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Abdominal sonography is a best method to defined implantation site of placenta. Determination of placental site is very important if the aggressive method is to be used this study design to define implantation site of placenta in 1585 pregnant women whom referred 28 wk to sonographic center to Deziani Hospital in their third trimester with routine prenatal care. Collection of data perform in nine month and the data was collected by interviewing the pregnant women using a checklist and questionnaire. The results from this investigation show that 51.79% of placenta located in fondoanterior 31.23% fondoposterior, 12.11% posterior another in lateral position and 0.18% of placenta was previa.

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Background & Objective: Asymptomatic bacteriuria (ASB) is a significant problem during pregnancy because it can be developed into more severe infections that may have repercussions for the health of the mother and unborn child. The aim of this study was to assess relationship between asymptomatic bacteriuria and preeclampsia in Gorgan. Materials & Methods: This case control study performed on 150 preeclamptic women (Case group) compared with 150 healthy pregnant women (Control group) who hospitalized from 2002 to 2002 (Gravid, age and history of preeclampsia was matched with 2 group). The questionnaires and checklist was completed, urine analysis, and urine culture were performed. The data analyzed with SPSS software and statistical descriptive and analytic such as: T-student, U-Mann Whitney. Results: The risk of preeclampsia in pregnant women with ABS was 3.2 fold to healthy pregnant women (OR=3.22, CI 95% for OR=1.99, 5.21). Conclusion: Asymptomatic bacteriuria may predisposing factor to preeclampsia, we suggest screening of ASB in the 1st prenatal care and follow in 2nd and 3rd trimester of pregnancy o prevent the main side effect in pregnancy and the safety of mothers.

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Background & Objective: Wound infection in post-operation is one of the side effect that bothering the patients’ quality of life. This study was done to determine the effect of subdermal irrigation with normal saline on the wound infection in abdominal surgery of obstetrics and gynecology. Materials & Methods: A randomized clinical trial of subdermal irrigation with normal saline versus no irrigation was performed on 200 patients who were candidate for abdominal surgery of obstetrics and gynecology. Contaminated wound was excluded. In the case group (100 patients) after facial repair and complete hemostasis, subdermic tissue was irrigated with 1000-milliliter normal saline and skin was closed. In the control group (100 patients) after facial repair and complete hemostasis skin was closed without subdermal irrigation. All of the patients were followed until complete repair of skin. Results: 2 groups were similar in age, BMI, duration of surgery and the type of operation. Wound infection was observed in 1% of case group and in 7% of control groups, which was statistically significant (P<0.05). Conclusion: Subdermal irrigation with normal saline is effective, simple, safe and not expensive which can reduce the wound infection and can be offered particularly in high risk patients for wound infection.

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Background&Objective: Primary dysmenorrhea is one of the common causes of absence from work place and life quality among women. According to some studies, fish oil administration results in production of weaker prostaglandin’s (PG) and reduces the severity of dysmenorrhea. The aim of this study is to experience the efficacy of fish oil on dysmenorrhea, which is a cheap drug and with low side effects. Materials&Methods: In this clinical trial, the students separated into two groups those affected with primary dysmenorrhea by referring to girls' high schools and complete the questionnaires. In the next stage randomly were selected two groups each group included 22 students with primary dysmenorrhea. In first group fish oil capsules and the other group placebo were recommended for duration of two months. These students were evaluated before drug recommendation, at the end of two months treatment and two months afterward. In these three stages pain severity by VAS (Visual Analogue Scale) system and pain duration by Cox scaling system were be recorded in each group. Results: There is not meaningfull statistically difference in the average age, age of menarche, menstrual condition (regular or irregular) and accompaniment with symptoms of PMS (premenstrual syndrome) between fish oil and placebo groups. Before recommendation of capsules the average of pain severity did not have a meaningful statistically difference between two groups. The average pain duration also had similar situation. After two months treatment, the average of pain severity (VAS) in fish oil group was significantly less than which in placebo group (p<0.05). Also the average of pain duration in fish oil group was less than which in placebo group with a statistical difference of (p<0.05). Moreover, two months after the end of treatment the average of pain severity (VAS) and pain duration (hour) had meaningfull statistically difference between fish oil and placebo groups and were less in fish oil group. Conclusion: As compared with placebo, the fish oil capsule after two months of consumption had a significant effect on reduction of pain severity and duration in primary dismenorrhea. Also two months afterward from the end of this clinical trial the effect was more than placebo.

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Background&Objective: Abnormal BMI of mother and weight gain play very important role in the outcome of pregnancy. Several researches were done on the correlation between body mass index (BMI) and mother weight gain in pregnancy, and the complications in neonates, like low birth weight and prematurity and mother complications like preeclampsia. This study was performed in order to determine the correlation between body mass index and weight gain during pregnancy, maternal and fetal complications in patient admitted to Deziani hospital in Gorgan, Iran. Materials&Methods: This cross-sectional study was done on 350 pregnant women in Deziani hospital during a year (2002-03). Patients' information's like mother age, pre-pregnancy weight, weight gain during pregnancy and maternal-fetal complications (preeclampsia, PROM, preterm labor and macrosomia) were recorded. After coding, data were analyzed by SPSS and Chi-Square test was used for description. Results: In high BMI women, higher weight gain was seen than normal BMI women. Preterm labor was significantly related with pre-pregnancy BMI (P<0.05) but no relationship was seen between weight gain and preterm labor. PROM and birth weight were significantly related to pre-pregnancy BMI and weight gain during pregnancy (P<0.05). Preeclampsia has significant relationship with weight gain (P<0.05) but not with pre-pregnancy BMI. Conclusion: Abnormal maternal pre-pregnancy BMI and weight gain during pregnancy can complicate the delivery. Low and high BMI and weight gain during pregnancy can contribute with the complications in mothers and neonates.

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Background&Objective: The incidence of cesarean delivery has been increased during these years. Relations are reported between mother's educational level and knowledge about various delivery methods. This study was done to find the distribution of cesarean delivery in female doctors, dentists, nurses, midwives and specialists under 45-years-old had been working in Gorgan city, 2004. Materials&Methods: In this descriptive cross-sectional study, 187 women in medical fields were recruited. A questionnaire was filled for each of them which included demographic data, causes of the cesarean delivery, and causes of personal tendency to it. Data was entered in SPSS-10 and analyzed with X2 . Results: In our study 307 deliveries were occurred, and 49.8% was cesarean delivery. The most common cause of the personal tendency to cesarean delivery was feeling less pain. Cesarean percentage in doctors, midwives and specialist was significantly higher than nurses and dentists (P<0.05). Cesarean frequency was significantly higher in nulipars (P<0.05). Conclusion: These results showed that the frequency of cesarean delivery in health care workers is higher than the general population.

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Background and Objective: Placenta previa (PP) is a common cause of pri-partum bleeding leading to high mortality and morbidity in mothers and neonates. This study was conducted to determine risk factors and outcomes of PP in Golestan province of Iran. Materials and Methods: This case-control study was done on pregnant women admitted for deliverly to the Dezyani hospital of Gorgan, Iran during 2002-07. All PP cases were recruited as case group and 251 non-PP ones were entered into the study as control group. Student t-test and Chi-Square test were used to assess the relationship between variables. Results: In this study out of 33473 pregnant cases, 82 women (0.24%) had PP. The mean (±SD) age of mothers with PP was 28.5 (±6.2) years. There was a significant correlation between PP and delivery method (P<0.05). History of cesarean section was significantly higher in cases than controls (P<0.05). The prevalence of hysterectomy due to PP was significantly higher in women with history of cesarean section (24%) than other ones (5%) (P<0.05). Conclusion: We found a significant relationship between history of cesarean section and hysterectomy due to PP. Therefore, PP should be considered in women with a history of cesarean section.

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Background and Objective: Millions of women in the world use oral contraceptive pills (OCPs). On the other hand %16 to %19 of women suffer from migraine and many of them have tension headaches. These women may wonder whether the consumption of OCPs is harmful for them. This study carried out to determine the effects of combined low estrogen oral contraceptive pills on migraine and tension headaches. Materials and Methods: This case control study was done on 344 women which reffered to health care centers in Mashhad, Iran during 2009. Case group include 244 women which consumed oral contraceptive for at least three month. 100 women without OCPs consumption were considered as control group. The criteria of International Headache Society for migraine and tension headaches were used to diagnose headache. The severity and the frequency of headaches before and after the consumption of OCP were recorded. Data was analyzed by Chi-Square, Fisher exat, Logestic regresion and Wilcoxon tests. Results: The frequency of migraine headache was 5% and 6% in case and control groups respectively. This different was not significant (OR=0.88, 95%CI: 0.3-2.69, P=0.804). The frequency of tension headache in cases and controls was 12% and 10%, respectively. This different was not significant (OR=1.26, 95%CI: 0.56-2.86, P=0.055). Conclusion: This study showed that the consumption of OCPs, has no effects on the advent of migraine and tension headaches and do not increase the rate and severity of the attacks.

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Background and Objective: Anterior Cruciate Ligament (ACL) tear is One of the most common injuries at knee joint. Threshold of motion sense included inputs that are received by mechanical receptors at dynamic position. The objection of present study was to find the effect of functional brace on the Kinesthesia motion sense in patients with ACL rupture.

Materials and Methods: In this Quasi- experimental study, 20 patients with ACL tear, with aging range between 18 to 44 years old were recruited. Patients were selected in a simple non probability sampling manner. Using Continuous passive motion for testing the Kinesthesia motion sense, as a dependent variable. Data was analyzed with Paired t-test and Colmogrof-Smirnof tests.

Results: Threshold of motion sense at affected knee before and after bracing was 3.93±1.67, 4.45±1.86 in open eyes and 3.82±1.61, 4.13±1.96 in closed eyes (P<0.05).

Conclusion: This study showed that the functional brace did not play in important role in the improvement of threshold of motion sense in patients with ACL tear.

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Background and Objective: Carpal tunnel syndrome (CTS) is one of the most common disease among the entrapment neuropathies. The purposes of this study was to compare the efficacy of a new dorsal wrist splinting versus common palmar splinting for CTS based on sensory nerve conduction measurements. Materials and Methods: This single blind randomized control trial study was carried out on 22 idiopathic CTS patients. Subjects were randomly divided in two groups: Dorsal splint group (n=12) and palmar splint group (n=10). Both groups used splints for 4 weeks. Sensory conduction study of median nerve were done initially for having baseline and after 4 weeks follow up. SPSS-16 and Kolmogorov–Smirnov, independent T, and paired T tests were used for analysis of Data Results: After four weeks median nerve sensory distal latency and conduction velocity improved significantly in both groups (P<0.05). There was significant difference between both groups due to electro-diagnostic improvement. Conclusion: This study showed that based on electro-diagnostic method, dorsal wrist splint is more effective than cockup splint in carpal tunnel syndrome.

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Background and Objective: Sleep disurbance is considered to be one of the most common problems in menopausal women. Herbal supplements are being used as herbal supplemental medication to solve the problem. The aim of this study was to determine the effect of Sedamin capsule on sleep disorder among menopausal women. Materials and Methods: This randomized controlled trial study was done on 100 Menopausal women aged 50-60 with sleep disorder. Women randomly divided into intervention and contol groups. Subjects intervention group were received Sedamin capsule (530 mg Valerian root) twice a day for 30 days. Women in control group were received capsule (50 mg of carbohydrate) twice a day for 30 days. Demographic data form and Pittsburg sleep quality index was instrumented for the evaluation of disorder. Data analyzed with using independent T and ANOVA tests. Results: Mean score of sleep disorder peior and after intervention was 9.8±3.6 and 6.02±2.6 (P<0.05) in interventional group and 11.14±4 and 9.4±3.9 in controls, respectively. Also, 40% of the participants in the intervention group and 12% in the control group showed an improvement in the quality of sleep (P<0.05). Conclusion: This study showed that consumption of Sedamin capsule improves the quality of sleep in menopausal women with sleep disorder.

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Background and Objective: Research have been focused on the applying the chemical inducer for trans-differentiation the adult BMSCs into neural cell. So that, at the first should investigate the toxcity effect of the chemical inducer on the induced cells. Plasticity and easy accessibility of bone marrow mesenchymal stem cells is a unique charactristic for treatment of neural disorderies. This study was desgined to determine the inductive effect of Deprenyl and Dimethyl sulfoxide on proliferation and survival of the mesenchymal stem cells. Materials and Methods: In this experimental study, BMSCs isolated from the adult rat bone marrow and cultured in αMEM containing 10% FBS. Cell identity for surface antigens was performed in third passage by immunocytochemistry and multipotancy capacity of BMSCs was done by BMSC differentiation into adipocytes and osteocytes. The cells were exposed to chemical agents (a: the αMEM medium supplemented with 2% DMSO, b: the αMEM medium supplemented with 10^-8M Deprenyl) for 24 houres and then transferred to αMEM containing 10% FBS cell survival and proliferation was evaluated after the 24, 48, 72 and 96 houres by MTT [3-(4-5-Dimethylthiazolyl-2-y1)-2,5-diphenyltetrazolium bromid] test. Data were analyzed using SPSS-16, One-Way ANOVA and Tukey tests. Results: In addition to expression the surface antigens and adipogenic and osteogenic differentiation by BMSCs, MTT test results showed that proliferation and survival of induced-deprenyl and DMSO cells within 48, 72 and 96 hours after the induction was increased significantly than negative control group. Conclusion: Deprenyl increases survival and cell proliferation compared to Dimethyl Sulfoxide. It can be used as cell inducer.

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Background and Objective: The first carpometacarpal joint osteoarthritis reduced the ability of upper limb in elderly with subsequent disability in physical activities. This study was carried out to determine the effect of prefabricated and custom-made splints on quality of life in the first carpometacarpal joint osteoarthritis. Materials and Methods: This quasi-experimental study was done on 24 elderly (>60 years of age) patients with the first carpometacarpal joint osteoarthritis and 12 matched healthy subjects in Tehran rehabilitation University during 2010-11. Patients assigned randomly in two groups with 8 weeks treatment period, prefabricated thumb and custom-made splints. Persian version of The Short Form 36 quastioner (SF36) was used to assess the quality of life. Data were analyzed using SPSS-16 and paired t-test. Results: There were significant differences between osteoarthritis patients and healthy subjects in the quality of life according to SF36 score physical health problem (P<0.05), general health (P<0.05), limitations of activities (P<0.05), emotional health problem (P<0.05), social activities (P<0.05), pain (P<0.05), energy and emotions (P<0.05). Using splints significantly improved the quality of life of patients, but there was no significant difference between two splints in improving the quality of life. Conclusion: Prefabricated and custom-made

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Background and Objective: Epidermis is the outer layer of skin, regenerating continuously. Epidermal stem cells play important roles in tissue regeneration, scar regeneration and neoplasm formation.This study was displayed for the isolation and culture of interfollicular epidermal stem cells from newborn mouse skin without feeder layer. Materials and Methods: This experimental study was displayed on 0-3 old-day newborn NMRI mouse skin 60-70 gr weight. The epidermal keratinocytes were separated mechanically and enzymatically from 0-3 old day newborn mice skin (NMRI strain) and seeded on fibronectin-collagen culture substrates. Putative epidermal stem cells were selected by rapid adherence for 10 minutes on this composite matrix of type 1 collagen and fibronectin and the unattached cells were discarded and attached cells were cultured in essential minimal eagle medium (EMEM) (ca+2-free culture medium containing 0.05 mM Ca+2, 9% FBS, 50% conditioned medium, EGF (epidermal growth factor) and Cholera Toxin. The immunocytochemistry of β1-integrin analysis used to indicate their stemness nature. Results: The results indicated that rapid adherence yields 50% purity. By using this method, the stem cells have been subcultured continuously without any change in the cell properties. The isolated interfollicular epidermal stem cells, expressed epidermal stem cells special marker (β1-integrin) in high levels, which indicates stem cell nature. Conclusion: This new method yields pure viable epidermal stem cells that can be used in regenerative medicine and cell therapy.

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Background and Objective: Behavioral disorders among children and adolescents are common and incapacitating which cause many problems for the families and the patient themselves and associated with high prevalence of negative social consequences. This study was done to evaluate the prevalence of psychiatric disorders among children and adolescents in Gorgon, north of Iran (2019).
Methods: This descriptive-analytical study was performed on 1025 children and adolescents aged 6-18 years in Gorgan, north of Iran (2019). Subjects were selected by Multistage Cluster Sampling. Digital version of K-SADS test was studied for 24 types of child and adolescent psychiatric disorders. Sampling was done by trained psychologists, among general population and by referring to the house of people. Psychiatric disorders included mood disorders, behavioral disorders, neurodevelopmental disorders, substance abuse disorders, and elimination disorders.
Results: The prevalence of psychiatric disorders among children and adolescents was 13.2%. This prevalence was 14.3 % and 12.1% in males and females, respectively. According to age groups, The prevalence of psychiatric disorders was common in 6 to 9 years olds with 17.8% which in comparison with other age groups was significant (P<0.05). Eliminatory disorder with 6.1% was the most common illness followed by behavior (6%), tension disorders (4.8%) and neurodevelopmental disorders (3.3%).
Conclusion: The prevalence of psychiatric disorders among children and adolescents in this area is in a median range compared to other domestic and overseas.

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Background and Objective: Obesity considered to be one of the major health problems and risk factors of a wide range of diseases including diabetes, cardiovascular diseases, blood pressure and various types of cancer. This study was performed to compare the effectiveness of integrated group psychotherapy and cognitive-behavioral stress management on body image and mindful eating of obese women.
Methods: In this clinical trial study, 45 obese women were randomly divided into three groups including integrated group therapy (first intervention), behavioral-cognitive stress management (second intervention) and control groups. All of the three groups fulfilled a pretest but the control group did not receive any intervention. Intervention groups received nine sessions of therapy. Data were collected through questionnaires of body image and mindful eating.
Results: Reduction in worry in body image and mindful eating were observed in integrated group therapy and behavioral-cognitive stress management (P<0.05). However, the difference between mean values of body image and mindful eating scores in behavioral-cognitive stress management and integrated groups were 0.852 and 22.93, respectively which was not significant.
Conclusion: Integrated group therapy and cognitive-behavioral stress management was shown to have an effect on the body image and mindful eating in obese women.

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Background and Objective: Anxiety disorders are one of the most common psychiatric disorders in childhood. Some studies have identified the household dimension as an important factor in causing these disorders. However, no convincing results have been achieved. The aim of this study was done to determine the frequency of anxiety disorders among of 8-12 years old children in families with single and multiple children.
Methods: This descriptive-analytical study was performed on 732 children (343 boys and 389 girl) referred to Taleghani hospital (except than psychiatric clinic) and offices of pediatricians in Gorgan, north of Iran during 2017. Subjects were recruited using available sampling method. Demographic questionnaire and Spence Anxiety Scale (SCAS) were completed. Variables including separation anxiety, social anxiety, general anxiety, panic attack, agoraphobia, obsession and compulsion, fear of physical damage were evaluated.
Results: In all anxiety subgroups except general anxiety, mean scores were significantly higher in children with multiple children than single children (P<0.05).
Conclusion: This study showed a high prevalence of anxiety disorders in multi-child families compared to single-child families.

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Background and Objective: Chronic hypertrophy of tonsils and adenoids is the most prevalent cause of sleep apnea in children, leading to multiple behavioral disorders. Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder caused by adverse biological, social and psychological conditions. This study aimed to evaluate the effect of adenotonsillectomy on ADHD symptoms in children with adenotonsillar hypertrophy before and six months after the surgery.
Methods: This descriptive-analytical study was performed on 37 children with adenoid hypertrophy in Gorgan, north of Iran during 2018. The data gathering tool was a two-part questionnaire; the first part contained personal data (age, gender), and the second part included the strengths and difficulties checklist. Patients were placed in three groups of hyperactivity, inattention and impulsivity based on 18 criteria of Diagnostic and Statistical manual of Mental disorders. The questionnaires were completed directly by the project performers. Information was collected from the parents. The strengths and difficulties questionnaire (SDQ) was used to assess children before and six months after the adenotonsillectomy surgery.
Results: The average and standard deviation of scores in subscales of emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems and prosocial behavior were improved, also a significant difference was observed between SDQ scores before and after adenotonsillectomy (P<0.05).
Conclusion: Adenotonsillectomy can significantly reduce the SDQ score. Therefore, in children with hyperactivity, a medical disorder such as adenoid hypertrophy can cause the onset, exacerbation and persistence of the disease. Proper treatment can be a major factor in controlling the severity of symptoms and even in improving the patient’s recovery.

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Background and Objective: Psoriasis is one of the most common inflammatory skin diseases. About 37 to 50% of patients report exacerbation of symptoms following psychological stress. This study we done to determine the frequency of personality disorders in psoriatic patients in north of Iran.
Methods: This descriptive-analytical study was performed on 128 psoriatic patients referred to the dermatology clinic of Sayyad Shirazi Hospital and private clinics in Gorgan, north of Iran during 2019. Firstly severity of psoriasis was determined based on the PASI score (PASI: Psoriasis Area and Severity Index). Then, personality disorders were assessed using the Millon MCMI-III multivariate questionnaire.
Results: The mean age of psoriasis patients was 40.84±12.91 years and the duration of the disease was 8.87±y7.62 ears.72.7% of patients were females. The prevalence of most personality disorders was histrionic (22.7%), depressive (6.3%) and obsessive-compulsive personality disorder (3.1%), respectively. There was a significant relationship between histrionic personality disorder, which was the most common personality disorder, with disease severity, education level and type of treatment (P<0.05). There was significant relationship between depressive personality disorder and level of education, gender, occupation and ethnicity (P<0.05).
Conclusion: The most common personality disorder in psoriatic patients was histrionic personality disorder.

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Background and Objective: Inflammatory bowel disease (IBD) is a common gastrointestinal disease which is associated with psychosocial factors. IBD is a gastrointestinal disease with chronic recurrence and with an uncontrolled immune response. There is no definitive treatment for IBD and treatment is based on management of inflammatory response during relapse and maintain of recovery. This study was conducted for evaluation of anxiety and depression disorders in patients with IBD in Golestan province, north of Iran during 2017.
Methods: In this descriptive-analytical study, 117 patients (67 women and 50 men) aged 17-75 years with IBD registered in IBD bank in Golestan Research Center of Gastroenterology& Hepatology (GRCGH), north of Iran during 2017. Diagnosis was made by conventional endoscopy, radiology and histological criteria. Demographic information including age, sex, race and marital status, time of diagnosis until now and duration of treatment are recorded. Hospital anxiety and depression scale (HADS) were used for determine depression and anxiety in these patients.
Results: 80.3% ulcerative colitis and 19.7% Crohn's disease was observed in patients. The mean of total anxiety score in the group with Crohn's disease was higher than ulcerative colitis but there was no significant difference. Total score of depression was similar and not significant in both groups. There was a significant statistical relationship between marital status and anxiety in patients with ulcerative colitis only (P<0.05). As borderline and suspicious status of the patient in married patients is 42.4% and in single patients is 33.3%. Abnormal anxiety state was 31.8% in married patients and not seen in single patients. A positive and significant correlation was seen between total anxiety scale and total depression scale in patients with ulcerative colitis (correlation index: 0.657, P<0.0001) and in patients with Crohn's disease (correlation index: 0.644, P<0.001). Therefore in these patients, if depression increases, anxiety was also increasd. Anxiety observed in 29.8% and 26.1% of ulcerative colitis and Crohn's disease, respectively. Depression disorders observed in 18.1% and 8.7% of ulcerative colitis and Crohn's disease, respectively.
Conclusion: This study showed that the level of anxiety and depression in patients with inflammatory disease is very high.