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Background and Objective: Gingival recession is a common disease leads to esthetic problems, increased sensitivity of teeth and root caries. This study was done to determine the prevalence of gingival recession in dental students with high level of oral hygiene.
Methods: This descriptive-analytic study was performed on 214 dental students of Golestan University of Medical Sciences, Gorgan, Iran during 2017-2018. After collecting demographic information, clinical examination including Oral Hygiene Index (OHI) and Gingival Index (GI), Severity of gingival recession, width of keratinized gingival, attachment of frenulum, toothbrush trauma, tooth malpositions, periodontal diseases and other iatrogenic factors was measured.
Results: Prevalence of gingival recession was 23.8% .Class 1 and 2 of gingival recession was 84.62 % and 15.38%, respectively. Class 3 and 4 of gingival recession did not observe in any subjects. Toothbrush trauma was the most etiologic factor in 35.4% of dental students suffering of gingival recession (P<0.05). Also, dental malposition with 20.83%, loss of keratinized gingival with 14.58%, orthodontics procedures with 12.5%, periodontal diseases with 10.4% were the other factors in gingival recession.
Conclusion: Toothbrush trauma and dental malposition are the most important etiologic factors in dentistry students suffering from gingival recession.

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Background and Objective: Cancer can cause many problems in all aspects of the physical, mental, social, economic and family life of the elderly patients. This study was done to determine the supportive care needs of the elderly people with cancer in north of Iran.
Methods: This descriptive- analytical study was carried out on 248 elderly patients with cancer whom referred to governmental and private medical centers in Gorgan, Northern Iran during 2018. Data were collected by a valid and reliable questionnaire "Supportive Care Needs Survey-SCNS" consisted of five domains of physical needs and daily functioning, health system and information, supportive and care, mental, and sexual chracteristics.
Results: There was a significant relationship between physical activity and daily functioning, sexual domain, support and care, health and information system with gender (P<0.05). Female seniors were more in need of assistance in the areas of physical and daily functioning, and male seniors in the areas of sex, support and care, health systems, and information.
Conclusion: This study showed that unmet needs in the elderly with cancer are particularly high in physical and functional areas.

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Background and Objective: Acquired kidney cysts usually occur in end stage renal disease (ESRD) patients undergoing long-term hemodialysis. Increasing growth of cysts is also seen in asymptomatic patients and they can cause complications such as retroperitoneal and intrarenal bleeding, Erythrocytosis, infection of cysts and renal cell carcinoma with distant metastases. This study was designed to evaluate the prevalence of acquired kidney cysts and its related factors in hemodialysis patients.
Methods: In this descriptive-analytical study, 123 patients (mean age 55.22+13.23 years) were selected from hemodialysis patients referred to dialysis center. Patients with autosomal polycystic kidney disease, medullary sponge kidney and medullary cystic kidney disease were not included. Diagnosis of acquired kidney cysts of Patients was performed by ultrasonography.
Results: The overall prevalence of kidney cysts was 44.6%. 30 percent of diabetic patients had kidney cysts, while kidney cysts were present in 51.2% of nondiabetic patients. 32.4% of patients were received twice a week dialysis and 42.4% of patients were received three times a week dialysis had kidney cysts. Mean±SD of duration of dialysis history in patients with cystic kidneys was 22.02±22.65 months, while these measures in patients with noncystic kidneys were 22.65±14.65 months. There was a relationship between kidney cysts and the numder of hemodialysis per week (P<0.05). There was a relationship between prevalence of kidney cysts and the qulity of hemodialysis (P<0.05)
Conclusion: This study showed that there was a relationship between prevalence of kidney cysts and the qulity of hemodialysis and the numder of hemodialysis per week.

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Background and Objective: The prevention of clot formation during hemodialysis improves the effectiveness of treatment by maintaining patency in the dialyzer. This study was done to evaluate the effect of intermittent bolus of normal saline on the quality of clot formation in venous chamber and dialyzer.
Methods: In this clinical trial study, 51 eligible patients were divided into intervention (n=26) and control (n=25) groups. Patients in the control group received routine care and the intervention group received 100ml of normal saline, each hour, as an intermittent bolus, during 4 hours of dialysis beside the routine care. After three consecutive hemodialysis sessions (first round), all patients received routine care to clear the intervention effect (washout period). Then, patients crossed over from intervention group to control and vice versa. At the end of each session, the quality of clot formation in intravenous chamber and dialyzer was recorded and analyzed.
Results: The venous chamber of dialysis circuit in 74% of patient in intervention group no clot was formed, whereas in 58% of patient in control group it contained fibrous ring (P<0.05). After intervention, dialyzer of 68% of patients in intervention group, were free of clot, whereas in control group only 16% of dialyzers were free of clots (P<0.05).
Conclusion: Using intermittent bolus of normal saline during hemodialysis can reduce the risk of clot formation in venous chamber and dialyzer.

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Background and Objective: Unhealthy lifestyle is the main cause of morbidity, mortality and preventable complications in the elderly. Performing health promotion behaviors are one of the most effective factors in maintaining and improving health. This study was done to determine the health promotion lifestyles in the elderly people.
Methods: This descriptive-analytical study was performed on 110 elderly people aged 60-88 years referred to teaching and medical centers in Gorgan, north of Iran during 2019. Data was collected using Health Promotion Lifestyle Profile 2 (HPLP-II) questionnaire. This questionnaire includes six dimensions of spiritual growth, responsibility for health, interpersonal relationships, stress management, physical activity and nutrition for evaluation health promotion behaviors status. The total score range of the instrument ranges from 52 to 208. A score of 52-103 was considered low level of compliance with health promotion behaviors and a score of 104-155 and scores above 156 was considered intermediate and high level, respectively.
Results: The mean±SD of health promotion lifestyle was 143.52±17.36. There was a significant relationship between lifestyle and demographic characteristics (P<0.05). Spiritual growth and interpersonal relationships had the highest score among the six dimensions of health promotion behaviors.
Conclusion: Health promotion lifestyle in the elderly was low in terms of physical activity and stress management.

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Background and Objective: Gilbert's syndrome is a relatively common genetic disorder, which is caused by defection in uridine diphosphate glucuronosyl transferase enzyme. The indirect bilirubin increases in this syndrome, although the function of the liver is normal. Gilbert's syndrome can be seen in 3 to 10% of different populations. According to the differences in ethnic groups in Golestan Province, no studies have been conducted on the prevalence of the syndrome in the province, so far.This study was conducted to determine the prevalence of suspected Gilbertʼs syndrome in Golestan province in north of Iran.
Methods: This descriptive-analytical study was performed on 1664 subjects with 18-45 years old referring to rural and urban health centers in Golestan province, North of Iran during 2014. Liver function tests were normal in subjects. Fasting blood samples were taken from each subject and total bilirubin was tested. People with a total bilirubin of more than 1.5 mg/dl were treated with a single oral dose of rifampin 600 mg. After taking rifampicin, the individuals with an indirect bilirubin level of more than 1.3 mg/dl were found suspected of Gilbert’s syndrome.
Results: The prevalence of suspected Gilbert's syndrome was 5.8%. Moreover, suspected Gilbert’s syndrome was more common in males than females (10% in males and 4.3% in females) (P<0.05). According to ethnicity, the prevalence of suspected Gilbert's syndrome was 5.4%, 5.4%, and 6.8% in Sistani, Fars and Turkmen subjects, respectively. This difference was not significant. The prevalence of suspected Gilbert's syndrome in three ethnicities was higher in males than females and it was statistically significant in Sistani and Fars ethnicities (P<0.05) but not significant in Turkmen ethnicity.
Conclusion: Suspected cases of Gilbert's syndrome were more common in men than women, and more prevalent in the Turkmen ethnic group.

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Background and Objective: Ensuring suitable access to hemodialysis, which provides high-quality dialysis over an extended period, is a significant challenge for patients with End-Stage Renal Disease (ESRD). One crucial aspect of this is maintaining the performance of hemodialysis catheters. Our study, which aimed to evaluate the one-year performance of long-term catheters in chronic hemodialysis patients in Golestan Province, is a critical step toward improving patient care in this population.
Methods: This descriptive-analytical study was conducted on 99 patients (34 men and 65 women) with ESRD who were candidates for starting or continuing dialysis with a catheter in the educational and therapeutic centers of Golestan Province, Iran during 2021-22. Transjugular catheters were placed for the patients, and after one year, variables such as age, gender, history of diabetes, history of hypertension, catheter placement site (right or left jugular), and antiplatelet medication use were evaluated concerning the performance of long-term catheters in providing adequate flow for hemodialysis.
Results: In 91 patients (91.9%), the one-year catheter performance was assessed as satisfactory. The age of 61.6% of the patients were over 60 years old. Sixty-nine patients (69.7%) had a history of hypertension, and 58 patients (58.6%) had a history of diabetes. Fifty-seven patients (57.6%) received antiplatelet medication. The catheters were placed on the right side in 82 patients (82.8%). Catheter performance in patients taking antiplatelet medication was non-significantly higher than in those not taking antiplatelet medicines.
Conclusion: The performance of long-term catheters in chronic hemodialysis patients with ESRD showed no significant correlation with age, gender, diabetes, hypertension, antiplatelet medication use, or the side of the jugular vein where the catheter was placed.

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Background and Objective: Breast cancer has a high prevalence and mortality rate in the world and also in Iran. Neoadjuvant chemotherapy (NAC) is one of the treatment methods to improve patient survival. This study aimed to determine the response rate to NAC in patients with locally advanced breast cancer based on common molecular receptors.
Methods: This descriptive-analytical study was conducted on 100 patients with breast cancer (mean age= 41.14±10.06 years) referring to the surgical clinic of the Fifth Azar Educational and Therapeutic Center in Gorgan, Iran during 2013-18. Patients without distant metastasis underwent NAC treatment regimen followed by surgery. Demographic characteristics, types of drugs, and molecular receptor characteristics, and their response to treatment were recorded in a checklist. Treatment response and overall patient survival were evaluated.
Results: The mean tumor size before NAC was 3.01±2.47 cm (range= 0-8, median= 2) and 16% were determined to be grade one, 52% were determined to be grade 2, and 32% were determined to be grade 3. Thirty-six percent of patients had a positive family history. Forty-six percent were estrogen receptor (ER) positive, 40% were PR positive, 22% were human epidermal growth factor receptor 2 (Her-2) positive, and 78% were Her-2 negative. Thirty-six percent had a Ki-67 index greater than 30%. Eighteen percent of patients had a complete pathological response, and 82% had a partial or negative response. In terms of family history of breast cancer, Her2, ER, progestrone receptor (PR), Ki-67 receptor status, histological grade, tumor size, and axillary lymph nodes, there was a significant statistical difference between the two groups with and without complete pathological response (P<0.05).
Conclusion: The rate of complete pathological response to NAC in patients with locally advanced breast cancer was 18%.

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Background and Objective: Breast cancer is the most common cancer among women, causing the death of many worldwide each year. Given the importance of determining prognosis and the role of biomarkers, this study aimed to determine the expression level Ki-67 biomarker and its relationship with metastasis time and location in breast cancer patients.
Methods: This descriptive-analytical study was conducted on 154 breast cancer women admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, during 2009-2019. Upon admission, Ki-67 expression levels in tissue were determined using immunohistochemistry (IHC). Other required information, including demographic characteristics, disease stage, time interval from diagnosis to metastasis, and metastasis location, were identified and evaluated.
Results: Most of the patients (63%) were in the 40-60 age group. Ki-67 levels were determined to be below 15% in 45 patients (29.2%) and above 15% in 109 patients (70.8%). A statistically significant relationship was observed between Ki-67 expression levels and the time interval from diagnosis to metastasis (P<0.05). No statistically significant relationship was found between Ki-67 expression levels and age group, metastasis location, or disease stage.
Conclusion: The results of this study demonstrated that individuals with tissue Ki-67 levels above 15% experienced metastasis within a shorter period of time.