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Background & Objective: The burden of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of psychiatric disorders in our country are brief and their numbers are few. Providing essential mental health services to the people requires us to be knowledgeable about the present status of psychiatric disorders in the society. The objective of their research was to carry out the epidemiological study of the psychiatric disorders in the 18 years and above individuals in the urban and rural areas of Golestan province. Materials & Methods: 518 individuals selected through randomized clustered and systematic sampling methods from among the existing families of Golestan province and the schedule for affective disorders and Schizophrenia (SADS) questionnaires completed by the clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. Results: The results of the study showed that the prevalence of psychiatric disorders in the province is 14.69%, which was 18.14% in the women, and 11.47% in the men. The mood and affective disorders respectively with 7.93 and 4.05% had the higher prevalence in the province. The prevalence of psychiatric disorders in this study was 0.97%, neuro-cognitive disorders 1.16% and dissociative disorders 0.58%. In the group anxiety disorders, panic disorder with 4.05% of had the higher prevalence and in the group of affective disorder, major depression, hypomanic and manic disorder with 1.93. Conclusion: This study showed that 7.53% of individuals that were studied suffered from at least one of the psychiatric disorders. The prevalence of psychiatric disorders in the province among the individuals in the age group of 41-55 years with 13.04%, separated or divorced individuals 50%, residents of urban areas 11.03%, illiterate individuals 12.75% and housewives 13.04% was more than other individuals in the sample. Being aware of this matter reveals the responsibility of the health policy makers and programmers, prevention, treatment and medical education more than before in relation to preparing application and executive plans in Golestan province for mental health.

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Background&Objective: Morphine is an opioid analgesic and has known effects on different organs. This study was done to determine the histopatological changes of liver due to morphine adminstration in adult mice. Materials&Methods: In this experimental study, 20 male Blab/c mice divided experiment and control groups. In experiment and control group, animals recived 15mg/kg/day morphine and salin normal interperitoneally, for 21 days respectively. Day 22 the livers were dissected under anaesthesiology. Specimens were processed for histological study and stanied with H&E. Results: In experimental group, small sites of necrosis with poly morphic inflammatory infiltration and debris formation of necrotized nucleus in death area, so hepatitis was suggested. Also accumulation of micro droplets of lipid inside the hepatocyte cytoplasm withont nucleus displacement (fatty damages with small vacuoles) observed in cases. In addition, microvesicular steatosis and mouth teeth necrosis in liver parenchyma with inflammation in the vein and portal space were seen in cases. Any changes was not seen in control group. Conclusion: The interperitoneal adminstration of morphine can cause histopatological changes in mice liver.

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Background&Objective: Silis (SiO2) is an oxide of silicon that its existence in food products is known as a contamination, classified as a human carcinogen. Some suggest it as an etiology of esophageal cancer. Golestan province has a high incidence and prevalence of esophageal cancer and is on the world belt of this disease. This study was designed to determine the concentration of silis in flour produced in Golestan province, north of Iran Materials&Methods: This descriptive study was done in spring 2005. Census method was used to gather flour samples from flour manufactures. Samples were transported to laboratory. Base-melting method in nickel cruise was used in 550°c and the extract was reduced with acid. The complex was evaluated with spectrophotometer. Data entered into SPSS-12, and the differences between silis concentration in various regions were compared with non-parametric Kruskul Walis test. Results: Median silis concentration was 0.0030 grams, mean concentration was 0.008760 with 0.004265 standard deviation, minimum was 0.003 and maximum was .018 grams in each 100 grams flour produced in province's factories. Mean silis concentrations were 0.012, 0.01 and 0.003 in Gorgan and the central part of the province, western and eastern part, respectively. The differences were not significant. Conclusion: Although in earlier reports it was shown that silis level in the flour is high, but the findings of this study indicated that the above element is in normal range.

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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: Thalassemia is an inherited and chronic hemolytic disorder. Like other diseases it can make psychological, social and financial problems for both patients and families. The necessity of this research is to teach the way of treating the psychosocial problems of this illness and to increase the quality of patients and families life. It is also a descriptive study to examine psychosocial and financial disorders and coping strategies among families with patients suffering major beta thalassemia Materials&Methods: 320 parents (229 of mothers and 91 of fathers) were included in this study. These families were those who were visited clinics associated with Gorgan's University. Data collection was done using a self structured questionnaire as well as Mc Cubin and Thompson scale for identifying coping strategies. Results: Findings revealed many problems, such as: stress for disease (82.8%) and the patients' vague future (81.8%). The mentioned problems were of psychological disorders. And about social problems: 33.8% of patients families were deprived of having picnics in their free times and helping the patient meddles the routine work of homes in 30.1% of families. The financial problems: the cost of traveling and providing the medicine (63.8%). In addition 97.5% of families had faith and reliance in God in order to help them and to believe their child's illness as a reality. It is apparent that families use different kinds of method in order to cope with psychological, social and financial problems and to face the disease. Conclusion: Most of families have a strong belief in religion and as a result they believe that any kind of problems and especially disease is one of ways to reach God. This is the idea which helps them to face this disease stoutly.

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Background and Objective: Opium usage for sedating/relieving from diarrhea or cough causes a public health problem. In the northeast of Iran (Golestan province), opium is used widely for symptomatic therapy of routine illnesses in young children. It may cause severe intoxication and even death. This study was done to determine the toxification with opium in five years old children in Golestan Privine in Iran. Materials and Methods: This cross-sectional study was performed in collaboration with “Adverse Drug Reaction (ADR) Committee” in Golestan University of Medical Sciences. All members of ADR committee in pediatric centers trained to complete a certain valid questionnaire in children under 5-years-old, which either referred or admitted for opium intoxication (September 2006 to February 2007). Data analyzed by Chi-square and Fisher exact tests. Results: In this survey, 67 opium-intoxicated children were recruited. Minimum age of the subjects was 6 days and maximum was 5-years-old. In 41.3% of subject. The opium was given by the mother with low awakness and 61.2% of in toxicated children reside with rural area. More that 80% of the parant had the educational level below. The highschool diploma in 63.6% of cases the pure form of opium were consumed, diarrehea anxiety, were the two main cause for consuming the opium. In this study four subjects decleard dead due to toxification of the opium. Conclusion: Opium intoxication has a high prevalence among children under 5-years-old in our area. Therefore it is suggested that the intoxicated children accompanied with parant ambigious explanation opium toxification should be taken seriously.

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Background and Objective: Systemic lupus erythematosus (SLE) is an inflammatory multi-system disease with an unknown origin. In patients with lupus disease cardiovascular events is an important cause of mortality and morbidity. This study carried out to measurement of high sensitivity C –reactive protein (HsCRP) and homocysteine in patients with SLE and their relation with diseases activity and cardiovascular risk factors.

Materials and Methods: This case control study carried out on 60 patients (55 females and 5 males) with lupus disease which referred to Clinical Research Center of Rheumatology, Mashhad, Iran and 30 controls (26 females and 4 males) during 2007-08. Information of subjects were gathered using SLEDAI questionare. HsCRP and homocysteine of subjects were measured. The level of low density lipoprotein (LDL), Triglycerid, hypertension and Body mass index (BMI) was assessed. Systemic lupus erythematosus activity was assessed by using SLEDAI so that if the score was higher than 10, lupus was called as active disease.

Results: Mean age was 28.8±10.3 and 33.8±9.13 years in SLE and control groups respectively. The mean of HsCRP in SLE patients were 3±2.42 mg/dl versus in controls were 1.58±2.1. The serum level of homocysteine were 12.3±1.93 µmol/L and 24±8.13 µmol/L in SLE patients and controls (P<0.001). Mean disease activity was 15.37. There was no any associtation between homocysteine and HsCRP and disease activity. LDL, Triglycerid, hypertension had significant association with homocystein (P<0.05). BMI and Triglycerid had significant association with HsCRP (P<0.05).

Conclusion: This study showed that there is no linear significant corrolation between homocysteine, HsCRP and disease activity, but there is significant corrolation between increase of homocysteine and HsCRP and cardiovascular risk factors.

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Background and Objective: Klebsiella species are gram-negative bacteria with positive voges proskauer (VP) reaction. Klebsiella species are found as commensal in human digestive and respiratory system. This group of organisms can create a serious health hazards in hospitalized patients, and their ability to drug resistance is a major health problems. This study was done to evaluate the efficacy of Ciprofloxacin, Ceftizoxims and Carbenicillin on Klebsiella species isolated from hospital specimens. Materials and Methods: In this laboratory study, 1200 clinical samples were isolated from patients in Imam Khomeini hospital, Tehran, Iran. The identification Klebsiella species were carried out according to conventional biochemical tests. The minimum inhibitory concentration (MIC) of carbenicillin, ceftizoxime, and ciprofloxacin antibiotics were determined using Macrodilution broth test. Results: Out of 1200 isolated samples, 25% were identified as Klebsiella species. 73% of identified Klebsiella were obtained from urine samples. Klebsiella.peumoniae with rate of 94% was the most abundant among other species. The results of MIC and minimum bactericidal concentration by using standard microdilution method showed drug resistance range of 16-1024 μg/ml, 4-256 μg/ml and 0.25-16 μg/ml for carbenicillin, ceftizoxime, and ciprofloxacin, respectivley. In general, 94%, 6% and 1% of species were resistance to carbenicillin, ceftizoxime and ciprofloxacin, respectively. Conclusion: Ciprofloxacin and Ceftizoxime are suitable for the treatment of infections due to Klebsiella species.

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Background and Objective: Gastroenteritis due to Salmonella is common in human and considered as a global dilemma of public health. This study was done to determine the Pattern of serotyping and antibiotic resistance of Salmonella in children with diarrhea in Iran. Methods: In this laboratory study, 306 stool samples were collected from children with diarrhea in public health centers in Robat-karim, Tehran province, Iran. The specimens were enriched in Selenite F medium and then cultured on Hekton agar. The identification of Salmonella was carried out by conventional method and antimicrobial susceptibility testing was performed according to CLSI procedures. Results: Out of 306 stool samples, 7.2 % were identified as Salmonella species, as follow: 7 Salmonella typhi, 6 Salmonella paratyphi B, 3 Salmonella paratyphi C, 2 Salmonella paratyphi A and 4 samples were not identifiable. There was a significant relation between presence of WBC in fecal and salmonellosis (P<0.05). In drug sensitivity trends, 92.3% of Salmonella species were sensitive to chloramphenicol, ceftizoxime, Nalidixic acid and Amikacin. Conclusion: This study showed that Salmonella was the cause of children diarrhea in 7.2% in this region.

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Background and Objective: Yersinia is a gram-negative bacillus that cause diarrhea through consumption of contaminated food and water.  This study was performed to identify the atypical Yersinia virulence markers isolated from children with diarrhea.

Methods: This descriptive cross -sectional study was done on 384 fecal samples of 0- 14 years old children admitted at children medical center from August 2011 to August of 2012. Fecal samples, for the enrichment, after 21 days of incubation in alkaline buffer with pH=7.2 at 4degree C, on days 7, 14 and 21 samples were cultured on CIN agar and Mac agar and then confirm the differentiation atypical Yersinia from other typical Yersinia species from fermentation of different sugars. Isolates were tested for marker of virulence including calcium dependence, auto agglutination, Congo red uptake and binding of crystal violet.

Results: Out of 384 stool samples, 4 (1.04%) were infected with Yersinia (Yersinia frederikseni, Yersinia kristensenii and Yersinia enterocolitica). Out of these three, only two samples in association was positive with virulence markers.

Conclusion: Phenotypic markers can be used to study the properties of phenotypic strains of Yersinia.

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Background and Objective: Polycystic ovary syndrome (PCOS) is the most endocrine disorder in women. This study was done to determine the effect of N-acetylcysteine with letrozole to induction of ovulation in infertile women with polycystic ovarian syndrome.

Methods: This clinical trail study was carried out on forty PCOS women with normal TSH, prolactin, hysterosalpingographies and normal spermograms. The patients in control group were received letrozole 5 mg/d for 5 days starting at day 3 of the cycle. The patients in interventional group were received letrozole 5 mg/d with NAC 1.2 g/d (group II) for 5 days starting at day 3 of the cycle. On 14^th day of cycle, transvaginal ultrasonography was performed to evaluate endometrial thickness and follicles properties. If mature follicle detected, hCG was injected and timed coitus at 12, 36 and 60 hours later advised. β-hCG level was checked on day 16 after hCG injection.

Results: The mean of endometrial thickness and follicles ovulation in hCG injection day was similar in the two groups. The pregnancy rate was 15% and 20% in control and interventional groups, respectively. This difference was not significant. The mean of follicles number was 1.13% and 1.47% in control and interventional groups, respectively. This difference was not significant.

Conclusion: NAC as an adjuvant to letrozole was not effective for ovulation induction in patients with PCOS.

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Background and Objective: Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.
Methods: This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mo'menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.
Results: Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.
Conclusion: Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.

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Background and Objective: The most common enterohemorrhagic Escherichia coli strain is the O157: H7 serotype, which is one of the most important intestinal pathogens and can cause complications such as hemorrhagic colitis, hemolytic uremic syndrome and acute renal failure. The aim of this study was to evaluate the enterohemorrhagic Escherichia coli causing molecular outbreaks of foodborne illness in Iran.
Methods: In this descriptive cross-sectional study, 189 fecal swab specimens were examined during April to September 2018. All suspected isolates were tested for biochemical tests. The isolates were confirmed by molecular PCR and evaluated by antimicrobial susceptibility tests.
Results: From 189 stool swab samples studied, 98 Escherichia coli isolates were detected based on phenotypic tests. Most of the outbreaks occurred in summer and the prevalence of enterohemorrhagic Escherichia coli was 24.5%, which 4% of them were non-O157H7. Most patients were between 1 and 12 years of age and the highest antibiotic resistance to cotrimoxazole and chloramphenicol was observed at 80% and 79%, respectively.
Conclusion: This study showed an increase in enterohemorrhagic Escherichia coli with 24.5% and an increase in antibiotic resistance to the antibiotics of chloramphenicol, cotrimoxazole and carbapenems. Increased resistance to imipenem and meropenem antibiotics makes it difficult to treat beta-lactamase-resistant strains.

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Background and Objective: Campylobacter is one of the most important pathogens causing bacterial gastroenteritis, which is usually transmitted through the food of animal origin. This study was done to evaluate the status of Campylobacter in diarrheal food outbreaks compared to other microbial agents.
Methods: This descriptive study was performed on 305 diarrheal swab samples from 102 food outbreaks during six months from spring to the end of summer 2018. Presence of Campylobacter species were assessed according to the protocol of the General Directorate of Laboratory Affairs.
Results: Out of 305 samples, 8 (2.6%) were identified as Campylobacter species, 3 (37.5%) Campylobacter and 5 (62.5%) Campylobacter coli. The epidemiology of the outbreaks showed that female (54.5%), average age of 16-30 years (28.2%), consumption of salads and vegetables (16.1%) and living in the cities (59.7%) were the most cases.
Conclusion: This study showed that in addition to classic pathogens such as Salmonella, Shigella, Escherichia coli, attention also should be paid to Campylobacter bacteria. In addition, recognizing epidemiological factors can play an important role in preventing and controlling food outbreaks.

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Background and Objective: Yersinia is water and foodborne organism that cause human gastroenteritis. This study was done to evaluate the frequency of Yersinia species isolated from children diarrheal samples and chicken meat in Tehran, Iran.
Methods: In this descriptive study 250 sample of diarrhea of children referred to the Children's Medical Center, Tehran, Iran and 250 samples of chicken were collected and examined for Yersinia infection during July 2016 to March 2017. Isolation method was performed based on initial enrichment in phosphate buffer for 3 weeks in refrigerator (cooling in c4 +) and then using KOH as secondary enrichment and culture on CIN agar medium. Biotyping method was used to determine pathogenic strains.
Results: In this study, 5(2%) isolates from pediatric diarrhea samples and 20 isolates (8%) from chicken meat samples were obtained from Yersiniaenterocolitica. Biotyping of human Yersiniaenterocolitica isolates identified 3 cases of biotype 1A, one case of biotype 1B, one case of biotype 2 and from chicken meat isolates, 16 isolates belonged to biotype 1A and 4 isolates belonged to biotype 1B.
Conclusion: Presence of common pathogenic 1B and non-pathogenic 1A biotypes in pediatric diarrhea samples and chicken meat can indicate the cause of diarrhea in children.