 1000 and 17 per 1000 birth in Turkman, native Fars and Sistan racial groups respectively. The results from this investigation showed that there were relations between rate of over malformations, races and sexes of individuals.

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Background and Objective: The association between discordant growth and the complication of twin pregnancy has been recognized for more than 30 years. Recent publications have presented evidence that 30% or even 40% discordance presents the threshold for significant. Our purpose was to define twin growth discordance on the basis of perinatal outcome and other factors like maternal age pariety and systemic disease. Materials and Methods: Twins delivered at age more than 32 week’s gestation between 1998-2000 at Deziani Hospital Gorgan was identified. Birth weight, pre-term birth, maternal age pariety and systemic disease and sex of Twins recorded. Discordance was calculated as: 100×larger BW-smaller BW/larger BW. Results: The mean discordance for 435 twins was 8.18±6.79, 96.4% of pre-term birth associated with discordance?20%. 10.6% of mothers had a systemic disease and mean discordance in twins term and pre-term of normal mothers was 5.8±4.5, 7.9±6.3 and in systemic disease was 9±9.2, 11.1±8.8 (P?0.008). There were no differences in pariety age and sex. Conclusion: Twin birth weight discordance had now clearly been demonstrated to be a risk factor for pre-term birth. The effect was found particularly with discordances?20% after 32 week’s gestation.

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Background & Objective: Neural tube defect is one of the most important malformations of the newborns. The aim of this study was to investigate the rates of NTD, anencephaly, spina-bifida cystica, encephalocele and the relation of these abnormalities with sex, ethnicity, mother’s age and consanguineous marriage in north of Iran (Gorgan). Materials & Methods: A cross-sectional study was done on 26280 birth in Dezyani Hospital in Gorgan during 1998-2001. Results: This study has showed that, the NTD rate was 3.08, 2.78 and 3.38 per 1000 in total, males and females, respectively, female to male ratio was 1.31. The rate of spina-bifida, anecephaly and encephalocele were 1.48, 1.48, 0.11 per 1000, respectively. In regard to different races, the rate was 6.78/1000, 4.76/1000 and 2.41/1000 among Turkmans, Systani and native Fars, respectively (P<0.05). The rate of NTD in the mothers under 20 years was 2.29/1000, in 20-34 years was 3.37/1000 and over 35 years was 2.54/1000. Interstingly, 29.6% of parents with affected newborns had consanguineous marriage. Conclusion: We concluded that there is a higher rate of NTD in this, area, that it might be due to race-ethnicity variations.

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Background & Objective: Fetal weight and gestational age are important factors in evaluation of neonatal safety and basic prediction factors in outcome of pregnancy and satisfactory criterion in decision of management in obstetrice and neonatalogy. Therefore finding a method for pridiction of fetal weight is critical. The present study employs, detect on value of Janson's formula in prediction of fetal weight. Materials & Methods: In this analytic study, 223 pregnant women who had a safe, live, singleton fetus, with cephalic presentation were admitted to labor ward at Dezyani hospital. Medical or obstetrical complication was excluded. Subjects selected by purposive sampling. For collecting data: First, using the same flexible tap measure calibrated in centimeters by using this tap, the fundul height was measured. The fundual height was also taken in Janson's formula and estimated weight was also calculated each cases. The actual weight of post delivery was measured immediately. Data analysis was done by correlation test paired T-test. Results: This study shows mean estimated fetal weight (3730±546) were higher than the actual birth weight (3270±429). Conclusion: This study indicates that Janson's formula is not a good way to estimate fetal weight.

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Background & Objective: Approximately one-third of the world’s population is infected with Mycobacterium Tuberculosis (TB), which is a indicator of high distribution of these bacteria in our environment. The only vaccine currently available against TB is the attenuated Mycobacterium Bovis strain bacillus Calmette-Guerin (BCG), which used regularly for many years to prevent the Tuberculosis in Iran and many part of the world. The efficiency of this vaccine varies in different populations, and is a matter for discussion. On this basis, the present study has been set up to determine the level of Tuberculin reaction in 4.5 months and in 7 years old children that receive BCG vaccine at birth time, in Golestan province. Materials & Methods: 2700, 4.5 month infant and 2400, 7 years old children in Golestan province were chosen by cluster sampling after the proper permission from the parents, public health centers and educational authorities were taken. The presence of the BCG scar were assessed, and 0.1 ml of 5 tu Tuberculin were injected subcutaneously. The induration was measured 48-72 h after Tuberculin injection. The results were determined as present and compare with T-test. Results: In these study 2559 infants and 2193 child were taken part in the final evaluation. The BCG scar were present in 97.9% of infants and 87.8% of 7 years children, this difference was meaningful. The average induration in 4.5 months babies were 2.29 mm, and in 7 years child was 0.66 mm, this difference was significant (P<0.05). More than 44.7% of babies and 82% of 7 years children didn’t show any reaction after PPD test, this difference was also significant (P<0.05). Conclusion: The level of positive Tuberculin reaction in infants of this province in spite of vaccination was very low, and this level was reduced after 7 years time, this indicate that BCG vaccination at birth did not have any major role in positive Tuberculin reaction. Our results also indicate that the presence of scar can be a good indicator for previous vaccination. In regard to the negative Tuberculin reaction in majority of babies, it is suggested to evaluate the efficacy of BCG vaccine in preventing the TB disease itself, by other method such as studying the TB incidence among children in long term or by determination of cytokines level after Tuberculin injection.

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Background&Objective: Hepatitis B, is a common kind of viral hepatitis. Vaccination is the most secure way of prevention for the health care worker. The present study was designed to survey the seropositivity of Gorgan teaching hospitals. Materials&Methods: This descriptive and cross-sectional study was done on 300 medical and official personals at 3 hospitals in Gorgan in 2003. with using 3ml of pripheral blood, sampling assay was performed to determine HBs-Ab and HBs Ag. Questionnaire form concerning demographic information, vaccination status and risk factors were compeleted for participants. Statistical analysis was done by means of SPSS soft ware with confidence interval equal to 95%. Results: 13% of individuals were not be vaccinated and 74.6% of them were vaccinated completely. There were statistically significant differences between HBs Ag and vaccination status ,individual’s age , the last vaccination time, occupation and use of glove (p<0.05). Furthermore, 1% of samples (one female, two males) were HBs Ag –positive. These three Persons has 10 years at service and were vaccinated compeletely were HBs –Ab neagtive. Conclusion: As a result of vaccination project, vaccination coverage of emplyees and immunologic status of them were satisfactory. Because of repetitive encountering of under considertion individuals with hepaptitis virus, 2% of unvaccinated subject had been infected but fortunately were be cured. Concomitant reduction in probability of immunity was being occurred after vaccination with the passing time and considering the importance of booster dose injection.

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Background and Objective: Diabetes is a major risk factor for stroke. Some studies have shown that difference between clinical signs and prognosis in diabetic patients with stroke compared to non-diabetic patients with stroke is due to difference in pattern of cerebral vascular involvement. This study was done to compare the findings of extracranial and transcranial doppler sonography in diabetic and nondiabetic patients with thrombotic stroke. Materials and Methods: This case – control study was done on 70 diabetic patients and 70 non-diabetic patients with thrombotic stroke. All patients were new cases. Extracranial and transcranial doppler sonography was performed for all subjects. Results: Basilar artery stenosis was significantly more frequent in diabetic cases in comparison with non-diabetic patients (P<0.05). The prevalenc of posterior circulation stenosis in diabetic patients was significantly higher than non-diabetic patients (P<0.05). Conclusion: In diabetic patients, stenosis in vertebrobasilar circulation was more frequent. Higher morbidity and mortality in diabetic patients may be due to vascular stenosis pattern.

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Background and Objective: Cryptorchidism or undescending testis is a developmental defect and occurred in 2-4% of male newborns. This study was done to determine the pattern and risk factors of cryptorchidism in Gorgan, northern Iran. Methods: In this cohort study, 2851 male newborns were examined for cryptorchidism at the birth and follow up for one year after birth in Dezyani referral teaching hospital in Gorgan, northern Iran during April 2010 - December 2011. Mother ethnicity, working in farmland, addiction, consanguinity, age, infant maturity and birth weight were recorded for each subject. Results: The rate of cryptorchidism was 18.9 per 1000 live birth. Bilateral and unilateral cryptorchidism was 11.7 and 7.1 per 1000, respectively. The rate of cryptorchidism in preterm newborns (30 per 1000) was significantly higher than the term (20 per 1000) and post term (11.4 per 1000) newborns (P<0.05). The Mean±SD of newborns weight with unilateral cryptorchidism (3024±537grams) was significantly lower than the healthy newborns (3253±489 grams) (P<0.05). The rate of cryptorchidism in Turkmens (10 per 1000 births) was significantly lower than Fars (21 per 1000 births) and Sistani (23 per 1000 births) newborns (P<0.05). One year Follow up of newborns showed that 41 (77.3%) testes were descent to scrotum. Conclusion: Low births weight, prematurity and ethnicity are the main risk factors of cryptorchidism in northern Iran.