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Background and Objective: The association between discordant growth and the complication of twin pregnancy has been recognized for more than 30 years. Recent publications have presented evidence that 30% or even 40% discordance presents the threshold for significant. Our purpose was to define twin growth discordance on the basis of perinatal outcome and other factors like maternal age pariety and systemic disease. Materials and Methods: Twins delivered at age more than 32 week’s gestation between 1998-2000 at Deziani Hospital Gorgan was identified. Birth weight, pre-term birth, maternal age pariety and systemic disease and sex of Twins recorded. Discordance was calculated as: 100×larger BW-smaller BW/larger BW. Results: The mean discordance for 435 twins was 8.18±6.79, 96.4% of pre-term birth associated with discordance?20%. 10.6% of mothers had a systemic disease and mean discordance in twins term and pre-term of normal mothers was 5.8±4.5, 7.9±6.3 and in systemic disease was 9±9.2, 11.1±8.8 (P?0.008). There were no differences in pariety age and sex. Conclusion: Twin birth weight discordance had now clearly been demonstrated to be a risk factor for pre-term birth. The effect was found particularly with discordances?20% after 32 week’s gestation.

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Background & Objective: Neural tube defect is one of the most important malformations of the newborns. The aim of this study was to investigate the rates of NTD, anencephaly, spina-bifida cystica, encephalocele and the relation of these abnormalities with sex, ethnicity, mother’s age and consanguineous marriage in north of Iran (Gorgan). Materials & Methods: A cross-sectional study was done on 26280 birth in Dezyani Hospital in Gorgan during 1998-2001. Results: This study has showed that, the NTD rate was 3.08, 2.78 and 3.38 per 1000 in total, males and females, respectively, female to male ratio was 1.31. The rate of spina-bifida, anecephaly and encephalocele were 1.48, 1.48, 0.11 per 1000, respectively. In regard to different races, the rate was 6.78/1000, 4.76/1000 and 2.41/1000 among Turkmans, Systani and native Fars, respectively (P<0.05). The rate of NTD in the mothers under 20 years was 2.29/1000, in 20-34 years was 3.37/1000 and over 35 years was 2.54/1000. Interstingly, 29.6% of parents with affected newborns had consanguineous marriage. Conclusion: We concluded that there is a higher rate of NTD in this, area, that it might be due to race-ethnicity variations.

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Background & Objective: Fetal weight and gestational age are important factors in evaluation of neonatal safety and basic prediction factors in outcome of pregnancy and satisfactory criterion in decision of management in obstetrice and neonatalogy. Therefore finding a method for pridiction of fetal weight is critical. The present study employs, detect on value of Janson's formula in prediction of fetal weight. Materials & Methods: In this analytic study, 223 pregnant women who had a safe, live, singleton fetus, with cephalic presentation were admitted to labor ward at Dezyani hospital. Medical or obstetrical complication was excluded. Subjects selected by purposive sampling. For collecting data: First, using the same flexible tap measure calibrated in centimeters by using this tap, the fundul height was measured. The fundual height was also taken in Janson's formula and estimated weight was also calculated each cases. The actual weight of post delivery was measured immediately. Data analysis was done by correlation test paired T-test. Results: This study shows mean estimated fetal weight (3730±546) were higher than the actual birth weight (3270±429). Conclusion: This study indicates that Janson's formula is not a good way to estimate fetal weight.

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Background & Objective: Approximately one-third of the world’s population is infected with Mycobacterium Tuberculosis (TB), which is a indicator of high distribution of these bacteria in our environment. The only vaccine currently available against TB is the attenuated Mycobacterium Bovis strain bacillus Calmette-Guerin (BCG), which used regularly for many years to prevent the Tuberculosis in Iran and many part of the world. The efficiency of this vaccine varies in different populations, and is a matter for discussion. On this basis, the present study has been set up to determine the level of Tuberculin reaction in 4.5 months and in 7 years old children that receive BCG vaccine at birth time, in Golestan province. Materials & Methods: 2700, 4.5 month infant and 2400, 7 years old children in Golestan province were chosen by cluster sampling after the proper permission from the parents, public health centers and educational authorities were taken. The presence of the BCG scar were assessed, and 0.1 ml of 5 tu Tuberculin were injected subcutaneously. The induration was measured 48-72 h after Tuberculin injection. The results were determined as present and compare with T-test. Results: In these study 2559 infants and 2193 child were taken part in the final evaluation. The BCG scar were present in 97.9% of infants and 87.8% of 7 years children, this difference was meaningful. The average induration in 4.5 months babies were 2.29 mm, and in 7 years child was 0.66 mm, this difference was significant (P<0.05). More than 44.7% of babies and 82% of 7 years children didn’t show any reaction after PPD test, this difference was also significant (P<0.05). Conclusion: The level of positive Tuberculin reaction in infants of this province in spite of vaccination was very low, and this level was reduced after 7 years time, this indicate that BCG vaccination at birth did not have any major role in positive Tuberculin reaction. Our results also indicate that the presence of scar can be a good indicator for previous vaccination. In regard to the negative Tuberculin reaction in majority of babies, it is suggested to evaluate the efficacy of BCG vaccine in preventing the TB disease itself, by other method such as studying the TB incidence among children in long term or by determination of cytokines level after Tuberculin injection.