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Inguinal hernia is common in midlle age and elderly. It is in two form of direct and indirect. Often the hernia sac consists of omentum and or intestinal segmants, but bladder hernia is very rare. In present patient massive inguinal hernia and urinary retention were associated with ipsilateral nonvisulization and nonfuncting kidney that showed the disease is chronic in nature. The diagnosis is confirm by ultrasonography and retrograde cystography. In cystography, contrast maternal is show in scrotal cavity and commnication of it with bladder. In our case, the diagnosis is made preoperatively with ultrasonograpy and cystography. The patient able to void post-oprative day and scrotal enlargment is compelely reduce. In conclusion it is advised that in patients older than 50 years who have massive inguinoscrotal herina and prostatism cystography to be done mandatory and also preoperative diagnosis is to be made to prevente the injury of bladder and ureter in operating time.

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Background&Objective: Hirschsprung's disease (H.D) is a congenital disease in which intestinal ganglionic cells are absent and can cause intestinal obstruction .The disease has various clinical manifestations and different length of bowel may be involved. Our aim was to study Hirschsprung’s clinical presentations and its rate of intestinal involvement in hospitalized patients in a 6-year course study in Rasht. The capital city of Gillan province in north of Iran. Materials&Methods: We studied the Hirschsprung’s patients referred to Poursina Referal Hospital between 1995-2001.A cross sectional descriptive- analytic study whose data was collected from patient’s files and questionnaires including demographic data, disease presentations, diagnostic methods, involved segment, surgical procedure types, surgical complications. Finally, the data was analyzed in SPSS10 software. Results: We detected 58 H.D in these 6 years, whome underwent surgery. There were 19 females and 39 males. Age of patients differed from one day to 18 year. Clinical findings were variable as follow: constipation (79.31%), abdominal distention (67.24%), inability to pass mecunium (17.24%), diarrhea (5.17%) and other less common manifestations. Pathologically, we divided our patients into 3 kinds: rectosigmoid, ultra short – segment, total – colonic. Surgeries were performed in three ways as follow Swenson - Soave - Lynn. Early complications, which come within one month after operation, contain anastomotic leakage (10.2%), prolonged constipation (10.2%). There were not any significant differences between these three types of surgical procedures. Conclusion: Majority of patients presented with a chronic course of constipation and abdominal distention. There wasn’t any difference between kinds of involvement and age and type of presentations. There are few associated anomalies in our patients. In some cases, surgical complications were less than other studies so, it is probable that our procedures had fewer complications or they had performed in appropriate time.

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Background & Objective: Hypertension is the most important Cardio-Vascular risk factor, and also the most common cause of heart failure, stroke and renal failure. This semi-experimental study aimed at determining the effect of education, by means of Health Belief Model (HBM), on nurse’s staff knowledge, attitude and their practice toward hypertension. Materials & Methods: This semi-experimental study was done on 136 nurse’s staff selected by stratified random sampling. Data collection instrument were a questionnaire and a check-list. At first, the subjects’ knowledge, attitude and their Practice were studied by a questionnaire and a check list, and then a HBM-based educational program was carried out. For three months, Afterwards, their knowledge, attitude and practice were measured and compared with pretest findings. In statistical analysis, Wilcox on test, independent t test, ANOVA and Pearson correlation. Results: Before education the mean score of knowledge, benefit perceived, barrier perceived, threat perceived, attitude and practice was 9.68, 23.76, 25.63, 22.82, 71.99 and 4.55 respectively. After education these scores reached 16.66, 26.06, 28.94, 24.98, and 80.08 and 4.83. Based on the results, nurse’s staff training via HBM led to high knowledge, positive attitude and practice improvement (p<0.05).The difference between this research variables such as age, gender, marital status, record of service and family background was not significant, But there was significant difference between variables (occupational levels, educational levels, and hospital ward) and knowledge and practice. Furthermore, the relation between hospital ward and attitude was positive (p<0.05). Conclusion: In terms of the results, it is a necessity for nurse’s staff to participate in a HBM based educational program.

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Background&Objective: Hospital infection is one of the important determinants on lengthening hospitalization and increasing the costs and mortality rates in hospitals. Intensive Care Unit (ICU) is one of the wards that are most afflicted with the incidence of this morbidity. This study involves investigating the incidence of infection in one of the Intensive Care Units. Materials&Methods: This study was designed in the form of a prospective cohort which was implemented on patients who were hospitalized in the ICU of Khatamol Anbia Hospital from September 21st 2002 for at least 72 hours and didn’t reveal signs of infection. The status and duration of using tracheal tube, ventilator, urinary catheter, and venous catheter, the duration of hospitalization in ICU and the time infection appeared were all recorded. Results: During the six months spent on this study, 234 patients were hospitalized in ICU, among which 50 patients were investigated. The group of these 50 patients cumulatively spent 528 days in ICU. During their hospitalization, 9 cases of infection occurred in these patients. The incidence of infection was 18% (with a 95% confidence interval of 7.35% to 28.65%). The incidence rate was 17 patients in 1000 person-year of hospitalization in ICU (with a 95% confidence interval of 8.8 to 106.3). Conclusion: Hospital infection is a relatively common complication among patients who have been hospitalized in ICU for at least 3 days. The frequency of infection reported in Iran is equal or more than the results of studies carried out in other parts of the world.

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Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

 

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

 

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

 

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

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Background & Objective: Nutritional support is a basic process for survival in trauma patients. The purpose of this study was to evaluate the daily nutritional support practice in head injury patients admitted to Neurosurgery Intensive Care Unit.

 

Materials & Methods: This descriptive cross-sectional study was done on 115 Head injury adults patients who received enteral nutrition for at least 48h in Rasht Poursina hospital during 2005. Nutritional measurements were included the number of patients who received enteral nutrition, the time to initiate nutritional support, amount of initial feeding and clinical outcome were included the duration of mechanical ventilation, ICU and in-hospital length of stay (loss), in-hospital mortality rates .Data was reported as Mean±SD and percent. T-test analysis was used for comparing of calorie and nutrient intakes and requirements.

 

Results: Mean±SD of age patient was 41.22±21.9, 84% of patients received enteral nutrition. The time to feeding and the amount of initial feeding was 4.6±1 day and 52.79±27.83 ml/h respectively. Duration of ventilation was 12±13.4 day and ICU length of stay 18.96±18.3 day, Hospital length of stays 24.47±19.84 day. Mortality rate in six month was 48%. Mean of energy, carbohydrate, fat and protein (P<0.05) intakes had significant differences compared with requirements.

 

Conclusion: The recording process has revealed undesirable feeding practice in head injury patients. Nutritional outcomes would be improved with implementation of standard protocol in neurosurgery intensive care unit.

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Background & Objective: More than 50% of patients with hypertension will have end organ damage (such as: CHF, retinopathy ,CVA or renal failure).Left ventricular hypertrophy (LVH) is an independent risk factor for death and cardiovascular disease .Both renal dysfunction and LVH are signs of end organ damage so we carried out this study to evaluate the correlation between LVH in echocardiography and kidney function in patients with essential hypertension. Materials & Methods: This descriptive analytic study was carried out on 102 patients whome reffered to 5 Azar hospital in Gorgan- Iran, suffering from essential hypertension and had proved LVH in echocardiography with no other disease during 2005-6. Kidney and urinary tract assessment such as serum BUN, Creatinine level and kidney sonography was done on subjects. Left ventricular hypertrophy was defined as a left ventricular mass index (LVMI)>=135g/m2 in men and>=110g/m2 in women. Renal function was estimated by means of the serum Creatinine level and proteinuria and sonographic findings of kidney and urinary tract. Data was analysed by Spss-11.5 and Chi-Squre test. Results: The average age of patients were 60±8.8. 58%, 36% and 7% of patients had mild, moderate and sever LVH respectivly. The means of Creatinine and BUN level were 1.09±1.12 mg/dl and 20.6±10.76 mg/dl had direct correlation with kidney dysfunction (P<0.05). There was a significant relationship between LVH severity and presentse of Kidney scar in sonography (P<0.05). Conclusion: This study showed that a very large fraction of the subjects with essential hypertension have kidney problems. Therefore, serum BUN and Creatinine level and sonographic scar of kidney can be reliable markers for assessing and controlling target organ damages that are induced by Essential hypertension.

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Background & Objective: Glucose Amino Glycans (GAG) are unbranched polysacharides, major components of the basement membrane and play a key role in their molecular organization and function, also have an important role in the pathogenesis of some diseases such as hypertension. Hypertention is probably the most important health problem in several countries. But there is not yet a reliable indicator for early diagnosis of hypertension. The goal of this study was the measurement of serum and 24-h urinary GAG as an exact and early diagnostic marker. Materials & Methods: In this case – control study, 24-h urine and serum samples collected from the 53 patients and 38 persons as matched control normotensive group. Then amount of GAG was measured with spectrophotometery method. Results: Our findings showed that there is a direct relation between 24-h urinary GAG excretion and systolic blood pressure and it increases with increase of systolic blood pressure. Also amount of serum GAG increases in hypertensive patients in comparison with control group. Conclusion: This study showed that the concentration of GAG in sera and 24-h of urine samples increase in systolic hypertention.

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Background and Objective: In clinical situation, pain occurs during intravenous Catheterization (IVC). Finding methods to reduce pain related with insertion of Angiocut. This study was performed to evaluate the effect of types of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain severity regarding to insertion of Angiocut is very important. This study was performed to evaluate the effect of types of transcutaneous nerve stimulation (TENS) on the pain severity regarding to insertion of Angiocut. Materials and Methods: This clinical trial study was performed on the 80 patients of Internal and CCU wards of Fatemieh Hospital in Semnan, Iran during 2001. In this study, severity of pain related with insertion Angiocut assessed and compared in four conditions No TENS, low TENS (5 Hz), high TENS (100 Hz) and burst TENS (with frequence 100 Hz And burst frequence 2 Hz). The severity of pain measured by testes visual analogue scale (VAS), One-way ANOVA, Tukey, and Dunnett tests were used for comparing means of pain severity in different conditions. Results: Findings showed significant difference between severity of pain during Angiocut insertion in four conditions (P<0.05), so that the lower intensity of pain was in the high-TENS group, while higher pain was in the No TENS group. Significant difference was between intensity of pain in the No TENS group with high TENS and burst TENS group (P<0.05), but no significant difference was between low TENS and No TENS groups. Conclusion: This study showed that TENS was a effective method to reduce pain during Angiocut insertion. The lowest severity of pain was obtained in high TENS method. therefore, high TENS method can suggest as a effective method to reduce pain during Angiocut insertion.

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Background and Objective: Patello femoral pain syndrome is one of the most common orthopeadics complains, which effect athletes, militaries and ordinary people. The symptoms is idiopathic disease, but one of the most important reason for this disease can be the structural problem of lower limb and one of the efficient method of conservative treatment of patients with patello femoral pain syndrome can be using neoprene palumbo and geno direxa stable orthoses, but there is only a few experimental researches supporting the effects of these orthoses. This study was designed to determine the effects of neoprene palumbo and geno direxa stable on pain and daily activity of patients with patello femoral pain syndrome. Materials and Methods: In this clinical trial study 30 male patients (18-40 years old) with patello femoral pain syndrome randomly were divided in 2 groups of 15 patients. Which were placed in Neoprene palumbo and Geno direxa stable orthoses groups respectively. The pain intensity and activity of daily living joint rigidity were assessed before, during and 3 weeks after treatment by visual analogue scale (VAS) and KOOS questionnaire. Following both orthoses application data were analyzed using pair and independent t-test. Results: In both groups the mean of pain intensity decreased and daily physical activity increased after treatment (P<0.05), but there was not significant difference between neoprene palumbo and geno direxa stable methods, on pain and daily physical activities. Conclusion: This study indicated that Neoprene palumbo and geno direxa stable orthoses improved the sign of patello femoral pain syndrome including pain intensity and daily life, activity.

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Background and Objective: Osteoarthritis is the most common joint disease and associated with degeneration of the joint cartilage. Its high prevalence, particulary in the elderly, and the high rate of disability related to disease make it a leading cause of disability. The symptoms of osteoarthritis are pain, morning stiffness and joint limited motion. This study was carired out to compare the effects of physical modalities and home based exercise training on symptoms and function of knee osteoarthritis. Materials and Methods: In this randomized clinical trial study, fourty patients with knee osteoarthritis according to the American college of rheumatology (ACR) criteria randomly divided into two treatment groups. The physical modality group (A) received TENS, US and Hot pack at pain areas. The exercise group (B) received isometric exercise of the knee. Each group received 3 treatment sessions per week for 4 weeks. Evaluating measuring tools were pain intensity (based on Visual Analogue Scale: VAS) and function was measured with koos questionnare. Results: Improvement in pain, quality of life, symptoms, sports and reduction, in pain intensity on VAS in the physical modality group after treatment were seen (P<0.05). Also significant improvement in symptoms and quality of life observed in the exercise group. Improvement in activity of daily life found in the physical modality group in comparison with exercise group (P<0.05). Conclusion: This study showed that physical modality and exercise training reduce pain and improve quality of life, activity of daily life and sport in patients with the same rate. While activity of daily life improve more in physical modality method.

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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: Hypertension is considered as a major public health problem in most countries due to its association with ischemic heart disease. The aim of this study was to determine people awareness of hypertension in Golestan province of Northern Iran.

Materials and Methods: This cross sectional population based study carried out on 2497 subjects (15-65 years old) including 1500 men and 1247 women in Golestan province- Northern Iran during 2006. The subjects were chosen by proportional-cluster sampling based on sex and age groups. The subjects were interviewed, antropometric indexes and serum biochemical factors were evaluated. Blood pressure was measured three times with 5 minutes interval and defined based on JNC-7 classification. Serum cholesterol and fast blood sugar (FBS) were determined using laboratory kits (enzymatic methods), and spectrophotometery technique. Data was analyzed by SPSS-16 software and Chi-Square test.

Results: In general, the prevalence of hypertension in this region was 23.9%. with higher rate among women urban area by 3.3% and 5% respectively. Only 48.7% of hypertensive patients were aware of their disease and that was significantly more in women than men (P<0.001). Low physical activity, chronical age, diabetes, hypercholesterolemia, general obesity, central obesity and illiteracy were the risk factor for hypertension morbidity (P<0.05).

Conclusion: This study showed, in spite of prevalency of hypertension among 20% of subjects in this area only 48.7% of them were aware about their disorder.

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Background and Objective: There is a genetic background for polycystic ovary syndrome (PCOS). Due to increase metabolic disorders, lipoproteins, impaired glucose tolerance, and hypertension in PCOS patients, this study was done to determine the cardiovascular risk factors in first relative member of patients with polycystic ovarian syndrom in Shiraz, Iran. Materials and Methods: This case - control study was carried out on 107 parents and siblings of women with PCOS as cases and 107 non-PCOS parents and siblings of women as controls in Shiraz, Iran during 2007-08. Demographic characteristic, BMI, obesity and blood pressure were recorded for all subjects. Serum lipoproteins including total cholestrol, triglyceride, LDL, HDL and fasting blood sugar were measured in cases and controls. Data were analyzed using SPSS-16.5, independent t-test, Chi-Square and Kappa tests. Results: 35.3%, 26.5%, 11.76% and 5.8% of fatheres in cases were considered as overweight class I, class II, class III of obesity, respectively when compared to controls. This differecne was significant (P<0.05). Waist –hip ratio in mothers in cases (25.6%) and controls (17.9%) were higher than 0.85. Waist –hip ratio among the sisters in case and control groups were 23.5% and 17.6%, respectively (P<0.05). Hypertension was observed in 12.2% of cases and 3.7% of controls. This difference was not significant. High level of triglyceride were determined in 14.94% of cases and 6.5% of controls. A significant correlation was found between BMI and diabete II in case and control groups (P<0.05). Disorder in glucose tolerance test (GTT) in case and control goups were 19.62% and 7.47%, respectively (P<0.05). The obesity was found in 18.7%, 6.54% in cases and controls with disorder in GTT (P<0.05). Conclusion: This study showed that obesity, central obesity, high level of serum lipoproteins and hypertension among first relative member of patients with PCOS are significantly higher than the controls.

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Background and Objective: Headache is one the most common compliant of patients and has different causes and the migraine and tension headaches are common. Personality is characteristics forming an individual distinctive manner. This study aimed to determine the frequency and association of different types of personality characteristics in patients with migraine and tension headaches. Materials and Methods: This descriptive-analytic study was done on 160 (12 male and 148 female) subjects with chief complaint of headache whome referred to 5th Azar clinics of Gorgan, Iran during 2007-08. Subjects were selected by simple random sampling and were examined by either a neurologist or psychiatrist patient with diagnosis migraine either of or tension headache were included. Selected patients evaluated by short form of Minnesota Multiphasic Personality Inventory (MMPI). Data were analyzed using SPSS-13 and Chi-Square test. Results: The mean age was 11.18±33.29 in women and 34.33±13.7 in men. 96 patients (60%) had tension headache and 64 (41.2%) had migraine. In tension headache, depressed personality (43.8%) and hysterical personality (16.4%) were more common but in migraine headache, depressed personality (48.9%) and paranoid personality (20%) were common but this difference was not significant. Conclusion: This study showed that there is no relation between personality characteristics with tension headach and migraine.

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Background and Objective: The silent brain infarctions are common in first-ever stroke. Some recent studies show the possible role of silent brain infarction in ischemic stroke. The aim of this study was to evaluate the frequency of silent brain infarction in acute first-ever ischemic stroke and its association with stroke risk factors. Materials and Methods: This descriptive - analytical study was carried out on 203 (94 males, 109 females) patients with acute first-ever ischemic stroke in Shafa hospital in Kerman, Iran during 2010. The diagnosis of ischemic stroke was made by physical examination and was confirmed by MRI and CT Scan. A questionnaire containing demographic information and risk factors including hypertension, diabetes, hyperlipidemia, cigarette smoking, ischemic and non-ischemic heart disease for stroke as well as presence of silent stroke was completed for each patient. Data were analyzed using SPSS-16 and logistic regression test. Results: The mean age of patients was 62.56±17.35 years. Among our patients history of hypertension, hyperlipidemia, cigarette smoking, diabetes, history of ischemic heart disease, history of other cardiac disease and silent stroke were observed in 66 (32.5%), 26 (12.8%), 16 (7.9%), 40 (19.7%), 27 (13.3%), 16 (7.9%) and 31 (15.3%), respectively. The probability of silent stroke among patient with hyperlipidemia, was 3.7 times more than those without hyperlipidemia (95%CI: 1.556-12.780, P<0.05). There was no significant correlation between silent stroke and the above risk factors. Conclusion: Silent stroke was found in 15% of patients with ischemic stroke. Control of hyperlipidemia can have a vital role in the prevention of silent stroke.

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Background and Objective: Coronary artery diseases are one of the main causes of mortality and morbidity. This study was done to determine the prevalence of risk factors for coronary artery diseases in patients referred to angiography center in Sari, Northern Iran. Materials and Methods: This descriptive study was performed on 2540 patients referred to angiography center in Sari city, northern Iran, during 2005-10. Risk factors including diabetes, hypertension, hyperlipidemia, smoking, Family history, CRP and also ECG changes, type and number of involved artery and the severity of vascular involvement were recorded for each patient. Results: Hypertension, hyperlipidemia, diabetes, smoking were seen in 40.8%, 40.5%, 29.1%, 12.5% of patients, respectively. Positive family history and CRP were found in 10% and 3.4% of the patients, respectively. 23.8% of patients had abnormal ECG. One, two and three vessel diseases were observed in 26.5%, 48.3%, 48.3% of cases, respectively. Left anterior descending artery constriction was seen in 75.8% and 80.4% of males and females, respectively. A significant relationship was found between diabetes and left coronary circumflex (P<0.04) and left anterior descending artery (P<0.03) constriction. Conclusion: Diabetes, hypertension, hyperlipidemia, smoking, family history, abnormal ECG are among the risk factors of coronary artery diseases in this area.

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Background and Objective: Cardiovascular autonomic neuropathy (CAN) is the most common and important type of diabetic autonomic neuropathy. Silent myocardial infarction, respiratory failure and increased mortality are the outcomes of CAN. This study was carried out to screen the cardiovascular autonomic neuropathy in non- insulin dependent diabetics patients. Method: This descriptive - analytic study was carried on 70 (22 males, 48 females) non- insulin dependent diabetics’ patients. Resting heart rate, heart rate variability, orthostatic changes in heart rate, blood pressure and corrected QT interval were recorded for each subject. The final findings were categorized as follow: 0=normal, 1=borderline and 2=CAN positive. Results: 10 (14.3%) of patients were normal, 35 (50%) of patients were borderline and 25 (35.7%) of patients were considered cardiovascular autonomic neuropathy positive. There was significant differences between duration of diabetes and three CAN scores (P<0.05). The systolic blood pressure alterations showed the maximum correlation with CAN scores (r=0.509). Conclusion: In our study, the rate of cardiovascular autonomic neuropathy was higher than other reports. The most important risk factor for cardiovascular autonomic neuropathy was more than 10 years history of diabetes mellitus.

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Background and Objective: Hypertension in long time can cause cardiovascular disorders and increase chance of stroke. This study was done to determine the association between some dietary factors and risk of hypertension. Methods: This cross-sectional study was conducted on the fourth phase (2008-11) of Tehran lipid and glucose study (TLGS). In this study 6089 subjects (2807 males and 3282 females), aged 19-70 years, were participated and dietary, demographic, anthropometric and blood pressure of each subject were collected. Dietary intake was assessed using a validated and reliable food frequency questionnaire with 147-items. Odds ratio for hypertension according to quartiles of dietary factors was determined using logistic regression with adjustment for confounder variables. Results: The rate of hypertension was 29.8%. Mean of weight, body mass index, waist circumference, prevalence of abdominal obesity and alliteration in the hypertensive subjects were significantly higher than normotensive subjects (P<0.05). There was a non significant direct relationship between energy density, total fat and saturated fat. Higher consumption of fiber was associated with lower risk of hypertension (OR: 0.62, 95% CI: 0.37-0.97). The risk of hypertension increased in the highest quartiles of dietary protein (OR: 1.20, 95% CI: 1.02-1.43). Odds ratio for hypertension was higher among subjects whom consumed lower fruits and nuts than those subjects with higher fruits consumption (OR: 1.33, 95% CI: 1.15-1.85) and nuts (OR: 1.21, 95% CI: 1.02-1.42). Conclusion: High consumption of fiber could protect against hypertension while some dietary factors such as high consumption of protein could increase risk of hypertension.

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Background and Objective: Modification of life style, nutrional regiment and insulin therapy is used for improvement of pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). This study was done to evaluate the effect of the dietary approaches to stop hypertension (DASH) eating plan on pregnancy outcomes in pregnant women with gestational diabetes mellitus. Methods: In this clinical trial study, 52 women with GDM were randomly divided into DASH and control groups for 4 weeks. The control diet contained 45-55% carbohydrates, 15-20% protein and 25-30% total fat. The DASH was rich in fruits, vegetables, whole grains and low-fat dairy products, and contained lower amounts of saturated fats, cholesterol and refined grains with a total of 2400 mg/day sodium. The numbers of women whom commenced insulin therapy after dietary intervention, the mode of delivery and prevalence of polyhydramnios were assessed. The length, weight and head circumference of infants were measured during the first 24 h after birth. Results: 46.2% of women in the DASH group needed to have a cesarean section, this rate for the control group was 80.8% (P<0.05). The percentage of those who needed to commence insulin therapy after intervention was 23% for DASH group vs 73% for controls (P<0.05). Infants born to mothers on the DASH group had significantly lower body weight (3222.7 vs 3818.8 g, P<0.05), head circumference (34.2 vs 35.1 cm, P<0.05) and ponderal index (2.50 vs 2.87 kg/m3, P<0.05) compared to those born to mothers on the control diet. Conclusion: Consumption of dietary approaches to stop hypertension for 4 weeks among pregnant women with GDM resulted in improved pregnancy outcomes.