---

Vulvar mass is not a common problem in youngester and adults. The common complains are such as, vaginal impairment, infections, trauma, and rape. One of the rare vulvar mass has been presented in this case report. The mass was totally removed and was sent to the pathology department for medical examination. The diagnosis of neurofibromatose was confirmed by the laboratory results.

---

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.

---

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

---

Background and Objective: Due to high prevalence of pre-menstrual syndrome (PMS) and pre-menstrual dysphoric disorder (PMDD) and its effect on the educational, professional activities and familial behaviors, this study was conducted to determine the prevalence of clinical manifestations of pre-menstrual syndrome and pre-menstrual dysphoric disorder in medical students. Methods: This descriptive-analytic study was done on 162 female medical students of Golestan University of Medical Sciences in Gorgan, Iran during 2010. Demographic characteristics and PMS and PMDD clinical manifestations questionnaire based on DSM-IV-TR and ACOG criteria was filled for each subject. Results: Mean age and menarche age of subjects was 22.2±2.5 and 13.3±1.2 years, respectively. 145 students (89.5%) were single. 57.4% and 22.8% of participants fulfilled the criteria of PMS and PMDD, respectively. The most frequent affective and somatic symptom was lethargy and fatigability (57.4%) followed by sensation of bloating and weight gain (45.7%). The lowest frequent somatic and affective symptoms were dyspnea (8%) and insomnia (1.2%), respectively. There was significant correlation between the prevalence of PMDD and chronical and menarche age (P<0.05). Conclusion: Pre-menstrual syndrome is a prevalent disorder in medical students of Golestan University of medical sciences in Iran.

---

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.

---

Background and Objective: For many reasons, having children with the desired gender has long been a concern for human societies. Some studies have shown the effect of a maternal diet pregnancy on gender ratios. Considering that during the holy month of Ramadan, women's diet is undergoing a major change, and studies about the association of such diet change, especially the mother's fasting, on the gender of the fetus are rare and the results have contradictory; the present study, was conducted, to investigate the relationship of mother's fasting in the follicular phase of the last menstrual cycle and gender of newborn.
Methods: This descriptive - analytical study was conducted on 139 pregnant women who had started their last menstrual period before their pregnancy during Ramadan and referred to midwifery clinic of Sayyad Shirazi hospital or health centers in Gorgan city for prenatal care in 2016 and 2017. The data collection tool was a checklist containing the demographic characteristics of the pregnant mother, date of the last menstruation, gestational age, number of pregnancy and days of mother fasting.
Results: 86 pregnant women (62 %) were fasting and 53 non-fasting (38%). Frequency of newborn's gender in pregnant women who were fasting was 43 boys and 43 girls and in non-fasting women were 35 and 18, respectively. The frequency of boys in non-fasting mothers was higher than girls but this difference was not significant. In analysis of simultaneous effects of variables on baby's gender, none of the variables were statistically significant with the newborn's gender. Variables such as the number of pregnancies (P=0.051) and maternal fasting (P=0.083) non significantly reduced the ratio of boy born to 30%.
Conclusion: There is no relationship between gender of babies and mother's fasting in the follicular phase of the last menstrual cycle.