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Background & Objective: The burden of psychiatric disorders in the developed countries has been identified by the screening questionnaires and standard clinical interviews at a high level, but the epidemiological studies of psychiatric disorders in our country are brief and their numbers are few. Providing essential mental health services to the people requires us to be knowledgeable about the present status of psychiatric disorders in the society. The objective of their research was to carry out the epidemiological study of the psychiatric disorders in the 18 years and above individuals in the urban and rural areas of Golestan province. Materials & Methods: 518 individuals selected through randomized clustered and systematic sampling methods from among the existing families of Golestan province and the schedule for affective disorders and Schizophrenia (SADS) questionnaires completed by the clinical psychologist. The diagnosis of the disorders was based on DSM-IV classification criteria. Results: The results of the study showed that the prevalence of psychiatric disorders in the province is 14.69%, which was 18.14% in the women, and 11.47% in the men. The mood and affective disorders respectively with 7.93 and 4.05% had the higher prevalence in the province. The prevalence of psychiatric disorders in this study was 0.97%, neuro-cognitive disorders 1.16% and dissociative disorders 0.58%. In the group anxiety disorders, panic disorder with 4.05% of had the higher prevalence and in the group of affective disorder, major depression, hypomanic and manic disorder with 1.93. Conclusion: This study showed that 7.53% of individuals that were studied suffered from at least one of the psychiatric disorders. The prevalence of psychiatric disorders in the province among the individuals in the age group of 41-55 years with 13.04%, separated or divorced individuals 50%, residents of urban areas 11.03%, illiterate individuals 12.75% and housewives 13.04% was more than other individuals in the sample. Being aware of this matter reveals the responsibility of the health policy makers and programmers, prevention, treatment and medical education more than before in relation to preparing application and executive plans in Golestan province for mental health.

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Background&Objective: Low back pain (LBP) is common in youth, although `associated with chronic pain in adults. The purpose of this study was to determine the prevalence and risk factors of LBP in school children age 11-14. Materials&Methods: A cross sectional study was carried out on school children aged 11-14 in north of Iran. Using random multistage sampling 5000 children were selected. Demographic, mechanical and lifestyle data as well as the prevalence and LBP characteristics were collected by a questionnaire. Data analysis was carried out using SPSS (version11) software. Results: Of the original sample, 4813 (96.2%) children returned the questionnaire. Point, last month, last 6 months and annual prevalence were 15%, 14.4%, 15.6%, and 17.4%, respectively. LBP was significantly correlated with age (p<0.05), lifting (p<0.05), position and duration of watching TV, doing homework and duration of exercise (p<0.05). Conclusion: The results indicated that the prevalence of LBP in school children is relatively high. Further studies evaluating the effect of different preventive strategies to reduce the prevalence of LBP in school children is strongly recommended.

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Background & Objective: Burning is a general health problem and is also a global injury as well as a very serious sanitary issue in industrial and developing countries. In its severe form, burning can claim lives. It seems essential in every society to analyze burning, to study the causes of burning, treatment outcomes and the death rates, etc. to find proper preventive measures. Materials & Methods: In this cross-sectional study, the medical records of all patients who were hospitalized and finally deceased during the years 2002 and 2004 in Zare' teaching hospital, Sari, were examined. Some variables including the age span average, the degree and percentage of burning, patients' residence, gender, the cause of burning (i.e. boiling water, fire, acids and explosives), average hospitalization period, surgery and also the abundance of self – burning attempts were examined. Results: This study indicate that during these 3 years the total number of those who died from burns was 506 (23.4%). The residential places were in Mazanderan province (41.7%), Golestan province (41.4%), and Gilan province (10.2%). The abundance of burning ranges as below: The 2 and 3 degree of burning at 91.8%. Regarding the percentage of burns, 31.7% of abundance pertains to burning at 90% and more. The greatest external causes leading to burns are petrol, gas, and gas oil at 57.9%. Also, the percentage of burns does not have much influence on death rate among 50 – year – olds and older people. Conclusion: This study indicated that the importance of death between burned patient in special sex and age. To establish hospitals, some issues must be considered as: distance, transportation, route dangers, characteristics of area, existing epidemiological survey, and finally the epidemics and event statistics.

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Background and Objective: Treatment of the femural shaft fracture is imporoving. The aim of this study was to compare the outcome of Dynamic Compression Plating (DCP) and intramedullary nailing in the femural shaft fracture. Materials and Methods: This clinical trial study was done in orthopedic department of Shahid Kamyab Hospital in Mashhad – Iran during 2002-03. 40 patients with open fracture of femur divided into two groups. One group was treated by dynamic compression plate and the other group by intramedullay nailing. Follow-up time was 9-14 months. Results: Out of 40 patients, 75% were male. The time of clinical and radiological bone :::::union::::: was the same in both groups. There was 4 implant failure in the plate group (P<0.05). There was one deep infection in the intramedullary nailing group. Conclusion: This study showed that there is no difference between plate and intramedullary nailing group according time of bone :::::union:::::. But because of 4 implant failure in DCP groups, intramedullary nailing is recommended for femural shaft fracture.

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Background and Objective: Helicobacter pylori (H.pylori) with positive Cytotoxin associated Gene A (CagA) have higher potential for pathogenesis. Cytotoxin associated Gene A (CagA) accelerate the pathogenecity of bacteria due to cytotoxin production stimulation. The aim of this study was to determine the prevalence of the anti-CagA antibody among H. pylori infected persons in Golestan province-North of Iran. Materials and Methods: This descriptive study was carried out on 676 H. pylori positive subjects in Golestan province, northern Iran during 2008. Anti CagA antibody were determined in H.pylori positive subjects. Data analyzed by SPSS-16 software and chi-square test. Results: Prevalence of anti CagA in Helicobacter pylori infected cases was 57.7% (390 cases: 179 males and 211 females) (95% CI: 53.9-61.4). According to age the highest and lowest cases of anti CagA antibody were seen in, 15-24 (63.4%) and under 5 years old (26.3%). The level of anti CagA antibody in Sistanian ethnicity group (67.2%) was more than other ethnic group. Anti CagA antibody in Rural area was more than urban regions. Sero prevalence of anti CagA antibody was highest in Minudasht twon (78%), located in East of province in comparison with Bandar Gaz (44%) in west of province. Conclusion: This study showed the prevalence of CagA positive Helicobacter pylori strains in this region is similar to other regions of Iran, Asia and Europe and higher than African population.

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Background and Objective: Open fractures mostly appear in leg (24%), and often accompany with soft tissue defects that predispose the limb for amputation. One of the best ways for limb salvage is to support both bone and soft tissue by the means of soft tissue reconstructing surgeries. The aim of this study was to evaluate the outcomes of soft tissue reconstruction surgeries in legs open fractures. Materials and Methods: This descriptive study was performed on 59 patients with leg open fractures and soft tissue reconstruction surgery at Shahid Kamyab hospital in Mashhad, North-East of Iran during 2004-05. Individual characteristic, clinical and physical examination, and outcome of the surgery were gathered in a questionnaire and analyzed by descriptive and Chi-Square test. Results: Eight patients excluded and finally the study was done of 51 patients. Out of 51 patients 84.3% were male with mean age of 30 years. Leg open fractures in 76.5% of patients was IIIB type. Surgery was successful in 76.5% of patients. Delayed ::::union:::: occurred in 56.9% and osteomyelitis in 33.13% of patients. There was a correlation between the time of soft tissue reconstruction and ::::union::::, deep infection and osteomyelitis (P<0.05). Conclusion: This study showed that high frequency of deep infection, osteomyelitis and delayed ::::union:::: due to leg open fractures with lack of soft tissue.

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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: Ecstasy [3,4 Methylendioxy Meth Amphetamine (MDMA)] exerts destructive effects on body organs particularly on the nervous system. The current study was carried out to measure the adverse effects of MDMA on hepatocyte and liver-specific enzymes. Materials and Methods: In this experimental study, 50 male Wistar rats were randomly divided in equal numbers into 5 groups: control, sham, experimental 1, 2, and 3. Animals in the experimental groups were received, intraperitoneally 2, 4 and 8 mg/kg of MDMA, respectively. The sham group were received normal saline but the control group was not subjected to any injection. Serum samples were collected and levels of three enzymes under study: alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were measured. The sections from the liver tissue were prepared counting the hepatocytes. Data were analyzed using SPSS-16 and One-way ANOVA and Tukey's HSD tests. Results: Data indicated the levels of all three enzymes had been elevated in the animal groups that received MDMA and that the increase was statistically significant compared to sham and control groups (P<0.05). Also, in experimental groups the number of hepatocyte were reduced in comparison with controls (P<0.05). Conclusion: This study showed that the MDMA significantly increased ALT, AST, ALP and reduced the number of hepatocytes and these effects are dose depended.

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Anomalous coronary artery origin is a rare clinical entity with varied clinical outcomes ranging from asymptomatic to sudden cardiac death. The incidence of anomalous origin of left coronary artery arising from the right coronary cusp is 0.3-1%. CT angiography is the choice method for coronary anomalies, but often coronary angiography in RAO (right anterior oblique) view shows the coronary course. We present a case that referred to our hospital with post myocardial infarction angina for coronary angiography. A resting 12-lead electrocardiogram showed ST-segment elevation in leads v2, v3, v4. A transthoracic echocardiogram indicated LVEF 25% (Left ventricular ejection fraction), septal akinesia and apical dyskinesia. Coronary Angiography showed an anomalous origin of the left coronary artery from the right coronary cusp and significant stenosis in LAD (left anterior descending) and LCX (left circumflex) arteries with poor run off.

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Background and Objective: Leishmaniasis is one of the main Zoonotic Vector-Born disease which is transmitted by sand flies to human and animals. This study was carried out to determine the ecological characteristics of sand flies in Golestan province, North of Iran. Materials and Methods: In this descriptive study, 3 villages in Aliabad Katul district in north of Iran were selected according to rural geography distribution and positive detected samples of human infection during 2010-02. Sand flies were collected by sticky traps. Three places were sampled in each village and in indoor and outdoor places 10 traps were installed. Sand flies were collected and their species was determined. Results: Totally 299 sand flies (160 from indoors and 139 from outdoors) were collected and consequently, 7 species of sandflies were identified including 4 species of phlebotomus genus and 3 species of Sergentomiya genus Ph.papatasi (55%) and S.sintoni (51%) were predominant species in indoor resting places and outdoor places, respectively. Sand flies seasonal activity extended from mid May through early October. Sand flies had one peak of activity in early August. Among the detected species, S.hodgsoni reported for first time from Golestan province. Conclusion: Ph.papatasi was recognized as predominant species in Aliabad Katul district, Golestan provincein northern Iran.

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Background and Objective: Failure of tuberculosis (TB) treatment is a major problem of health systems in developing countries. This study was done to identify the Risk factors of tuberculosis treatment failure in the Sistan and Bulochestan province, the high risk region in South-East of Iran. Methods: This case – control study was carried out on 52 tuberculosis patients (smear -positive and category- I therapy) treated during six months period. Patients with treatment failure were considered as cases and patients with negative smear after 6 months of treatment with anti-tuberculosis (TB) medicines were considered as control group. Demographic, clinical and treatment outcomes were recorded for each patient. The multivariate logistic regression was performed to determine the predictors of treatment failure. Results: Family history of tuberculosis (95% CI: 1-12.56, OR=3.55, P=0.04,), smoking (95% CI:1.58-51.21, OR=9, P=0.01), drug addiction before or during the treatment period (95% CI: 5.28-123.91, OR=25.6, P=0.0001) and low body weight (95% CI:1.05-12.6, OR=3.65, P=0.04) were risk factors for treatment failure. Conclusion: Family history of tuberculosis, weight loss during treatment, smoking and drug addiction, were considered as risk factors for treatment failure in National Tuberculosis Control Programme (NTCP) in south-east of Iran.

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Background and Objective: Kawasaki disease is the common acquired heart disease in children. Kawasaki disease is a vasculitis that predominantly affects the medium-sized arteries, with a striking predilection for the coronary arteries. This study was done to determine the relationship between coronary aneurysm formation and neutrophylia, in childern with Kawasaki disease. Method: This descriptive – analytic study was done on 80 children (45 Males, 35 Females) with typic and atypical Kawasaki disease in Afzalipoor hospital, Kerman, Iran during 2011-13. According to transthoracic echocardiography, patients were divided into childern with and without coronary aneurysm. CBC count, ESR and Peripheral blood smear was performed for each subject. Results: White blood cells, neutrophils, platlets and ESR in childern with coronary aneurysm, was non- significantly more than without aneurysm. Duration of fever in chidern without aneurysm was non-significantly more than childern with coronary aneurysm. Conclusion: Neutrophils counting by itself is not sufficient critria for the prediction of the aneurysm risk in kawazaki disease.

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Acute necrotizing encephalopathy (ANEC) is a rare illness with high incidence in East Asia. It is accompanied with respiratory infection, gastrointestinal infections, and high fever with quick impaired consciousness, and convulsion. In this case report, Turkmen 6 month's girl that was introduced after an infection with no disease or clinical abnormalities. She was vaccinated accordingly; initially she had fever with generalized tonic-clonic convulsion (seizures) for 5 to 10 minutes level of consciousness decreased later on. She was transferred to Talghani Medicat Education center in nortern Iran. At the time of admition her vital signs were as below: RR: 30, GCS: 8-9, RP: 110, BP: 90/80. In the patient's history, there was neither Trauma history, nor food or drug poisoning, also no clinical history. After convulsion, the level of consciousness decreased and serum biochemistry showed normal electrolytes concentration. In further follow - up, AST increased to 98 units, ALT to 58 units, and ammonium to 215 units. In CSF Sample, protein level increased to 330 units, without any avidences of pleocytosis, blood, or Serum glucose drop. In CT without contract, hypodensity the cornea in thalamus and caudate cores were seen in 2 sides. The ventricles were normal and there were no signs of bleeding and pressure. In brain M.R.I, abnormal signal in 2 sides, blood samples cultivation, CSF, and testing urine for bacterial infection were negative. The patient was diagnosed with necrotizing encephalopathy and subsequently was treated with metyle prednisolone (20 mg daily). During hospitalization, level of consciousness increased and fever stopped. There was not recurrence of convulsion, but the patients still had some problems in moving, verbal and communication.

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Background and Objective: Individuals habit has been changed due to technology improvement as a result fast food consumption has dramatically increased in Iran. This study was done to determine the effective factors on Fast food consumption among high-school students based on planned behavior theory.

Methods: This descriptive-analytic, cross-sectional study was conducted on 500 high-school students in Aliabad city in Golestan province in north of Iran in one year study from October 2014-2015. A valid and reliable researcher-made and self-administered questionnaire based on TPB constructs (including attitude, subjective norms, perceived behavioral control and behavior intention) was utilized to collect the data.

Results: The frequency of fast food consumption was 4.01 per month and hamburger and pizza were the most prevalent fast foods. TPB explained fast food consumption behaviors with relatively high R2 around 0.65, effectively. Frequency of fast food consumption was significantly associated with behavioral intention and subjective norms (P<0.05).

Conclusion: As friends are the effective subjective norm for student fast food consumption therefore, they must specifically be considered in developing beneficial educational interventions.

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Background and Objective: Gastric cancer is the most common cancers worldwide. The survivin gene which encodes an apoptosis protein inhibitor plays an important role in maintenance and integrity of the gastric mucosa. The gene is necessary for the normal physiologic function of the stomach, but its expression increases in gastric cancer. Regarding with the role of polymorphisms of the promoter region in genes expression, this study was done to determine the association of single- nucleotide polymorphism (rs9904341) -31C/G in promoter survivin gene with risk of gastric cancers.
Methods: In this case-control study, 101 patients with gastric cancer and 101 matched age and gender healthy subjects as the control were examined by PCR-RFLP technique.
Results: Genotype CC was significantly increased the risk of gastric cancer up to 2.4 folds (95% CI=1.03–5.61, P<0.04) and allele C, as risk allele, significantly increased the risk of gastric cancer up to 1.5 folds (95% CI=1.02–2.30, P<0.03). Also, CC + GC genotypes significantly increased the risk of diffuse type of gastric cancer by 4.4-fold (95% CI=1.30-15.10, OR=4.4, P<0.01).
Conclusion: This study showed that single- nucleotide polymorphism (rs9904341) -31C/G in promoter survivin gene significantly increase the risk of gastric cancers.

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Background and Objective: Prolonged hospitalization lead to considerable financial burden for patients as well as health care system. This study aimed to identifying important factors resulting in excess hospitalization days in patients undergoing abdominal surgeries using the multilevel zero-inflated Poisson regression model.
Methods: In this descriptive - analytic study, 485 patients from five teaching and private hospitals in Shiraz (southern Iran) were selected based on convince sampling method. Multilevel zero-inflated Poisson regression model was used to determine the risk factors of excess hospitalization day. Maximum likelihood method was used to estimate parameters of the model. Moreover, Akaike Information Criterion (AIC) and Bayes Information Criterion (BIC) indices were applied to assess the goodness of fit of the model.
Results: The primary analysis of data showed that 81.2% of the patients did not undergo excess hospitalization days. Based on findings, age, respiration rate, blood infusion, fever, smoking and drug abuse did not affect excess hospitalization days. In contrast, gender, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days (P<0.05). Laparoscopic gallbladder removal, prostate surgery increased the chance of excess of hospitalization days to 4.64 and 9 times, respectively (P<0.05).
Conclusion: Geder, renal diseases, operation history, laparoscopic gallbladder removal, prostate surgery and ileus significantly led to excess hospitalization days.

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Background and Objective: Environmental hazards are one of the most important threats to human health. The dramatic increase in population and new lifestyles has led to a variety of environmental problems and outbreaks of illness. This study was conducted to determine the attitude and knowledge in environmental behavior of citizens of Gorgan city, north of Iran.
Methods: This descriptive-analytic study was carried out on 400 people (209 men and 191 women) in Gorgan citizens in northern Iran during 2017. A multi-stage sampling method was used to select the samples. The city of Gorgan was divided into 3 categories according to urban divisions, and the neighborhoods within the classes were considered as clusters. 40% of the neighborhoods were randomly assigned to each study. The instruments used for collecting data were demographic questionnaire and knowledge, attitude and environmental behavior questionnaires.
Results: The level of environmental attitudes and environmental knowledge of the citizens was poor and their Pro-environment behavior was highly valued. Persons with higher age, higher education and level of employment had better environmental behaviors (P<0.05). There was a significant and inverse relationship between environmental attitude and environmental behavior (P<0.05). Increasing
bio-environmental knowledge led to an increase in bio-environmental behavior (P<0.05).
Conclusion: The level of knowledge and environmental attitude of Gorgan citizens was weak and their pro-environmental behaviors were strong.

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Background and Objective: Leishmaniasis is one of the most important vector-borne diseases which transmitted by sand flies to humans and other animals. This study was conducted to determine the effect of wild rodents control in decreasing zoonotic cutaneous leishmaniasis (ZCL) in Golestan province, north of Iran during 2016.
Methods: In this descriptive-analytic study, rodent control operation was conducted using Zinc phosphide 2.5% in May, July and September 2019 in 45 villages of Gonbad Kavous County in Golestan province, north of Iran during 2016. The stages of operation in each of the villages were scored, as we considered 25 score for each stage of destruction of nests (one stage) and baiting in nests (three stages). Also, incidence rate which is reported in each of the villages was extracted. Finally, the relationship between rodenticide scores in each village with the incidence of disease was compared.
Results: There were rodent’s active burrows around 45 villages. After the end of rodents control operation, 17 villages got 0-25 scores, 8 villages 26-50, 16 villages 51-75 and 4 villages 76-100. The mean incidence rate in these villages was determined 3466.9±2473.5, 2828±1929.1, 4515.4±3478.4 and 636.3±546.6, respectively. There was a significant relationship between the implementation of  rodents control operation and incidence rate of ZCL, so that in villages with a score of between 76-100, the incidence rate was significantly lower than in the villages with a score of between 51 -75 and 26-50 (P<0.05).
Conclusion: Regarding the reduction of the incidence of cutaneous leishmaniasis in villages with high scores in Gonbad-e Kavus County, north of Iran, the implementation of rodents control operation seems to be necessary.

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Background and Objective: Nosocomial infection is a major challenge in health care system. In fact, it is regarded as one of the risk factors in hospitalized patients. The aim of this study was to determine the antibacterial effect of silver nanoparticles (AgNPs) nursing gowns on geram – positive bacterial.
Methods: This descriptive and analytical study was done on 200 nurses gowns were surveyed in two hospitals of Sirjan city in Kerman Province cenral area of Iran. At first, the antimicrobial activity of silver nano fabrics on Staphylococcus aureus bacteria was confirmed by examining the optical density OD (0.325) medium. Sampling was gathered into the two modes, before using nano gowns and after using nano gowns by using wet sterile swabs. The samples collected were cultured and the formations of colonies were examined and biochemical tests were used to identify isolated bacterial.
Results: The most commonly isolated gram- positive bacterial from normal gowns were Staphylococcus epidermidis (43%) and the lowest pathogen was Streptococcus (1%). In these hospitals, after using nano silver gowns, the amount of microbial load on the clothes were determind zero.
Conclusion: This study showed that gram- positive bacterials of nursing gowns after contact with silver nanoparticles were eliminated.