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Background&Objective: Copper and zinc, two essential trace elements, are neuroactive substances that can be synaptically released during neuronal activity. These metals have been implicated in diseases with neuropathological components, including Alzheimer's disease, Menkes disease, Wilson's disease, Pick's disease, stroke and seizures. Copper and zinc levels in body tissues reflect many physiological and pathological conditions, including dietary factors, hepatic disease, and acute and chronic infections. The purpose of the present study was to examine the plasma levels of copper (Cu) and zinc (Zn) in schizophrenic patients and to compare the Cu/Zn ratios with that of matched healthy subjects. Materials&Methods: Forty patients with schizophrenia (diagnosis were made according to DSM-IV) were sampled along with 50 healthy controls. Exclusion criteria included another concurrent psychiatric disorder, pregnancy, and medical disorders (endocrine, immune, liver cirrhosis, renal) or drugs (anticonvulsants, contraceptives, glucocorticoids) known to affect trace element metabolism. Fasting blood samples were withdrawn from an antecubital vein between 07.00 and 09.00 h. Plasma copper and zinc levels were measured using an atomic absorption spectrophotometer (Perkin Elmer GmbH, Uebelingen, Germany). Two-tailed t test was used to determine statistical differences. All data were analyzed with the computer program, GRAPHPAD software (V2.01+). Results: Mean±SE of sera copper levels in cases and controls were 145±28 and 65±3 µg/dl respectively (P<0.05). Also Mean±SE of sera zinc level in cases and controls were 67±2 and 81±4 µg/dl, respectively (P<0.05). Cu/Zn ratios was 2.07±0.38 and 0.87±0.04 in cases and controls respectively (P<0.05). Conclusion: There was a significant higher Cu/Zn ratio in schizophrenic patients compared to healthy subjects. These results suggest that Cu and Zn may be involved in the pathophysiology of schizophrenia.

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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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Celiac disease is one of the most common cause of malabsorbtion syndrom. The symptom of this disease associated secondary to malabsorbtive problems. Celiac can be accompanied with liver enzyme dysfunction with various extra intestinal findings. This case was a 27-year old man presented with abnormal liver function test over period of 1 year. He did not have another symptom such as diarrhea, weight loss or skin lesion. In medical examination, there was no ascites, peripheral edema or jaundice. Diagnostic re-examination of the paitent include serology tests and Viral hepatitis, Wilson disease and auto Imuune respones showed to be normal. Abdominal and biliary sonography had normal results. Liver biopsy revealed no sign of any pathology, but duodenal biopsy and serologic findings were compatible by Celiac disease. The symptom improved on a gluten-free diet and his liver enzyme function tests became normal subsequently.

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Background and Objective: The staging of gastrointestinal cancer has an important role in the treatment of tumor. This study was done to determine the efficacy of endosonography method for determining the stage and deepth of esophagus and stomach cancers. Materials and Methods: In this descriptive study, endosonographic staging was performed in 23 patients (15 male and 8 female) with esophagus and stomach cancers, confirmed with pathologic findings in Taleghani hospital, Tehran, Iran during 2002-04. The results of surgical staging compared to preoperative endosonographic method. Results: Mean age of 23 patients was 57.2 years (43-72 years). 30% and 70% of the patients had esophageal and gastric cancers, respectively. The accuracy of endosonographic staging of esophagus and stomach cancers was 82%. The accuracy of diagnosis, positive and negative predictive value of cancers in assessment of the depth of the tumor by endosonography procedure were 79.4%, 69.6% and 84.9%, respectively. Conclusion: Endosonography is a precise method for evaluating depth and staging of tumor and lymph node involvement.

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

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Background and Objective: Pregnancy can not only protect mothers against intimate partner violence but even it may increase the rate and severity of intimate partner violence. This study was done to determine the intimate partner violence during pregnancy in the Northern Iran. Method: This cross-sectional - analytical study was done on 1500 mothers whom attended the primary health centers of Mazandaran province, Northern Iran from Feb to Sep 2010. Mothers screened using modified standard world health organization intimate partner violence questionnaire via interview. The questionnaire included physical, emotional and sexual intimate partner violence. Intimate partner violence was categorized to severe, moderate and mild. A multivariate logistic regression analysis was used to identify predictor of intimate partner violence. Results: The most common intimate partner violence was restriction of mothers in terms of money, food, and clothing (88.8%). The prevalence of physical, psychological and sexual intimate partner violence was 14.1%, 69.9% and 10.8%, respectively. The adjusted odds ratio for physical intimate partner violence in mothers with low education and low socio-economic status were significantly higher in those mothers with high education and fair socio-economic status (P<0.05). Conclusion: Mild psychological intimate partner violence is prevalent in Mazandran province, North of Iran.

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Background and Objective: Cardioembolic stroke account for one-fifth of ischemic stroke and atrial fibrillation is the most common underlying cause. Taking an oral anticoagulation (Warfarin) is an effective way of preventing ischemic stroke but bleeding complication is common. This study was carried out to evaluate the validation of HASBLED score in prediction of hemorrhagic complications in patients with brain ischemia and atrial fibrillation under warfarin therapy. Methods: In this cohort study 112 patients with non-valvular atrial fibrillation in term of major and minor bleeding complications were followed to the predictive value of HASBLED criteria for one year. Major bleeding complications defined as intracranial bleeding, bleeding leading to hospitalization, drop of hemoglubin of more than 2gr/dl or requiring transfusion. HASBLED criteria were defined as hypertension, abnormality in liver and renal function tests, history of stroke, history of bleeding, large fluctuations in coagulation tests results, age more than 65 years and an Anti-platelet and non steroidal anti-inflammatory drugs and alcohol use one point is awarded to each of the aboves. Results: During one year follow up, 10 (9.1%) of patients had major bleeding and 28 (25%) patients had minor bleeding. The risk of major bleeding was significantly related with a history of minor bleeding and HASBLED scores (P<0.05). The risk of minor bleeding was significantly related with warfarin toxicity and high INR (P<0.05). HASBLED score>3 was associated with the likelihood of major bleeding in future. Conclusion: Patients with HASBLED score>3 should be causious in initial stage of taking oral anticoagulant.

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Background and Objective: Changing of lifestyle in women and increasing their social activity especially in working places can affect women’s sexual quality of life (SQOL). This study was done to determine the affecting factors on sexual quality of life among hospital employee's women.

Methods: This descriptive - analytical study was carried out on 121 women who work in the two hospitals in Sabzevar city and Birjand city in Iran during 2014. Data was collected using two questionnaires including the Iranian version of sexual quality of life-female (SQOL-F) questionnaire and a researcher-made measure to assess demographic characteristics, health related, and work-related variables.

Results: The mean±SD score of SQOL-F was 80.1±19.7. The univariate analysis showed that the mean score of SQOL-F significantly related with age (P<0.05), duration of sleep (P<0.05), marital duration (P<0.05), educational level (P<0.05), and physical activity (P<0.05). The regression modeling indicated that educational level (β=0.33), marital duration (β=0.32) and quality of sleep (β=0.56) were predictors of SQOL-F scores.

Conclusion: This study showed that educational level, marital duration and quality of sleep were predictors of SQOL-F scores among hospital employee's women.

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Background and Objective: Aloe Vera is considered as one of herbs causes oxidative indexes modification due to antioxidant properties. On the other hands, High-fat diets (HFD) cause liver disorders prevalence. This study was done to evaluate the protective effect of hydro-alcoholic extract of Aloe Vera gel on enzymes and liver tissue structure of high-fat diet rats.
Methods: In this experimental study, 40 adult male rats were allocated in five groups including control, sham (HFD 10 ml/kg) and three experimental groups receiving HFD with doses of 150, 300 and 600 mg/kg/bw of Aloe Vera gel extract. Prescriptions were conducted by gavage and for 60 days. Blood samples were collected to measure AST, ALT and ALP enzymes. Liver removed subsequently and following preparing tissue sections liver cells were counted.
Results: High-fat diet significantly increased ALP and ALT enzymes (P<0.05). High-fat diet significantly increased the number of Kupffer cells and reduced of hepatocytes in compared to control group (P<0.05). High-fat diet caused liver tissue alterations including blood congestion, inflmation; Vacuole breakdown, apoptosis, and ballooning of hepatocytes. On the other hand, the consumption of Aloe Vera with high-fat diet caused reduction in tissue changes and a significant decrease in the serum levels of ALP and ALT enzymes in compared to control group (P<0.05).
Conclusion: High-fat diet by damaging the liver tissue  increased  the serum levels of ALP and ALT enzymes and Aloe Vera extract with its anti-oxidant characteristic prevent the effect of a high-fat diet on the liver tissue and reduced the ALP and ALT enzymes.

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

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

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

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

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Background and Objective: 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.