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Background & Objective: Dyslipidemia and smoking are among the most important medical problems in human society. Their share in the mortality of coronary heart disease (CHD) has led to multiple investigations about them. This study was done to determine the prevalence of dyslipidemia and the effect of cigarette usage on it. Materials & Methods: This epidemiological cross-sectional study was carried out on 9632 persons selected randomly in Tehran urban with a minimum age of 20 years and over. We measured fasting blood sugar, blood sugar 2 hours after 75 grams oral glucose, triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol. Degree of physical activity was registered according to Lipid Research Clinics classification. Anthropometrics data, social condition, family history and smoking exactly delineated. Our patients were divided into: those having normal lipid profile and primary dyslipidemia (without any risk factor for dyslipidemia) and secondary dyslipidemia (having one or more risk factors such as diabetes mellitus). ANOVA, t.test, and logistic were used to analyze the level of significance. Results: Our population sample consisted of 5619 female and 4013 male. 68.5% of our cases had dyslipidemia. 65.8% of females and 72.3% of males had at least one type of dyslipidemia. There were 1085 smokers (11.4%) that 73.2% of them were dyslipidemic. With comparing smokers to nonsmokers shows that in smokers HDL.cholesterol, LDL.cholesterol and total cholesterol had decreased and triglyceride increased (p<0.05). Conclusion: Tehran population suffers from dyslipidemia. Large number of secondary dyslipidemia and smoking highlighted the importance of education to overcome to these preventable and modifiable factors.

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Background and Objective: Thalassemia major is a genetic disorder. Blood transfusion is critical for survival in these patients. Over the course of the past two and three decade’s hyper transfusion therapy in these patients has increased significant improvement in life expectancy and quality of life. Unfortunately this type of therapy increased the frequency of complication due to iron overloud. The aim of this study was to evaluate the prevalencey of diabetes, impaired fasting glucose and impaired glucose tolerance in patients with thalassemia major, with 10-27 years of age in Tabriz. Materials and Methods: This descriptive study was done on 56 patients between 10-27 years of age with thalassemia major. The demographic informaiton theraputic regiment, the age of first trasfussion. The level of blood transfusion, the history and dosage of familial history of diabetes, Fe, TIBC, ferritin levels were assessed and recorded. For each patient glucose tolerance test, blood glucose level are performed. Results: In this study prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test were found in 8.9%, 28.6% and 7.1% of patients respectively. Conclusion: This study showed that despite recent therapy with Desferal in the management of beta-thalassemia major, the risk of secondary endocrine dysfunction remains high. Prevalence of diabetes mellitus, impaired fasting glucose and impaired glucose tolerance test are greater than general population. Endocrine evaluation in patients with thalassemia major must be carried out regularly especially in those patients over the age of 10 years.

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Background and Objective: Stress has been known as an important causative factor in irritable bowel syndrome. Various studies have indicated the relationship between serum leptin levels and stress levels. This study was undertaken to investigate the relationship between serum leptin levels with irritable bowel syndrome. Materials and Methods: In This case-control study, eighty irritable bowel syndrome patients and 80 controls were recruited. All participants were asked to fill in a questionnaire included demographic information and medical history as well as a stress questionnaire. Serum leptin level was measured by ELISA method. Chi-square, student t-test, pearson correlation and logistic regression were used for investigating the relationships between variables. Results: Participants in irritable bowel syndrome group had significantly higher stress levels than controls (p<0.05). In the other hand, Serum leptin levels were significantly lower in irritable bowel syndrome group than the other one (p<0.05). Multivariate logistic regression analysis showed that after adjustment of stress level and body mass index, serum leptin level was still significantly lower in irritable bowel syndrome group (Odds ratio=0.9 CI95%:0.85-0.94). Conclusion: The present study indicated that there is a relationship between leptin and irritable bowel syndrome and serum leptin level is significantly lower in irritable bowel syndrome group than controls. This relationship is independent of other variables such as stress levels, BMI.

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Background and Objective: Diabetes mellitus is the most frequent cause of chronic renal failure. Microalbuminuria is the first clinically important sign of renal impairment in diabetes mellitus. The main pathophysiology of diabetic nephropathy is not understood. This study was done on 100 patients with type 2 diabetes for determination of the prevalence of diabetic nephropathy with urine albumin assay in Sina Hospital in Tabriz, North-West of Iran. Materials and Methods: In this discriptive study, 100 patients with type 2 diabetes whome consecutively referred to Endocrine and Diabetes Clinic of Sina Medical Center in Tabriz were enrolled. At the first visit clinical and biochemical parameters such as systolic and diastolic blood pressure, age, sex, body weight, length, body mass index, FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine were measured. FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine measurements repeated every 2 months up to three times during the study. Patients with confounding factors such as uncontrolled hypertension, urinary tract infection, congestive heart failure and hyperlipidemia were excluded. Results: The prevalence of diabetic nephropathy was 36% in our patients. There were not statistically significant differences in age and sex and diastolic – systolic blood pressure and creatinine between nephropathy and, non-nephropathy groups. There was significant differences in body mass index between two sex groups, females were more obese than males. Mean duration of diabetes in diabetic nephropathy group and in diabetic patients without nephropathy were 12.4±8.1 and 9.1±5.5 respectively (P<0.05). Comparison of HbA1c, FBS and drugs used for diabetes treatment were not significant differences between these groups. Conclusion: This study showed that prevalence of diabetic nephropathy was higher than other studies, although there were not significant differences between FBS, HbA1c and hypertension in patients with and without diabetic nephropathy.

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Background and Objective: Osteoporosis is the most common metabolic bone disease that characterized by reduced bone strength. The aim of this study was to evaluate the prevalence of effective factors in decreased bone density and secondary causes of osteoporosis.

Materials and Methods: This descriptive cross sectional study was done on 105 patients (76 female and 29 male) suffering from osteoporosis, evaluated in the endocrinology Department of Sina hospital, Tabriz- Iran from March 2003 to March 2006. Past medical history clinical symptoms and biochemical results were of patients. Data analyzed using SPSS-14  and chi square test.

Results: Osteoporosis and osteopenia were seen in 55% and 45% of patients with reduced bone density, respectively. Daily calcium intake in patients with less than 400 mg, between 400-1000 mg and more than 1000 mg were 63.8%, 31.9% and 3.4%, respectively. The mean±SD of sera calcium and vitamin D level were 9.5±0.6 mg/dl, 45±37.1 nmol/l respectively. 61.2% of patients had vitamin D deficiency. 33% of patients had secondry osteoprosis. Among the patient with primary osteoprosis 11.3% afflicted to hyper claciuria.

Conclusion: This study showed that decresing bone density was more prominate in women. The rate of daily calcium intake among patients were low. It is sugested these patients osteoprosis could be prevented by consumption food nutrient rich in calcium and vitamin D suplementation.

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Background and Objective: Jaundice is a common problem among neonate undiagnosed case finally lead to kern-icterus, with significant increasing rate of subsequent morbidity. This study was done to determine the etiology of of severe indirect hyperbilirubnemia in term neonates. Materials and Methods: This cross sectional descriptive study was performed in Taleghany hospital of Gorgan on neonates admitted due to severe hyperbilirubinemia from Sep 2004-Sep 2005. Severe hyperbilirubinemia was considered as bilirubin≥18 mg/dl in term neonates weighing more than 2500g. Bilirubin (total, direct), blood culture, retic count, coombs test, level of glucose 6 phosphate dehydrogenase enzyme, complete blood cell count, mother's and neonate's blood group, urine culture and C-reactive protein tests were measured. Results: 766 term neonates (>2500g) were hospitalized due to hyperbilirubinemia. Severe hyperbilirubinemia was detected in 12% of cases (54 boys, 38 girls). The etiology of 41 cases were unknown, 25 cases were diagnosed as sepsis, 15 neonates were glucose 6 phosphate dehydrogenase enzyme deficient, 7 cases had UTI, 3 neonates had ABO incompatibility and one neonate was due to breast feeding. Conclusion: This study indicated that the most common etiology of severe hyperbilirubinemia in this region is unknown. Sepsis, glucose 6 phosphate dehydrogenase enzyme deficiency, UTI, ABO incompatibility and breast feeding were among other reasons for severe indirect hyperbilirubinemia.

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Background and Objective: The vaccination against hepatitis B is a front line defence for all at-risk groups. Conventional methods of hepatitis B vaccination (0, 1 and 6 months) is considered a long process. But vaccination at shorter intervals (0, 10 and 21 days) is suggested to achieve rapid immunity. This study was carried out to compare for the protective antibody level against hepatitis B in accelerated and conventional vaccination. Materials and Methods: In this descriptive and analytical study 160 health personnel of Imam Reza hospital of Kermanshah, Iran with no history of vaccination against hepatitis B were selected and divided into two groups during 2009. The volunteers were received vaccination according to accelerated (0, 10 and 21 days) and convetional (0, 1 and 6 months) methods. The antibody titer measured two years after the final dose of vaccination. The acceptable level of antibody was considered higher than 10 IU/ml. Results: After two years the acceptable level of antibody was observed in 94.5% and 97.9% of subjects in accelarated and conventional methods, respectivley. This difference was not significant. Conclusion: This study showed that there is not significant differences between accelerated and conventional methods in antibody production against hepatitis B antigen.

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Borreliosis or recurrent fever is a spirochete disease which is caused by various species of borrelia and characterized by recurrent episodes of fever, chills and spirochetemia that could lead to multiple organ involvement and even death. In this case report, a 23 years old man was presented with shaking chills, fever and abdominal pain from a week before hospital admission. Borrliosis was confirmed following observation of Spirochete in peripheral blood smear. The patient was treated with doxycycline orally and one week after treatment discharged with a good general condition. Coincidence of borreliosis with underlying haemolysis in this patient was misled clinical presentation.

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Background and Objective: Aloe vera (Aloe barbadensis M.) as a medicinal herb is practiced in wound healing. This study was carried out to assess the effect of Aloe vera gel (mucilage) on TGF-β gene expression in incisional skin wound in BALB/c mice. Method: In this experimental study, 36 BALB/c male mice with weight range 22±2 gr were allocated equally into negative control (no wound), sham-operated (wound treated with physiological serum) and teratment (wound treated with Aloe vera gel). Two equal full-thickness skin wounds of 10±2mm were made on either side of the vertebral column in the sacral region. The animals in the teratment group were received daily, 2 gram of Aloe vera gel (without any bandage) as a thin layer for a period of 16 days. On 8th and 16th post wounding day, TGF-β gene expression in incisional wounds and Malonyldialdehyde (as end-product of lipid peroxidation) in serum samples was measured using RT-PCR and spectrophotometry methods, respectively. Results: TGF-β gene expression in incisional skin wound increased in Aloe vera gel treated group in compared to negative control and sham-operated groups (P<0.05). Malonyldialdehyde concentration was significantly reduced in Aloe vera treated group in comparision with negative control and sham-operated groups. Conclusion: Aloe vera gel can induce growth factor TGF-β gene expression and reducing the lipid peroxidation content can play an important role in incisional skin wound healing process.

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Background and Objective: Overweight, obesity and ethnicity are effective factors on pregnancy complications. This study was conducted to determine the relationship between third tri-mester body mass index (BMI) with maternal and neonatal complications. Methods: This descriptive analytic study was conducted on 551 pregnant women in third tri-mester with Fars, Sistani and Turkman ethnicities in Sayad Shirazi teaching hospital in Gorgan, north of Iran during 2012. BMI calculated at the time of labor admission and the subjects categorized into three groups of normal / underweight, overweight and obese. Results: The mean of maternal age among Fars, Sistani and Turkman ethnic groups were 26.5±5.5, 24.6±5.3 and 26.2±5.2 years, respectively. The mean of gestational age among Fars, Sistani and Turkman ethnic groups were 38.4±2.3, 38.6±2.3 and 37.4±3.2 weeks, respectively. A significant relationship was found between BMI and cesarean section and labor dystocia in Fars and Sistani ethnic groups, respectively (P<0.05), while no relationship was found between BMI and neonatal complications. Conclusion: Overweight and obesity in Fars ethnicity are at risk of cesarean section and those with Sistani ethnicity are at risk of labor dystocia.

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Background and Objective: Anxiety is a common psychological disorder. This study was carried out to evaluate the effect of hydro-alcholic extract of Pimpinella anisum seed on anxiety in male rat. Method: In this experimental study, 42 male Wistar rats, randomly allocated into six groups including: negative control group (no injection), positive control (saline) and experimental groups (receiving doses 100, 200, 250, 300 mg/kg/bw of hydro-alcholic extract of Pimpinella anisum seed, intraperitoneally). Indices of anxiety including time spent in open arms and number of open arm entries were evaluated using elevated plus maze, 30 minutes after injection. Results: At doses of 250 and 300 mg/kg/bw of hydro-alcholic extract of Pimpinella anisum seed, the time spent in open arms of maze were significantly increased and the time spent in maze close arms were decreased in compared to controls (P<0.05). At dose of 300 mg/kg/bw of Pimpinella anisum seed extract, number of open arm entries increased in compared to control group (P<0.05). None of the doses showed any significant effect on locomotor activites. Conclusion: Hydro-alcholic extract of Pimpinella anisum seed with dosage of 250 and 300 mg/kg/bw reduces anxiety in male rats.

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Background and Objective: Many surgeries are performed on anterior region of mandible. Incisive branch of the inferior alveolar nerve is located in the anterior region of mandible. The identification of various form of nerve is important for diagnosis and treatment plan. This study was carried out to the assessment of visibility and extension rate of incisive branch of the inferior alveolar nerve in cone beam computed tomography (CBCT) imagings. Methods: This descriptive – analytic study was performed on 105 CBCT images. The presences or absence of incisive branch of the inferior alveolar nerve and assessment of visibility and extension rate of mandibular incisive canal were studied. Results: In 79% extension of the incisive branch of the inferior alveolar nerve were observed. 18.07% of extensions were observed in one-side and 78.31% were bilateral. Extension of the incisive branch of the inferior alveolar nerve was observed to central, lateral and canine tooth in 59%, 26.5% and 14.5% respectively. There was no significant relation beween gender and age of subjects with extension of the incisive branch of the inferior alveolar nerve. Conclusion: Regarding the high visibility of the incisive nerve branches in the lower dental CBCT images this method can be used to evaluate the anterior region of mandible.

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Background and Objective: Artificial sweeteners are chemical or natural substances used in foods and beverages. The aim of this study was to compare the glycemic control status before and after the use of artificial sweeteners with conventional nutrition in type 2 diabetic patients.
Methods: This quasi-experimental study was performed on 30 patients with type 2 diabetes (10 males and 20 females) whom referred to the endocrinology clinic in Tabriz in west of Iran. At the beginning of the study, patients were asked to refrain from using dietary supplements containing artificial sweeteners for three months and continue their usual diabetic diet. Then, each patient was received nutritional supplements containing artificial sweeteners including sugar, special biscuits and candy under a dietitian for three months.
Results: Mean glucose level of fasting serum and serum glucose 2 hours after meals in patients during the second trimester increased significantly with the use of artificial sweeteners compared to the first three months (P<0.05). The mean fasting glucose in patients with diabetes mellitus was 121.33±25.3 mg/dl at the end of the first trimester and it was 152±42 mg/dl at the end of the second trimester. The mean serum glucose level increased from 164.44±44.44 mg/dl to 222±7.2 mg/dl
2 hours after meals. The mean of HbA1C in the first trimester was 6.89±0.9% and in the second quarter it was 7.4±1%.
Conclusion: The use of artificial sweeteners in diabetic patients may result serum glucose increase.

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Background and Objective: Postpartum depression has a negative effect on maternal health and adverse effect on psychological development of newborns. Also patterns and personality traits can also be associated with postpartum depression. This study aimed to determine the role of social support and Personality in the incidence of postpartum depression.
Methods: This descriptive-analytical study was performed on 200 mothers referred to health centers by available sampling method between 6 weeks to 6 months after delivery. Data were collected using a Questionnaire Personal Information, Edinburgh Postnatal Depression Scale (EPDS, 1987), NEO-Five Factor Inventory (NEO-FFI, 1985) and Social Support Questionnaire Philips (1977).
Results: Postpartum depression was observed in 49 (24.5%) of mothers. Neuroticism had the highest relationship with postpartum depression. The correlation coefficient of this variable with postpartum depression was 52% and this variable alone was 27% of the variance. There was a significant negative relationship between postpartum depression and social support (r= -0.027, P<0.01). There was a significant positive correlation between postpartum depression and neuroticism (r= 0.52, P<0.01).
Conclusion: This study showed that personality traits and social support are two important factors in relation to postpartum depression.

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Background and Objective: Any factor that disrupts the tear duct can cause epiphora, one of the most prevalent causes for patients to go to ophthalmology clinics. Nasolacrimal duct obstruction can be congenital or acquired. Dacryocystorhinostomy (DCR) surgery, which can be operated using external or endonasal approaches, is the standard treatment for nasolacrimal duct obstruction. This study was carried out to assess the success rate of endoscopic dacryocystorhinostomy surgery for patients with nasolacrimal duct obstruction.
Methods: This descriptive study was carried out on 38 patients (29 females and 9 males), aged over 18 with an average age of 43.07±13.83, suffering from epiphora referring to 5 Azar Hospital in Gorgan (Iran) between 2015 and 2018. The success rate of endoscopic dacryocystorhinostomy surgery for epiphora treatment was evaluated 6 months after the surgery. Furthermore, from the viewpoint of the complications of the surgery and the connection to the CT scan results, endoscopic dacryocystorhinostomy surgery was assessed.
Results: The surgery was successful for 36 patients (94.74%). The extent of the nasolacrimal duct obstruction of the right eye and the left eye was measured at 63.2% and 36.8%, respectively. Slight and heavy bleeding during the surgery was observed in 76.3% and 7.9% of the cases, respectively. Cerebrospinal fluid leakage and orbital injury during the surgery were not seen in the patients. According to the CT scan findings, deviation of the septum was seen in 76.3% of the patients, while septoplasty was operated on in 41.37% of the patients during the surgery. Moreover, half of the patients were suffering from chronic sinusitis for whom, the involved sinuses were opened and sinuses drainage was performed.
Conclusion: Endoscopic dacryocystorhinostomy surgery is an acceptable and successful method for treating epiphora, especially for patients with sinusitis or nasal septum deviation.