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The amount of stainable Iron in the bone marrow is frequently used as a means of assessing Iron stores. In our study marrow Iron assessed in needle biopsy sections and simultaneously obtained aspirated smears from 75 patients. Significantly different amounts of stainable Iron were observed in needle biopsy and aspirated smears in 53.3% of the specimen. The usual difference consisted of significantly less stainable Iron in needle biopsy sections as compared to the aspirated smears (49.3%). In according to this study, in comparison of needle biopsy section to aspirated smears (As a golden test), sensitivity and specificity were 88 and 64 percent, respectively. Also, positive and negative predictive values were 56.5 and 91%, respectively. It can be appreciated that marrow assessment of Iron content may be associated with distinct differences between the needle biopsy specimens, and the aspirated smears, and could lead to diagnostic error, although, with some limitations and cautions biopsy specimen can be used for Iron assessment.

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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: Mucocutaneons manifestations are common in hemodialysis patients.The aim of this study was evaluate the prcvalence of cutaneous and mucosal manifestations in end stage renal disease (ESRD) patients who are on the maintenance hemodialysis.

Materials and Methods: This cross sectional study was performed on 100 (51 males, 49 females) hemodialysis patients in 5 Azar hospital in Gorgan, North of Iran during 2009. Patients selected on randomly based an all of them completely examined by a deramatologist for any changes in skin, hair, nail and mucous membrane. If necessary biopsy perform and refer to a pathologist. Data analysed with SPSS-13, mann-whitney, t-test, Chi-Square and Fisher tests.

Results: The average age was 49±12.3 years. The most common causes of ESRD was dibetes mellitus. The most common skin lesion was xerosis (78.3%), after that pruritis (39.1%) lentigo (34.8%) skin discoloration (32.6%) leukonychia (32%) thining of nail bed (24%) were common lesions. Lentigo was more common in female than male 42.85% vs 21.50% (p=0.042). Xerosis (p<0.01), scaling (p=0.042), lentigo (p<0.01), folliculitis (p<0.01), idio pathic guttate hypopigmentation (p<0.01) leukonychia (p<0.01) and half and half nail (p<0.01) have meaningful correlation with age. There was also meaningful correlation between dialyis duration and skin discoloration (p<0.031) and leukonychia (p<0.041). Clubhing and ca-p product also have meaningful correlation (p<0.027). Pruritis (p<0.048) and skin fungal infection (p<0.047) (tinea versi color) also have meaningful correlation with serum ferritin level.

Conclusion: Mucocutaneous manifestation were common in end stage renal disease patients.

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Background and Objective: Urinary tract infection is the most common bacterial infection during pregnancy. The pregnant women seems to be at risk for pyelonephritis and untreated infection. Timely recognition and on-time appropriate treatment of urinary tract infection particularly in pregnant women reduce the related complications. This study was done to assesse Sensitivity of isolated E.coli from pregnant women urine to antibiotics. Materials and Methods: In this descriptive study E.coli isolated from 360 urine samples from pregnant women, were examined, using Eosin Methylene Blue, blood sugar method. Antibiogram diffusion disk Kirby-Bauer was performed to assess the antibiotic response. Results: The persent of sensitivity of Escherichia coli to antibiotics were Co-amoxiclav (5.72%), Ampicillin (8.86%), Amoxicillin (11.87%), Cefazolin (32.12), Cephalexin (36.1%), Gentamicin (40.28%), Co-trimoxazole (48.15%), Nalidixic acid (55.3%), Nitrofurantoin (72.48%) and Ceftriaxone (80.78%). Conclusion: This study showed that there is a high level of E.coli antibiotics resistance toward Amoxicillin and Ampicillin high sensevity is related to Ceftriaxone and Nitrofurantoin in this region.

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Background and Objective: The prevalence of hepatitis B infection is increasing worldwide. The main way to prevent hepatitis B transmission to newborns can be through accurate detection of HBsAg positive pregnant women and implementation of standard protocol for their infants. Therefore, this study carried out to determine the frequency of HBsAg in pregnant women in Gorgan, Iran. Materials and Methods: This cross sectional study was done on 1553 pregnant women whom attended to Dezyani hospital in Gorgan, North of Iran during 2008-09. Blood samples were taken and tested for HBsAg and HBeAg using ELISA method. Results: HBsAg was found positive in 15 (1%) pregnant women. However, HBeAg were negative in all cases. Seven of these cases (46.7%) were not diagnosed before admission to the hospital for delivery and therefore had not received any immunoprophylaxis or HBIG treatment for their newborns. In contrary, six mothers and their newborns received immunoprophylaxis due to falsely diagnosed HBsAg seropositive. Conclusion: This study showed that the current protocols for dealing with HBsAg seropositivity and case finding among pregnant women in this region should be thoroughly revised. Furthermore, it is suggested that pregnant women during third trimester should be screened for HBsAg.

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Background and Objective: Androgens are among the causative factors in preeclampsia. This study was done to compare the serum androgens and progesterone in preeclampsia and normal pregnancy. Materials and Methods: This case-control study was done on 30 preeclamptic and 30 healthy pregnant women in Gorgan, Iran. Higher or equal to 140/90 mmHg and proteinuria equal or more than +1 in dip stick test in the third trimester of pregnancy were considered as the diagnostic criteria of preeclampsia. Progesterone, free and total testosterone, and dehydroepiandrosterone sulphate (DHEA) were measured by ELISA method. Results: Total testosterone level was 1.8±0.3 ng/ml and 1.3±0.9 ng/ml in cases and controls, respectively. This difference was not significant. Progesterone was lower in cases (95±46.9 ng/ml) than in controls (165.4±75 ng/ml) (P<0.01). Free testosterone and DHEA were 5.6±2.3 ng/ml and 1±0.5 ng/ml in cases, respectively which was significantly higher than the controls (3.2±1.5 ng/ml and 0.7±0.4 ng/ml, respectively) (P<0.045). Conclusion: Serum level of free testosterone, DHEA and progesterone increased and reduced respectivley in preeclampsia.

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Background and Objective: Rheumatoid arthritis (RA) is a systemic and chronic disease. Anticitrulinated anticyclic antibody (Anti-CCP) and rheumatoid factor (RF) are applied for the diagnosis of rheumatoid arthritis. This study was designed to evaluate the diagnostic value of anticitrulinated cyclic antibody and rheumatoid factor in rheumatoid arthritis patients. Materials and Methods: This laboratory study was done on 238 affected RF patients and 152 RF symptom free subjects in Gorgan, Iran. Anti-CCP and RF were measured by ELISA and Latex agglutination. Results: Out of 238 patients with rheumatoid arthritis Anti-CCP test was positive in 196 patients, and the sensivity was 82%. In control group, Anti-CCP was positive in 5 cases, and the specificity for RA was 96%. RF test was positive in 206 patients and sensitivity for RF in rheumatoid factor was 86%. In control group, RF was positive in 28 cases and specificity was 81%. Positive RF and Anti-CCP (simultaneously) showed sensitivity as 89%. Conclusion: The specificity of CCP is higher than RF and therefore can be substituted as diagnosis of rheumatoid factor.

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Background and Objective: Gastrointestinal polyps have pre-carcinomatous potential. In regard to increasing rate of gastrointestinal cancers and the relation between polyps with cancers, this study was done to determine the anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran. Materials and Methods: This cross-sectional study was conducted on 290 patients with gastrointestinal polyps were undergoing colonoscopy or endoscopy in 5th Azar teaching hospital in Gorgan, northern Iran during 1999-2008. The diagnosis was confirmed by histopathologic method. Gender and age was recorded for each patient. Results: 56.6% of patients were males 19.3% of polyps was diagnosed in the sixth decade of patient's age. The most frequent pathological type of gastrointestinal polyps was adenoma (54.1%) followed by hyperplastic (19.7%), acute inflammatory (13.8%) and young polyps type (11.4%). Tubular type with 63% was the most common type of adenoma polyp followed by various villouses (19.1%) and tubulovillous (17.9%). 87.2% and 12.8% of polyps were in colon and stomach, respectively. The most frequent anatomical position of polyps was rectum (30%) followed by sigmoid with 26/1%. Conclusion: Adenoma polyp in colon was the most common type in gastrointestinal tract.

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Background and Objective: Colonoscopy is the best method for management of patients with Hematochezia or lower gastrointestinal bleeding (LGIB). This study was conducted to assess the endoscopic and histopathologic findings in patients with hematochezia. Methods: This descriptive –analytical study was done on 117 (50 males, 67 females) patients whom referred to 5th Azar hospital in Gorgan, northern Iran during 2010. Demographic characteristics, medical history and colonoscopic and histopathologic findings were recorded for each patient. Results: Hemorrhoid was the most common finding in colonoscopic examination. Inflammatory bowel disease (IBD) and cancer were the most common feature in the under and higher than 43 age old patients, respectively (P<0.05). Ulcerative colitis (22.2%) was the most common finding in histopathological examination. Rectosigmoid was the most common anatomical location of involvement in IBD cases. Cancer and IBD were occurred in the left colon. Conclusion: Flexible sigmoidoscopy can be a selected procedure for evaluation of hematochezia in the <43 age old patients but in >43 age old subjects sigmoidoscopy or colonoscopy should be made based on patients' status.

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Background and Objective: Helicobacter pylori is the main gastric pathogen in human. BabA2 and Hsp genotypes are essential for enormous clinical outcomes in gastreodeoneal and dyspepsia. This study was done to determine the assessment of babA2 and hsp genotype frequency in Helicobacter pylori specimens isolated from digestive disorders patients. Method: This descriptive-analytic study was carried out on 80 digestive disorders patients in 5th hospital, Gorgan, northern Iran. Stomach specimen biopsy was taken by a gastroenterologist. Urease test, histopathologic assessment and DNA extraction were performed. The frequency of babA2 and hsp geno-types was determined using poly merase chain reaction. Results: In 80 affected patients with H.pylori, 36, 18 and 26 patients were found to suffer from gastritis, stomach cancer and stomach ulcer, respectively. 51 specimens (63%) were positive babA2 genotype. 49 specimens (61%) were positive hsp genotype. No significant relationship was found between babA2 and hsp geno types with stomach diseases. Conclusion: In spite of positive babA2 and hsp genotype in isolated Helicobacter pylori speicments from digestive disorders patients, this finding was not correlated with type of digestive disorders.