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Background&Objective: Nowadays epidemiologic paterns of the diseases are verifying rapidly non-contagious diseases like mental disorders are replacing contagious one. Several people, unaware of their psychiatric problems seek medical advise and treating. College students are susceptible to mental disorders because of their conditions. This research was done to evaluate mental health state in students of Golestan University of Medical Sciences. Materials&Methods: 218 students of Golestan University took part in this research. SCL-90-R was the test for evaluation, after collecting the questionnaires and entering into SPSS-10 software, data were analyzed with chi-square and Fisher-exact test. Results: The momental prevalence was estimated 72%. 157 persons had disorder, at least in one dimension, and 16 persons (7.34%) had severe disorder at least in one. Marriage and psychosis, paranoid & anxiety had meaningful relations (P<0.05), residental site and paranoid had meaningful relations (P<0.05), higher levels of father’s education and interpersonal sensitivity had meaningful relation (P<0.05), Family history of mental disorders, moderate interest in education, field of study and phobia had meaningful relationships (P<0.05), females had higher scores in depression (P<0.05). Conclusion: According to this high prevelence of mental disorders it seems that mental health’s problem is critically high in this region, much more attention should be paid to prevent further complications.

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Background&Objective: 15-20% of TB cases are extra pulmonary tuberculosis (EPTB). Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province (Iran) between 1999 and 2003 and determined their demographic characteristics. Materials&Methods: We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province .Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. Results: 30 patients had been treated for GI and abdominal TB, most of them were females (22 cases, 73.3%). Mean age of the patients was 32.03±13.73 with higher incidence in age before 40 years old (70%). Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Conclusion: Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports (3%).

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Background&Objective: Celiac is a digestive disease. In this disease, small bowel is damaged and the absorption of nutrients are adversely affected. These patients do not absorb gluten. There is probably a correlation between esophagus cancer and celiac. The aim of this research was to study the seroepidemiology celiac disease in this area with high prevalency of esophagus cancer. Materials&Methods: This research was a descriptive study, which was performed on blood donors in Golestan province during the year 2005-06. blood samples were taken from 2547 subjects. tTG-IgA determination were carried out using ElISA technique, the titre<4U/ml, 4-10U/ml and >10Um/l were considered to be as negative, weakly positive and positive respectively. EMA antibody assessment were carried out on all sample population with more than 4U/ml, using IFA method. Results: 28 subjects (1.1%) had tTG-Ab positive test, out of this number 18 subjects (0.7%) were weakly positive and 10 persons (0.4%) were considered to be positive. EMA test were positive in 70% of subjects with tTG positive results. There was not any significant meaning between positive tTG test and ethnicity from weakly positive tTG, 15 subjects (83.3%) and 3 subjects (16.7%) were male and female respectively. The entire tTG positive were male subjects. Conclusion: In regard to high prevalency of esophagus cancer in the region and the relation of celiac disease with above cancer, it seems necessary to look more seriously at the celiac disease.

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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 & Objectives: Diabetes mellitus contains a group of common metabolic disorders that induces problems in health status. Its prevalence is increasing in the world, due to increase the rate of obesity and decrease in physical activities. This study was done to evaluate incidence of diabetes and prevalence in rural areas of Kalaleh city(North of Iran).

 

Materials & Methods: In this descriptive cross-sectional study all persons over 30 years old were enrolled, according to diagnosis of diabetes before 2005 or diagnosis in the screening programs (with FPG>126 in two turns) in rural areas of Kalaleh during 2005-06. After collection of demographic data with questionnaires and laboratory findings, they were entered to computer with SPSS-15 software. Central and distributive indices and incidence & prevalence of diabetes were assumed according to the whole population.

 

Results: In this study, 394 cases were enrolled. Incidence and prevalence of diabetes was 0.6% and 1.13%, respectively. Mean age of cases was 51.61 years. Male to female ratio was 0.4. Mean BMI was 29.43 kg/m² and a significant difference was seen between two gender (P<0.05). Most of the cases were Turkmen (72.8%). Illiterates were the major group (77.2%) and 1.8% had diploma or higher educational levels.

 

Conclusion: Prevalence and incidence of diabetes was lower than the other area of Iran.

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Background & Objective: The Acquired Immunodeficiency Syndrome (AIDS) is in its third decade and has become a pandemic disease that threatens the world population. Educational programs are well known as the most effective strategy to preventing the AIDS. The purpose of this study was to determine the knowledge and attitude of participants about AIDS and to test the effects of an AIDS education program on it. Materials & Methods: This case-control study was conducted during 2005. 149 Red Crescent personnel in Golestan, Iran. The sample subjects participated in a pre/post intervention study. The activity consisted of a workshop 90 minutes in length, in conjunction with educational material. A 13-item questionnaire was used as the gauging tool. Results: 47% of subjects had adequate knowledge about AIDS. Mean level of knowledge in post-test exam was significantly higher than pre-test one (P<0.0001). Individuals with higher educational level (high school and university) had lower knowledge in pre-test (P=0.001), but the difference in pos-test was not significant. A significant relationship was shown between the history of participation in previous AIDS education programs and subject's knowledge in pre-test (P<0.001). Conclusion: This study indicated that education program based on special traing considerably increase general awareness and attitde towards AIDS.

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Background & Objective: Hepatitis B virus (HBV) infection is one of the most important health problems all over the world. This study was conducted to determine the co-infection of hepatitis C virus (HCV), hepatitis D virus (HDV) in HBV infected patients in Golestan province of Iran. Materials & Methods: This population based cross sectional study was done in 2004. 139 HBsAg positive cases were assessed for co-infection with HCV and HDV. Serologic tests were done by ELISA method using available kits. Data were analyzed by SPSS-12 and STATA8 software. P-values of less than 0.05 were considered as significant. Results: Sixty eight (48.9%) of 139 cases were males and 71 (51.1%) were females. The mean (±SD) of participant's age was 41.89 (±11.3) years (range: 25-64 years). Anti-HCV and Anti-HDV antibodies were positive in 17 (12.3%) and 8 (5.8%) cases, respectively. Females were more infected with HCV and HDV than males. But the differences were not significant. Conclusion: The prevalence of co-infection with HCV and HDV in HBV infected cases is relatively high and notable in Golestan province of Iran. Because of negative effects of these co-infections in clinical outcome of the disease, it is recommended to assess possible HCV and HDV infection in individuals with HBV infection. This may result in more efficient management of the disease.

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Background and Objective: Esophageal and gastric cancers are among the most common and fatal cancers. These are diagnosed at the latest phase and the prognosis is too poor. Due to the importance and high incidence rate of the upper gastrointestinal cancers in Golestan province, this study was conducted to explore the overall survival rate of these patients in rural area of this region. Materials and Methods: In this descriptive cross-sectional study, a total of 121 pathologically confirmed esophageal or gastric cancers, with rural place of residence, were retrieved from the cancer registry at the health department in Gorgan. After conducting interview with patients or their relatives, analysis of their sociodemographic and clinicopathologic features was performed. The median survival rate was compared regarding age groups and gender using Kaplan-Meier statistical test. Results: Male to female ratio in esophageal and gastric group were 1.2 to 1 and 3.8 to 1, respectively. Short-term survival rates were 54.76% and 26.2% for esophageal cancer and 66.6% and 37.5% for gastric cancer. Collected information regarding patients’ sociodemographic and clinicophathologic factors did not have significant association with patients’ survival in both esophageal and gastric cancers. The mean survival rate in patient with gastric and esophageal cancers according to age and gender was not significant. Conclusion: This study showed that the overall short-term survival rates for upper gastrointestinal cancers are very low in Golestan province. Therefore the need for intervention the need and allocating more diagnosis and therapeutic resources for upper gastrointestinal cancers are required.

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Background & Objective: Health evaluation and growth monitoring of the infant is a visual diagram of growth and primary health services are based on it. In the best option, these indices must be provided separately for each community. This study was done to evaluate growth indices of newborns in Gorgan- Northern Iran. Materials & Methods: In this observational descriptive study which was carried out during (Oct-Nov 2003), all healthy infants without any major abnormality born within 25-42 weeks of gestational age were evaluated in Dezyani Hospital, Gorgan growth indices (head circumference, length and height) were measured in 1011 infants. Gestational age was defined by Balard scoring and delivery type was recorded, too. After entering data into SPSS-10 software, data were analyzed using chi-square, t-test and correlation bivariate. Results: Mean gestational age (±SD) was 39.86±1.72 weeks and most of them were born by vaginal delivery. Amongst them, 3.2% were premature (less than 37 weeks), 4.4% were low birth weight and 0.69% were very low birth weight. Correlation between growth indices and gestational age was significantly positive in all cases (p<0.05). Conclusion: This study showed that growth indices are lower than other parts of Iran. Further investigations needed, especially longitudinally and cross-sectional, to determine the growth indices in this region and in other parts of country.

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Background and Objective: Colorectal cancer is the third common malignancy in the world. Personal habits including life style and nutrition have been proposed as risk factors of colorectal cancer. We conducted this study to assess the nutritional characteristics in colorectal cancer patients in Golestan province of Iran.

Materials and Methods: This case-control study was done on 47 colorectal cancer cases, diagnosed during 2004-05 and 47 healthy controls. A questionnaire containing socio-demographic and nutritional characteristics (FFQ) was filled for each of the participants. Chi square test was used to assess the relationship between variables.

Results: In each of the two groups, 40.4% were females and 59.6% were males. The mean±SD age of age in cases and controls were 52.4±13.4 and 52.1±13.1 years, respectively. Total energy expenditure of higher than 1837.5 Kcal/ day was significantly related to colorectal cancer (OR=3.8 95% CI: 1.2-11.3). Colorectal cancer risk was higher in individual with frying cooking method (OR=3 95% CI: 0. 8-11.1). The risk of colorectal cancer was 6.5 times higher in individuals with fat consumption of higher than 118.5 grams/day (95% CI: 1.5-28.8). No significant relationship was seen between vegetables consumption and the risk of colorectal cancer.

Conclusion: This study showed that high total energy expenditure, high fat consumption and using frying method for cooking are risk factors of colorectal cancer in Golestan prevince in Nothern of Iran.

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Background and Objective: Esophageal and gastric cancers are among the most prevalent cancers in the world which cause a high mortality rate annually. Several risk factors are supposed for them. Water hardness is considered as a protective factor against above cancers. This ecologic study was designed to determine the correlation between water hardness and upper gastrointestinal cancers. Materials and Methods: In this ecological study data on water components in Golestan's urban areas were obtained during 2004-05 and the averages were reported. All cases of esophageal and gastric cancers resided in urban areas which were diagnosed during this period were recruited to estimate the incidence and age standardized rates (ASR). The province was divided into low, intermediate and high incidence, based on 33% and 66% quartiles of both cancers. Pearson correlation coefficient test and regression model were used to analyze the data. Results: The water hardness was in the normal standard range permitted for the drinking water, and did not have any relation with the risk of esophageal and gastric cancers. Conclusion: This study showed that water hardness has no effect on the incidence of esophageal and gastric cancer in this area.

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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: Destructive effects of thyroid diseases in pregnancy and fetal frowth is well established subclinical autoimmune thyroid diseases can double the rate of preterm labor, abortion and postpartum thyroiditis. This study was done to compare thyroid function and autoimmunity derangment in goiterous and non-goiterous pregnant women. Materials and Methods: This case – control study was done on 100 healthy and 100 goiterous pregnant women in Dezyani hospital located in Gorgan, Northern Iran during 2005. Five mililiter of blood sample was obtained from each subject to measure thyroid hormones concentration including T3/ T4/ TSH/ T3 RUP and thyroid autoantibodies (Anti Tg/Anti TPO). Thyroid hormone and auto antibodies were measured using IRMA and ELISA techniques. Results: Thyroid volume was enlargel twice and tripl of its orginal size in 34% and 66% goitrious pregnant women respectively. Mean serum TSH in cases and controls were 1.81+/-1.33 microU/ml and 1.84+/-1.4 microU/ml respectively. The mean of Anti TPO and Anti Tg in cases were 373.91+-197.36 U/ml and 248.80+-70.59 U/ml respectively. The same indecs for controls were 79.52+-63.99 U/ml and 248.80+-70.59 U/ml respectively. In pregnant women with goiter 36% had high Anti TPO and 9% had high Anti Tg, but in control group 16% and 4% of controls had elevated Anti TPO and Anti Tg, respectively. Conclusion: According to thyroid function tests there were elevation of antibody in 20% of the healthy subjects and 45% of the goiterous subjects, therefore it is advisable to measure thyriod function tests accompanied with thyriod antibodies in all pergnant women either with or without goiter in order to prevent feto-maternal disorders.

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Background and Objective: Golestan province, located in north of Iran has been known as a high risk area for esophageal cancer. The relationship between esophageal cancer and Selenium (Se) has been assessed in previous studies. This study was conducted to assess the relationship between Soil selenium levels and development of esophageal cancer in Golestan province of Iran. Materials and Methods: In this ecologic study, Golestan province in northern Iran was divided into 135 blocks based on geographical altitude and longitude on the map. One Soil sample was collected from the center of each block. Selenium level in Soil samples was determined by flame atomic absorption spectrometry. Statistical analysis was performed by Pearson correlation and T-Student tests. Results: The mean±SD of Soil Selenium level in Golestan province was 3.7±1.61 mg/kg. There was a positive correlation between Soil level of Selenium and esophageal cancer rates in this area (P=0.03), (Pearson correlation coefficient=0.19). The Soil Selenium level for high risk and low risk area for esophageal cancer were (4.13 mg/kg) and (3.39 mg/kg) respectively (P=0.01). Conclusion: This study showed that there is high Soil Selenium level in Golestan province in north of Iran. Also it is found to be a significant positive relationship between Soil Selenium level and esophageal cancer rate in this area.

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Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

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Background and Objective: Floater is defined as dark and vague spots and lines, which presents in visual fields of patients. Etiologies are various and life threatening, due to the serious complications resulted from floaters, this study was designed to assess ophthalmic disorder among patients with floater Gorgan, Iran (2009). Materials and Methods: This cross-sectional study,was done on 164 patients (105 female, 59 male) with floater or photopsia in Gorgan, North of Iran during 2009. Findings of ophthalmic examination and demographic characteristics were recorded in a questionnaire for each patients. Results: The prevalency of floater was higher among patients over sixty years old. 57.2% women with floater were during monopausal period. Myopia (32.9%) and cataract (32.9%) were the most associated ophthalmic diseases. Posterior vitreous detachment and retinal bleeding in patients with floater was 84.1% and 6.1%, respectively. Retinal detachment was not seen in patients. Conclusion: This study showed that posterior retinal detachment is the most frequent associated ophthalmic disorder in patients with floater. Older age, gender, myopia and cataract are considered to be the related risk factors in floater.

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Background and Objective: Nausea and vomiting are the most frequent complications in the first trimester of pregnancy. Herbal medicine is among the traditional effective treatments. Ginger and Chamomile are hypothesized to be useful in decreasing the signs. This study was done to determine the effect of Ginger and Chamomile capsules on nausea and vomiting in pregnancy.

Materials and Methods: This triple-blind randomized placebo-controlled trial was carried out on 105 pregnant women in 6-16 weeks of gestational age with a mild to moderate nausea and vomiting, whome referred to the prenatal care clinic in Dezyani hospital and health centers, Gorgan, Northern Iran during 2009-10. Rhodes index questionnaire had been given to all participants to be completed before bed-time for two weeks. In the first week no intervention was done and prescribing the capsules was started the following week. Subjects randomly divided into 3 groups: In group 1, ginger capsules were consumped twice a day for one week, in group 2 twice daily chamomile capsule and in placebo group, glucose capsule was prescribed. Scores were calculated and all data were entered into the SPSS-16 software, analysis was done using variance analysis, Will-Cockson, paired T and Fisher-exact tests.

Results: The mean of Rhodes index before intervention in plasbo, Ginger and Chamomile groups were 12.71±5.88, 10.42±0.76 and 11.19±5.51, respectively. Also, the mean of Rhodes index after intervention in plasbo, Ginger and Chamomile groups were 11.47±6.43, 7.28±3.74 and 5.73±4.32, respectively (P<0.05). Bonferroni test indicated that there is no difference about scor chang (after and before) between Ginger and Chamomile and Ginger and plasbo, but this difference was significant between Chamomile and plasbo group (P<0.05).

Conclusion: This study showed that Chamomile capsule was more effective on nausea and vomiting during pregnancy compared to Ginger.

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Background and Objective: Liver enzyme tests are usually normal or slightly increased during pregnancy. Abnormal liver enzyme tests are seen in 3% of pregnancies and should be evaluated immediately. Early detection and timely treatment is the key to successful treatment. This study was carried out to determine the prevalence of abnormal liver enzymes and pregnancy outcome in women admitted to Sayyad-e-Shirazi hospital in Gorgan-north of Iran.
Methods: This descriptive, cross-sectional study was carried out on 73 hospitalized pregnant women out of 6680 pregnant women in the Sayyad Shirazi hospital, in north of Iran during April to September 2015. Clinical information was including laboratory tests, final diagnosis and complications postpartum of 73 women with impaired liver enzymes.
Results: The most common cause of abnormal liver enzymes were pre-eclampsia in pregnant women (16 patients 21.9%) which occured in the third trimester. HELLP syndrome was observed in 9 (12.3%) of patients which occurred in the third trimester. Also in 3 cases (4.1%) eclampsia was reported in the third trimester.
Conclusion: Due to the high incidence of pre-eclampsia and HELLP syndrome in women with impaired liver enzymes, careful examination of patients, especially in the third trimester of pregnancy is essential.

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In December 2019, the new acute respiratory disease spread in China presented with fever and dry cough known to be resulted from the new Corona Virus as the COVID-19. In Iran, the first case was reported on 20th of February 2020. Our management team in Golestan University of Medical Sciences held an immediate meeting to decide how to manage the cases suspected to the COVID-19.The two main hospitals had been selected as the Corona center in the Golestan province, northern Iran. Admitting patients other than COVID-19 has been stopped in these hospitals, and all patients had been transferred to the other hospital in Gorgan city and those in the recovery state had been transferred to a hotel prepared for this purpose. The capacity of Sayyad-e-Shirazi hospital was 300 bed for admission and 25 ICU beds that had been increased to 44 ICU beds (30 percent increases) to be prepared for COVID-19 admission. Clinical groups and specialists had been organized with special duty for each part. After 3 months of COVID-19 crisis, Sayyad-e-Shirazi hospital with 300 beds is in a good shape and admission of severe cases has been decreased.

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Background and Objective: Stroke has a high prevalence and is associated with a high premature mortality rate. Thus, it is important to identify the effective factors in increasing the incidence of stroke. The aim of this study was to investigate the role of seasonal changes and environmental factors in the occurrence of stroke.
Methods: This descriptive-analytical study was done on 3,639 patients including 3,102 (85.3%) with ischemic stroke, 472 (12.9%) with intracerebral hemorrhage and 65 (1.9%) with subarachnoid hemorrhage patients. After measuring environmental factors such as air temperature, air pressure, humidity and geomagnetic field, admission data of stroke patients between 2015-2019 were extracted from the Sayyad Shirazi Hospital information system.
Results: The mean occurrence of intracerebral hemorrhage was highest in winter, especially in January and March, and lowest in summer, especially in July and August. Intracerebral hemorrhage had a positive significant correlation with air pressure (P=0.001, r=0.452) and a negative correlation with ambient temperature (P<0.001, r= - 0.457). Subarachnoid hemorrhage and ischemia were not related to the season or the month. It was also found that ischemic stroke had a significant positive correlation with geomagnetic field fluctuations. Subarachnoid hemorrhage was not associated with any of the variables, but intracerebral hemorrhage was significantly positively associated with air pressure and inversely associated with temperature.
Conclusion: This study illustrated that winter, low temperature, high air pressure and high geomagnetic fluctuations are associated with a higher risk of stroke. Therefore, the underlying physiopathological causes of this relationship should be carefully investigated in future studies.