Search

Abstract Background Osteoporosis is one of the most common metabolic diseases that is characterized by a decrease in bone density and a loss of the quality of the bone structure. The use of deep learning in the prediction of osteoporosis can provide a non-invasive, cost-effective, and efficient approach. The aim of this study is to investigate the diagnostic accuracy of deep learning in the prediction of osteoporosis. Methods This is a systematic review and meta-analysis study that was conducted on the diagnostic accuracy of deep learning algorithms for predicting osteoporosis. A literature search was performed in electronic databases including PubMed, Elsevier, and Google Scholar to identify relevant articles until December 1, 2023. Articles were searched in databases by combining related terms such as “deep learning”, “convolutional neural network”, and “osteoporosis”. We conducted title, abstract, and full-text screening based on inclusion/exclusion criteria. Various metrics, such as sensitivity, specificity, and area under the curve (AUC), were used to assess the diagnostic performance of deep learning models. Results Out of the 181 articles initially identified, 10 studies were included in the analysis. All studies used a convolutional neural network (CNN) as the deep learning model. Three studies investigated multiple deep learning models. Eight studies used various architectures of CNN, such as ResNet, VGG, and EfficientNet. The pooled sensitivity and specificity were 0.86 (95% CI, 0.82–0.89) and 0.89 (95% CI, 0.85–0.91), respectively. The bivariate approach’s pooled SROC curve produced an AUC of 0.94 (95% CI 0.91–0.95). The Diagnostic Odds Ratio (DOR) for the deep learning models was 49.09 (95% CI, 28.74–83.84). Deeks’ funnel plot asymmetry test (P = 0.4) suggested no potential publication bias. Conclusions Deep learning has an acceptable performance for the diagnosis of osteoporosis, even better than other ML algorithms. However, further research is needed to validate the findings of this study in clinical trials.

Introduction: Antibiotic arbitrary use by increasing resistance changed to a growing issue in the 21st century and its optimal use in hospital could be essential for reducing health system costs and drug side effects. Objectives: The aim of this study was to investigate the pattern of antibiotic use in prescribed prescription. Patients and Methods: This was a cross-sectional study that has been done on 300 prescriptions which selected randomly form Ardabil city hospitals. The anatomical therapeutic chemical classification system with defined daily doses (ATC/DDD) standard measurement method recommended by World Health Organization (WHO) was conducted in the study. The amount uses rate of each medication calculated by DDD/100 bed days. Data collected by a checklist and analyzed by statistical methods in SPSS version 21. Results: The highest prescribed antibiotic was ciprofloxacin with 32% and the total antibiotics uses rate during study period was 44/95 DDD/100 Bed days. The mean number of drugs and prescribed antibiotics in intensive care unit (ICU) ward was more than other wards. However, comparing the rate of antibiotics use between wards based on ATC/DDD method showed that the infection ward with 62.9 was more than other wards. The most form of used antibiotics with 69% was in the form of Ampule and in intravenously method with 64% in all wards. Conclusion: The results of this study showed that the most used antibiotics by considering the studied method, prescribed dose and the hospitalized days were in internal and surgery ward respectively but according ATC/DDD method the most used antibiotics was in infection ward.

Background & objectives: Designing knee osteoarthritis (KOA) prevention programs requires recognizing modifiable risk factors. This study aimed to determine the frequency of osteoarthritis in patients with knee pain referred to Imam Khomeini Hospital in Ardabil city. Methods: In this cross-sectional descriptive study, 850 patients with knee pain who were referred to the clinic of rheumatology in Imam Khomeini Hospital in Ardabil city were studied. Demographic and personal characteristics and medical history of OA were collected from the participants by a checklist. Osteoarthritis was diagnosed based on clinical and radiographic evidence by a rheumatologist. Results: Of all patients, 310 (36.5%) were diagnosed with knee osteoarthritis. The most of patients (33.5%) were in the age group of 50-59 years old, women (80.6%) and housewives (29%). 39.9% of all patiens had obesity and most of them (43.2%) have not exercised at any time. A family history of knee osteoarthritis was reported in 45.2% of patients, while a family history of joint replacement was reported in 6.1%. 15.8% of patients reported a history of previous knee trauma. The type of used toilet was traditional in 90.3%. Conclusion: The frequency of knee OA in our study similar to other studies was at a moderate level and due to regional risk factors, it is suggested to reduce the incidence of KOA by presenting necessary training programs and changing the nutritional patterns of society people.

Background: Epilepsy is the second, most common and most dangerous neurological complication that can occur in a pregnant woman. Women with epilepsy (WWE) are at higher risk for miscarriage, prematurity, congenital anomalies and low birth weight (LBW). Objectives: The aim of this study was to investigate the outcome of pregnancy in women with epilepsy. Methods: This descriptive study was conducted on 131 pregnant women with epilepsy who referred to Ardabil Alavi Hospital from September 2019 to September 2021. Necessary information such as BMI, type of seizure, congenital malformation, treatment drug and name of used drugs collected through patients file by a checklist and then analyzed by using statistical methods in SPSS version 25. Results: The frequency of neonate term birth was 83.21% and preterm birth was 16.79%. The frequency of babies with LBW was 22.85%. Most of women with 65.96% had cesarean delivery. More than 83% of seizures were generalized and 67.93% used mono-therapy. Only one fetus had malformation (0.76%). The most frequency among the patients receiving mono-therapy was related to the carbamazepine with 26.71% and among the women treated with multitherapy was related to Levetiracetam plus carbamazepine with 12.97%. Conclusion: Pregnancies with epilepsy, even in cases with multidisciplinary care and no other risk factors, are still significantly associated with higher adverse outcomes.

Background: Beta-thalassemia is one of the most common genetic diseases with autosomal recessive inherited patterns in the world and is one of the most common diseases in Iran that exists in all age and sex groups. Determining gene mutations in this disease can be effective in controlling and treating the disease. The present study determined the frequency of polymorphisms of Hinc, RSaI, RDB, and Xmn in patients with beta-thalassemia minor in Ardabil province. Methods: 53 beta-thalassemia patients referred to the genetic department of Imam Khomeini Hospital were studied. Blood samples were taken to determine the type of gene mutation. PCR samples were genetically evaluated to determine genetic mutations using RDB-Sequence-RFLP-Haplotype methods. Results: A total of 53 samples were examined, of which 56.6% were male and the rest were female. The most positive cases in the first and second ranks were related to XmnI and AvaII enzymes with 73.5% and 60.3%, respectively. The most common mutation extracted in the studied samples with 14 cases (26.4%) was IVS2.1. Among the most common mutations extracted by the RDB method was related to IVS 1.2 with 26.4%. Conclusions: The results of the present study showed that the distribution of genetic mutations in the studied samples can be different from other places. Also, by performing targeted genetic counseling, it is possible to control and prevent the disease in the future.

Background: Currently there are several treatment plans for prophylaxis of vestibular migraine, but these treatments are based on physician's observations and there have not been studied on a consensual treatment plan. Objective: Based on diagnostic criteria, we collected vestibular migraine patients and created an individualized treatment plan for 3 months to interpret treatment results. Methods: In this prospective cross-sectional study, 28 patients with headache and dizziness diagnosed for vestibular migraine were enrolled. Demographics, clinical picture, and treatment results were evaluated for all patients at baseline and after three months follow-up duration. Collected data analyzed by statistical methods in SPSS. Results: Due to results, all of the patients with vestibular migraine were female and mostly were in the 30 to 50 years old age group. Dizziness, Headache before vestibular symptoms, increased intensity of headache on excretion, intermediate to high migraine intensity, and throbbing pain were the most common symptoms in the patients. The most common drugs used in the treatment were somatriptan, topiramate and Magnesium+Vitamin B6. After 3 months of treatment, duration, intensity, and frequency of migraine and frequency of dizziness episodes were significantly decreased but there was not a significant relationship between treatment plan and dizziness episodes in terms of duration and intensity. Conclusion: Effectiveness of the drugs in decreasing dizziness episodes can be explained by the effect of the drugs in preventing migraine episodes, whereas in recent studies non-pharmocologic treatments have had a significant effect on decreasing dizziness intensity and duration. Using both pharmacologic and non-pharmocologic methods in combination, is recommended for the treatment of the vestibular migraine.

Background and Objective: Alpha-thalassemia (α-thal) appears to be the most common monogenic disorder worldwide. The diagnosis of α-thalassemia depends on the detection of Hemoglobin Bart (Hb Bartchr('39')s) in newborns, which indicates one or more defective or absent α-globin genes. In addition, in patients with Hemoglobin H (Hb H), the Hb H range usually varies between 7-10 g / dL. Therefore, tracking Hb Bartchr('39')s and Hb H can be useful in diagnosing thalassemia α. This study was performed to evaluate Hb Bartchr('39')s and Hb H in infants with α thalassemia in Ardabil province, northwestern Iran. Material and Methods: In this cross-sectional descriptive study, 33 infants with alpha thalassemia mutation, including infants born in Ardabil province, Iran in the years 2020 to 2019. Hemoglobin analysis was performed by capillary electrophoresis system. Results: Hb H and Hb Bartchr('39')s were detected in only two cases (6%) and three cases (9%). In this study, only 5 patients (15.15) were observable by detection of Hb Bartchr('39')s and Hb H levels by electrophoresis. In cases of Hb Bart disease, -α3.7 was the most common genotype. Therefore, most infants with alpha thalassemia were lost when electrophoresis alone was used. Conclusion: This study showed that molecular analysis of Hb Bartchr('39')s newborns is necessary to confirm α-thalassemia. Capillary electrophoresis is a way to prevent the diagnosis of rare Hb H and Bartchr('39')s disease.

Background: Breast cancer (BC) is the most prevalent cancer in women and the second most common cancer in the world. Two million new cases were reported in 2018. The aim of this study was to investigate the changing trend of BC in the people of Ardabil during 2003-2016. Method: In this cross-sectional descriptive study, we analyzed BC incidence rates using population-based cancer registries stratified by city, age group, gender, and disease grading. We analyzed the collected data by statistical methods in SPSS version 21. Results: The mean age of patients was 48.4±13.1. Of all patients, 98.5% were female, and most were aged 40-60 (56%). The most of BC cases was registered in year 2011 with the most incidence rate about 10.41 per 100000 and the most of cases with 71.5% was registered in Ardabil city. The incidence rate of BC reached from 4.13 per 100000 in 2003 to 6.93 in 2016. The annual percentage change during the study years was 4.1%. Conclusion: Results showed that the incidence rate of BC during study years had an increasing trend in Ardabil’s people and reached from 4.13 per 100000 in year 2003 to 6.93 per 100000 in year 6.93 with Annual percentage change about 4.1%. The trend of BC incidence increased during 2003-2011 and then, decreased during 2011-2016.

Glucose-6-phosphate dehydrogenase (G6PD) is one of the most common genetic deficiencies that affect approximately 400 million people worldwide. This study aimed to identify neonates with G6PD deficiency in Ardabil province during 2017-2018. This cross-sectional study was conducted on all term and preterm newborns in Ardabil Province from April 2018 to April 2019. The sampling method was census and in study duration, 1044 newborns were entered in the study. For each infant, severe hyperbilirubinemia (total serum bilirubin equal or greater than 300 micromol/L) was tested by the diazo method and G6PD was evaluated by Fluorescent Spot Test (FST). Of all infants, 15 (1.4 %) were diagnosed to have G6PD deficiency by FST. The prevalence of G6PD deficiency was significantly in boys higher than in girls (80% vs. 20%, p=0.001). Of all infants, 97 (9.3%) had jaun dice 72 hours after birth that of them 7 neonates (7.2%) had G6PD deficiency. Results showed that the prevalence of G6PD deficiency in this study was less than in other places in Iran that may be because of different ethnicity and demographic features.

Introduction: Premature rupture of membranes (PROM) is not only a major medical problem but also a social and economic problem. According to the results of some studies, Vitamin D deficiency during pregnancy and labor may play a role in premature rupture of membranes by mechanism of inflammation in the placenta. Considering to the high prevalence of vitamin D deficiency in pregnancy and lack of knowledge about of the determinants of premature rupture of membranes, this study was performed with aim to investigate the relationship between maternal vitamin D levels with premature rupture of membranes. Methods: This case-control study was performed on 200 pregnant women with gestational age of 28-41 weeks who referred to Ardabil Alavi Hospital in 2018. 100 pregnant women with premature rupture of membranes were selected as the case group and 100 pregnant women without rupture of membranes as the control group. Blood samples were taken from both groups to measure serum levels of 25-Hydroxy Vitamin D. Demographic information, laboratory data, history and type of maternal delivery were collected. Data was analyzed by SPSS software (version 20) and Chi-Square and T-tests. P

Introduction: Early arrival of patients with acute ischemic stroke to start of treatment by recombinant tissue plasminogen activator (rt-PA) within 4.5 hours after onset of stroke. We aimed to develop a machine learning method to predict effective factors on arrival time of patients with stroke to hospital after symptom onset. Methods: We included 676 patients with ischemic stroke who referred to Ardabil city hospital a province in northwest of Iran at year 2018. Classification models such as Random forest (RF), Gradient Boosting Classifier (GB), Decision Tree Classifier (DT), Support-Vector Machines (SVM), Naïve Bayes (NB), artificial neural networks (ANN), and logistic regression (LR) with 10-fold cross-validation were developed to predict effective factors on arrival time of patient with stroke to hospital. The performances were evaluated with accuracy, sensitivity, specificity, positive prophetical worth, and negative prophetical worth. Results: Of all patients, 25.3% arrived to the hospital in less than 4.5 hours. The accuracy of RF, NB, ANN, GB, DT, SVM, LR and suggest method (Stacking) were 0.98, 0.72, 0.73, 0.79, 0.98, 0.73, 0.74, and 0.99. Conclusion: In this study, the Stacking technique provide a better result (Accuracy 99.51%, sensitivity 100%, and specificity 99.40%) among all other techniques and this model could be used as a valuable tool for clinical decision making.

Retinopathy of prematurity (ROP), which affects the retina of premature infants, is a leading cause of blindness in premature infants worldwide. The aim of this study was to evaluate the frequency and risk factors of retinopathy of prematurity infants referred to Alavi hospital between October 2018 and October 2019. In the present study, 400 infants with gestational age less than 34 weeks and or birth weight of 2000 g or less were enrolled in the study. Required information including sex, gestational age, maternal age, birth weight, type of delivery, oxygen therapy, septicemia, multiple gestations, consanguineous marriage, respiratory problem, and blood exchange were extracted from their hospital records and then included in the data collection form. These infants were also examined for ROP, stage and area of involvement by an experienced ophthalmologist and then classified into two groups including retinopathy and healthy group. Finally, the data were analyzed in SPSS 25 software using chi-square, fisher exact test, t-test, binary logistic regression, and ROC curve analysis. Of the 400 preterm infants studied (57.2% male and 42.8% female), 107 (26.8%) infants had ROP of whom 23 (21.5%) needed treatment (i.e. 5.8% of all infants need treatment). There were 4 (3.7%), 29 (27.1%), and 74 (69.2%) infants with zone I, II, and III, respectively. There were 91 (85%), 11 (10.3%), and 5 (4.7%) infants with stage I, II, and III, respectively. Multivariate logistic regression analysis showed that parental consanguinity (OR=2.263, 95%CI: 1.240-4.130, P=0.008), gestational age less than 32.5 weeks (OR=4.067, 95%CI: 2.340-7.069, P

Background: Overweight and obesity and its problems are the most important health and nutrition issues of adolescents in developed and developing countries. This study aimed to determine prevalence of overweight and obesity among studied population. Design and Methods: This Persian Cohort Study is a population-based study of 10,000 men and women, aged 35-70 years in northwest of Iran. Anthropometric parameters such as height, weight, waist circumference and hip circumference were measured by interviewers. Body Mass Index (BMI) and waist-to-hip ratio (WHR) were used to assess the overweight and obesity. Results: The mean age of all participants was 49.1±8.7 and 56.1% of them were female. The mean height of participants was 162.5±9.4 kg in range 126-196 and the mean weight of them was 78.5±13.1 cm in range 40-164. According to BMI, 42.7% of all participants had overweight and 45% had obesity. According to the WHR, 71.8% of male and 97.9% of female had high WHR (abdominal obesity). Conclusions: Results showed that the rate of overweight and obesity in studied people was more than country rate. So programing for raising their Quality of Life (QoL) and life style and also change their poor nutritional habits is essential in area healthy people.

Background & objectives: Gastric cancer has a very wide geographic distribution. Identification of the genetic factors involved in the cancer predisposition is very important. IL-1β as a pro inflammatory cytokine is involved in gastric acid secretion in the H. pylori infected individuals. This study was aimed to evaluate the role of IL-1β-511 polymorphism on the susceptibility to gastric cancer in residents of Ardabil province. Methods: One-hundred patients affected with gastric cancer and 100 normal individuals were selected as case and control groups, respectively. After DNA extraction from peripheral blood samples, the presence of the polymorphism IL-1β-511 was determined via PCR-RFLP assay. The results were evaluated by agarose gel electrophoresis. Results: Among cases, CC, CT, and TT genotypes were observed in 19%, 60%, and 21% of individuals, respectively. Also, the distribution of genotypes among the participated individuals in control group was 4%, 67%, and 29%, respectively. There was a significant difference (p

Introduction: Music and massage therapy are among the approaches of complementary medicine. Patients with cancer have been hugely encouraged in recent years to use complementary medicine to relieve chemotherapy-induced nausea and vomiting. The present study was conducted to determine the effect of music and periorbital massage therapy on chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancers. Methods: The present single-blind clinical trial study was conducted on 60 patients with gastrointestinal cancer undergoing chemotherapy who were randomly assigned to control and music plus massage therapy groups. Two interventions were concurrently carried out on patients in music plus massage therapy group while receiving chemotherapy medication, but the control group received no intervention. Rhodes questionnaire was used to assess nausea and vomiting before and 24 hours after chemotherapy. Data were analyzed using descriptive and analytical statistical tests (Chi-square and t tests). Results: Music plus periorbital massage therapy significantly reduced nausea and vomiting in patients undergoing chemotherapy compared to the control group (P

Introduction: Quality of life (QOL) is an important index in society that need for evaluation in all age groups people especially in medical university students as a people that their physical and mental health is related with community health. This study aims to investigate the quality of life (QOL) of Ardabil University of Medical Sciences. Methods: This is a cross-sectional study that has been conducted on 200 students who selected by random sampling method from Ardabil medical university students. The QOL was measured by WHOQOL-BREF which its validity and Reliability were investigated and approved. This questionnaire include 26 questions in four dimensions (physical, mental, social and environmental health). Collected data we analyzed by statistical test such as t-test for compare the mean of QOL score among demographic data. Results: Of all students, 57% were male and 91.5% were single. Of all students, 56% had desired quality of life. The relationships between QOL and variables such as gender, educational level, marital status and age of students wasn’t significant. The mean difference of four dimension scores among two sexes was statistically significant. The mean of Physical health dimension score was 11.6±2.1, Psychological was 12.3±2.4, Social relationships was 13.1±3.4 and environment was 12.7±3.2. The mean of total score of QOL in all students was 12.4±2.3. Conclusion: Results showed that the QOL of all students were in high level and in four dimension of QOL the female students had significant higher score than male students.

Introduction: Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health and increase the risk of more diseases in future. Body mass index (BMI) is a good method for measure the overweight and obesity and waist to hip ration is a good index for measure the abdominal obesity. Methods: This cross-sectional study was done on 1316 people who selected randomly from Ardabil city. Demographic data and anthropometric parameters such as age, sex, height, weight, waist circumference and hip circumference were measured by interviewers. Data were analyzed by statistical methods such as t-test, chi-square test, Pearson correlation and multinomial logistic regression model in SPSS version 21. Results: The mean age of the people was 28.5±7.4 years of them, 63.1% were in age group 20-30 years. The mean height of the samples was 162.7±8.6 cm in range 110-194 and the mean weight of them was 68.9±11.7 kg in range 43-111. The mean BMI of patients was 25.7. According to BMI, 35.6% of all samples had overweight and 18.6% had obesity. According to the WHR, 28.1% of male and 22.1% of female had high WHR (abdominal obesity). The prevalence of abdominal obesity based WHR was 25.2%. Conclusions: By using Multinomial Logistic Regression we showed that the relation between BMI and Age was positive and significant and by increasing one year at age of people, the rate of overweight increased 13% and the rate of obesity increased 17% in compare with normal patients.

Background: Iron deficiency anemia is common in patients on maintenance hemodialysis (HD). Serum ferritin is increased in HD patients. Vitamin C supplementation has shown to improve functional iron deficiency and anemia in HD patients. Objectives: In this study we aimed to evaluate the effect of vitamin C supplementation on serum ferritin level. Patients and Methods: In this randomized clinical trial, 39 HD patients were randomly assigned to receive routine therapy with (n=24) or without (n=15) vitamin C 500 mg IV twice a week after each dialysis session for 2 months. Changes in serum ferritin, iron, total iron-binding capacity (TIBC) and transferrin saturation (TS) before and after treatment were measured in each group. Results: Serum ferritin levels before treatment in case and control groups were 1859±1398.5 and 2567.5±1907.8 ng/mL which was significantly decreased to 1084.8±727.9 and 1313.5±1151.5 ng/mL, respectively (P=0.006 and P=0.007). Serum iron, TIBC and TS did not change significantly in each group after treatment. Comparing the mean changes in serum ferritin, iron, TIBC and TS, there was no significant difference between groups. Conclusions: Vitamin C had no effects on serum ferritin, iron and TS.

Background: Along with the complexity of social communications, the rate of suicide is increasing, and according to studies, women commit suicide more than men. Various factors affect the occurrence of this phenomenon. The purpose of this study was to determine the factors affecting unsuccessful suicide among women referring to the emergency room of the hospital of Ardabil City, Iran. Methods: This study was a descriptive cross-sectional study conducted on 236 women who had unsuccessful suicide. Questions were asked from patients with a checklist. This checklist has four parts. The first part relates to the patient’s personal information, and the second part relates to the patient’s previous history of mental, physical, and addiction problems. The third part asked about the causes of suicide and the fourth part related to the prior announcement. The collected data were analyzed by statistical methods in SPSS v. 18. Results: The Mean±SD age of the women was 27.66±9.95 years, and the majority was between 15 and 20 years old. About 64% of women were housewives, and 37.7% had undergraduate education. Also, 36% had a positive history of psychological diseases, and 30.9% had a history of suicide. The most common causes of suicide among women were emotional problems (91.9%), family and marriage conflict (81.8%), spouse’s disregard (50.4%), and economic issues (44.5%). Conclusion: The results showed that emotional problems and family and marital conflicts were common causes of suicide among women, and all women had at least one crucial reason for their suicide attempt.

Introduction: Hepcidin is the most important factor in iron metabolism and plays a potential role in erythropoiesis. It is a small peptide hormone which is cysteine-rich and is mostly secreted by hepatic cells. Aim: The purpose of this study was to evaluate the effect of andrographolide on the expression of hepatic hepcidin in an iron overload model. Materials and Methods: For the current study, 48 male Wistar rats were used in six groups. These groups included control group, andrographolide with 3.5 and 7 mg/kg doses groups, iron plus andrographolide groups with 3.5 and 7 mg/kg doses, and iron group. Hepcidin gene expression was performed by real-time method. Iron serum levels were measured by photometry. We used ANOVA and Kruskal Wallis to compare the means of the factors under investigation. Results: The results revealed that the quantitative expression levels of mRNA hepcidin decreased in all groups except in iron group compared with the control group. This decrease in andrographolide 7 mg/kg, iron plus andrographolide 3.5 mg/kg, and iron plus andrographolide 7 mg/kg groups was significant compared to the control group (p

Background: This study examined perceived cognitive function in patients with breast cancer and determined the main predictors of changes in cognitive function following treatment. Methods: The analytical cross-sectional study was performed in this study. 96 women receiving adjuvant treatment after surgery and who had already received adjuvant treatment were included in the study. The convenience sample was selected from the list of patients in Cancer Registry Center, private clinics and the Oncology Ward of Imam Khomeini Hospital in Ardabil, Iran. We used the Attentional Function Index to measure perceived cognitive function. SPSS version 16.0 was used to analyze the data. We used the t-test and analysis of variance to compare the differences in the Attentional Function Index scores to demographic and medical characteristics. Results: The mean Attentional Function Index score was 59.53±1.69. There was a statistically significant difference between the scores in terms of current non-surgical treatment (P

Background and Objective: Few studies have been done on lifestyle of Iranian physicians. As physicians have important role in health promotion, the main goal of the study was to assess the lifestyle of this influential group. Materials and Methods: A cross-sectional descriptive study was conducted on lifestyle of all registered physicians of Ardabil hospitals, Iran, 2012–13. In this research, 225 physicians were selected, by using simple random sampling. Demographic and lifestyle data were obtained by self-report using standard questionnaires, physical activity by official Iranian short-version of the international physical activity questionnaire, and dietary intake by food frequency questionnaire. Weight and height was performed according to standard protocols by using standardized and zero calibrated instruments. Data were analyzed by inferential statistics using Statistical Package for the Social Sciences.16 software. Results: Findings showed that 8% of participants were hypertensive, 21.3% smoker, 40%–47% inactive, 51.1% overweight, and 18.2% obese. There was a significant relationship between blood pressure and self-reported lifestyle habits (P < 0.05). And 70.7% of males and 74.1% of females had regular 10-min walking each day and moderate activity of males was significantly higher than females (P < 0.05). Food frequency weekly consumption of overweight and obese physicians were significantly higher than normal weight physicians (P < 0.05). Conclusion: Few doctors follow a healthy lifestyle; this may have a negative effect on society attitude about health.

Background: Gastric cancer is the fifth most common cancer in the world and the third leading cause of death from cancer worldwide. This study aims to assess the epidemiology of gastric cancer in Ardabil Province, Iran. Methods: This was a descriptive cross-sectional study performed on 1056 patients with gastric cancer registered in the Ardabil Cancer Registry. Data were collected by a checklist and analyzed by statistical methods in SPSS version 19. Results: Out of 1056 cases, 37% were smokers and 80.9% were illiterate. There were 73.1% male cases. Adenocarcinoma was the most common (89.5%) type of cancer and prevalent in males. The tumors were mostly located in the gastric cardia. Most cases were from rural areas. Conclusion: Results showed that the incidence of gastric cancer in Ardabil Province was higher in males compared to females. Compared to the country standards the incidence of gastric cancer was higher.

Background and Objectives:Oral and dental hygieneplays an important rolein provision and promotion of social health. The present study was carried out with the aim of evaluating the rate of availability of oral and dental health services and its effect on oraland dental health in 6-7 years old children in Qom city. Methods: This study was conducted as a cross-sectional study on 281 children in Qom province. The sampling method was Stratified sampling from rural and urban children. Data were collected using a checklist and analyzed by logistic regression model. Results: 56.2% of the samples were boys and the remaining were girls. 88.6% resided in urban areas and 11.4% in rural areas. The mean SD of decayed, missing, filled teeth (DMFT) and DMFT-ratio were 6.04 3.86 and 35.9 23.62%, respectively. From all children under study, 173 (61.2%) had a history of use of dentistry services and 167 (61.9%) had access to the services. There were significant associations between the use of oral and dental health services and DMFT variables, socioeconomic status, and access to the services. Also, there was a significant association between type of received services and socioeconomic status. Conclusion: The results of the present study showed that due to thenon-availability of free dentalcarein Iran, some of thebarriers tousing the services, especially the role of preventive services can be reduced throughincreasedaccess to the services inruralandurban areasas well as increasedparentalawarenessof theimportance ofprimary teeth in the health of permanent teethand physical health of children.

Background and objective: Organ donation has been considered as a recent method of supplanting patients’ organs or in the case of advanced disability. A key obsession in transplantation is the shortage of organs for transplanting. Depending on the type of disease, about 10-25% of patients in need of transplantation die on the waiting list. The present research was conducted to delve into the awareness and attitude of Bandar Abbas residents towards organ transplantation. Methods: In this descriptive-analytic research, 900 subjects from Bandar Abbas (487 men along with 413 women) all above 20 years of age participated. Sampling was done in multiple stages. The data gathering instrument was a questionnaire devised by the researcher, the reliability and validity of which were previously at tested by the field scholars. The collected data were later analyzed by SPSS16. Descriptive tests, ANOVA and Chi-squared test were used to analyze the data. The significance level was set at p

Background & objectives: Procalcitonin (PCT) is a precursor of calcitonin hormone, comprising 116 amino acids, which is produced in thyroid neuroendocrine cells. However, in conditions such as septic shock, metastatic cancers, bacterial and fungal infections PCT is secreted by lung neuroendocrine cells, liver cells, and leukocytes. PCT is involved in acute phase of inflammatory process as a reactant protein. Hence, in this study serum and pleural fluid PCT was evaluated in common types of pleural effusion. Methods: This is a cross-sectional case-series study carried out on 60 patients with pleural effusion. In this study, effusion cases due to tuberculosis, malignancy, effusion followed by pneumonia, and also transudate were investigated. Other cases of pleural effusion were excluded from this study. After collecting the samples, PCT levels in pleural fluid and serum of patients were measured and compared statistically with respect to the primary etiology of effusion. Results: Sixty patients (10 patients with TB, 10 patients with malignancy, 10 patients with para-pneumonic, and 30 patients with transudative pleural effusion) participated in this study in which 61.7% were men and 38.3% women (p=0.204). The mean age of participants was 62.68 ±19.38 years. Results showed that mean of PCT in pleural fluid of patients with exudative effusion was 0.74 ng/ml (0.63 ng/ml in malignancy, 0.42 ng/ml in TB and 1.51 ng/ml in para-pneumonic) and in patients with transudative was 0.42 ng/ml. In addition, mean of PCT in the serum of patients with exudative pleural effusion was 0.74 ng/ml (0.65 ng/ml in malignancy, 0.40 ng/ml in TB and 1.20 ng/ml in para-pneumonic) and in patients with transudative was 0.43 ng/ml. The analyzed data showed that there was a significant difference in the pleural fluid (p=0.016) and serum PCT (p=0.009) of patients with pleural effusion transudate and exudates. After excluding patients with transudative, a significant difference was also observed among patients with exudative in such a way that in the para-pneumonic group the amount of PCT level in the serum and pleural fluid was more than tuberculosis and malignancy groups. Conclusion: Serum and pleural fluid PCT is increased as a marker in response to inflammation. Although its increase in patients with bacterial and pneumonia infection is significant, it can be increased in patients with secondary inflammation of tuberculosis or malignancy and consequently can be used as an inflammatory indicator in the evaluation of patients with pleural effusion.

Introduction: About one third of the world's population is infected with tuberculosis (TB) and each year, about 1.5 to 2 million people die from TB. Procalcitonin (PCT) is an inflammatory marker that its level has variable results. There are some discussions in the utilization of PCT as a diagnostic marker in active pulmonary TB. The aim of this study was to compare serum PCT before and after treatment in patients with pulmonary TB. Materials and Methods: This conducted on patients with pulmonary TB. Data were collected using a check list. The serum level of PCT was measured by ELISA test at the beginning and after six months of treatment. All data were analyzed using SPSS 16. Results: Forty-two patients with active pulmonary TB entered in this study. The mean age of the patients was 45.48 ± 12.54 years and 54.8% of them were male. Most of the patients (59.5 %) were rural inhabitants. There was a family history of TB in 26% of patients. The most common symptom (45.2%) was cough. Mean PCT prior to treatment was 1.25 ± 0.98 ng/ml. and 81% of the patients had PCT higher than 0.5 to 5. After treatment PCT level reduced significantly (P

Background and objective: In recent decades there has been a growing increase in the consumption of fast-foods. As a result of over-consumption of these high-calorie and fatty foods and the unbalance between the received and consumed energy, the chance of affliction with cardiovascular diseases and diabetes in individuals has rised. The present research sought to determine the effective factors related to the consumption of fast-foods in Bandar Abbas in 2013. Methods: The present research was descriptive/analytic and of a cross-sectional type. Research population was comprised of 600 fast-food consumers. The samples were selected using a combination of cluster sampling and convenient sampling. The instrument used for gathering data was a researcher-made questionnaire (RMQ) to measure the reasons for people’s tendency toward consuming fast-foods. The validity of the questionnaire was confirmed by experts and its reliability was established in the pilot study. SPSS16 was used to analyze the data. Descriptive statistics (mean, SD, frequency and percentage) as well as analytical statistics (ANOVA and Chi-squared test) were used. Significance level was set at

Background & Objectives: Delivery is one of the most important events in a woman's life, and pain is an inevitable part of childbirth. The non-controlled pain leads to prolonged labor and multiple injuries to mother and fetus. This research was done to determine the effect of acupressure at the SP6 and LI4 points on the duration and pain of the labor in nulliparous women. Methods: This randomized controlled clinical trial was conducted on 84 nulliparous women who were attended hospital in Ardabil. The participants were divided into two intervention and control groups using randomized blocking. Pressure has been done on SP6- LI4 points in intervention group. Pain intensity was measured before and after the intervention using visual analog scales and length of active phase and second stage were recorded through vaginal exam in the checklist. Determination of the effect of pressure on the intensity of labor pain and delivery length performed using paired t-test, Student’s t-test and chi-square by SPSS v.16. Results: After the intervention the mean level of pain intensity in the intervention group was decreased. Also, there was a significant decrease in mean intensity of pain after each intervention in the intervention group with different dilations (4, 6, 8, and 10 cm) (p

Background & Objectives : Poisoning is a common cause of hospital emergency visits in many countries. Incidence of poisoning is different based on cultural and economic characteristics. The aim of this study was to investigate the epidemiology of poisoning in pediatrics. Methods: This cross sectional study was performed on 336 patients under 13 years of age referring to Bu-Ali hospital during five years (2007-2011). Variables such as age, sex, residency place, hospitalized duration, cause of the poisoning, clinical signs, treatment and outcome were obtained by a checklist. Collected data analyzed by statistical methods in SPSS v16. Results : Among the subjects, 197 patients (58.6%) were male. The average age of the children was 4.1 years and the most common age range was 1 to 4 years with (210 patients, 62.5%). The mean duration of hospitalization of children was 1.7 day (SD= 0.2), 77.7 % of the children were living in the city and the summer was accounted as a common season in which the patients referred to the hospital (32.7 %). The most used materials were drugs with 60.71% and in 86.6% of patients the cause of poisoning was accidental. Conclusion : Results showed that the most common cause of poisoning among children are drugs and methadone was the most commonly abused substance. It requires that parents should be trained about keeping their children away from drugs somewhere.

Introduction:Most women have experienced child birth and its pain, which is inevitable. If this pain is not controlled it leads to prolonged labor and injury to the mother and fetus. This study was conducted to identify the effect of acupressure on sanyinjiao and hugo points on delivery pain in nulliparous women. Methods:This was a randomized controlled clinical trial on 84 nulliparous women in hospitals of Ardebil, Iran. The participants were divided by randomized blocks of 4 and 6 into two groups. The intervention was in the form of applying pressure at sanyinjiao and hugo points based on different dilatations. The intensity of the pain before and after the intervention was recorded by visual scale of pain assessment. To determine the effect of pressure on the intensity of labor pain, analytical descriptive test was conducted in SPSS (version 13). Results:There was a significant decrease in mean intensity of pain after each intervention in the experimental group with different dilatations (4, 6, 8, and 10 cm). Moreover, the Student’s independent t-test results indicated that the mean intensity of pain in the experimental group after the intervention in all four dilatations was significantly lower than the control group. Repeated measures ANOVA test indicated that in both experimental and control groups in four time periods, there was a statistically significant difference. Conclusion:Acupressure on sanyinjiao and hugo points decreases the labor pain. Therefore, this method can be used effectively in the labor process.

Background & Objective: Evaluation is an essential process for educational institutions and one of the most common methods of evaluation of teachers is evaluation by students Students are the real customers in the educational process therefore their judgments should be important variables in determining teaching status of teachers According to customercentric principles the consumers satisfaction must be met This study assessed the validation of the current teacher evaluation form in theoretical courses Methods: This was a crosssectional study investigating the validity and reliability of the teacher evaluation form that is completed by students and identifying some factors affecting student evaluations To determine content validity of the teacher evaluation form 20 expert teachers were selected proportional to the number of teachers of each school of the Hamadan University of Medical Sciences To assess the reliability coefficient of the form 189 students were selected from different schools by proportional random sampling Results : According to the results questions such as rate of adherence to the determined topics providing practical application of teaching materials and the efficacy of determined assignments did not have the necessary validity score However the results indicated that validity of the questionnaire was acceptable In the present study the SpearmenBrown correlation coefficient indicated that the teacher evaluation form did not have an acceptable reliability (r = 0456 P < 0001) Conclusion: The current teacher evaluation form has an acceptable content validity but it does not seem reliable

Background & Objective: Currently, migration of rural population to cities and developing slums around them are main problems in population settlement that lead to imbalance in health standards such as difference in age groups death. The aim of this study was to examine factors associated with infant mortality in slums of the Ardabil city. Methods: This was a case- control study. All infants’ deaths from 2008 to 2010, which occurred in slums as a case, were included. For each case, tow controls, were chosen. Controls the ones who survived and were living in non marginalized area and years of birth and sex were matched in two groups. Information collected from health centers through questionnaires, interviews with parents and child death files. Results: The majority of mortalities (74.6%) were in neonatal period and 25.4% was in post- neonatal period. The most important causes of deaths in neonatal were prematurity (57%), and in post neonatal period were congenital abnormality (35.4%). Analysis of effective factors showed that birth weight, parents age and education, family income and occupation and smoking of father were highly associated with mortalities. Conclusion: Infant mortality of the family that their father is a smoker and they have low income, and low parental education level is significantly higher and should be taken into serious consideration to reduce the mortality.

Background & Objective s: Poisoning is one of the most common causes that referred to the Emergence and one of the most important Medicine immediacy. Correct and immediate diagnosis and accommodative treatment can be life saving. Knowing the overall pattern of poisoning in any geographical area would help to better manage and treat the victims. Methods : In a cross sectional descriptive study, the required information was collected from the records of patients showing drugs and chemical poisoning who referred to Imam Khomeini hospital Collected data was statistically analyzed using SPSS software. Results : Out of 2852 case of poisoning, 106 people passed away due to severe complication. Of these 56.8% were men and 43.2% were women. The majority of cases (76.8%) were from urban areas. Suicide was the main cause of poisoning (66.53%). Accidental poisoning was recorded for 5.01% of cases. In 28.45% of cases, the cause of poisoning was not identified. The age group 21-30 years made the highest number of cases (52.3%). Tramadol, Benzodiazepines and Aceteminophen were the most poisons used respectively. Benzodiazeine was the most taken drug is in suicide (19.97%). Conclusion : Results showed that poisoning with Tramadol and Benzodiazepines is high in Ardabil Province. Opioids, Aluminum Phosphide and Organophosphores are the main causative of death in poisoned victims in the province of Ardabil.

Background & Objectives: Insomnia is one of the most common sleep disorders in the world. It causes disruption in daily activities and increases the risk of major depression. Hence, clinically the appropriate and persistent treatment of insomnia is very important. Using of hypnotic drugs such as benzodiazepines is the common treatment for insomnia but they show several side effects and it seems that new medications should be used for treatment of sleep disorders. The aim of this study was comparison between the effects of electromagnetic therapy and conventional drug usage in the treatment of insomnia. Methods: In a blind randomized clinical trial study, 60 people referred to the private office of the psychiatrist and experienced more than 3 months extended primary insomnia were selected. They were diagnosed by DSM-IV criteria and had no other underlying problems. The subjects were divided in two groups: 30 people in each and treated electromagnetically or with Alprazolam for 3 weeks. Before treatment, immediately and one month after treatment, quality of sleep and severity of the insomnia were evaluated by using the standard questionnaires and finally, the results were analyzed statistically. Results : In this study, 60 individuals participated from whom 28 were male (46.7%) and 32 patients were female (53.3%).The mean age was 37.3 years old in a range of 17- 65. The mean point of each questionnaire, before and immediately after treatment significantly didn't show any difference but one month after treatment, there was a significant difference in both groups. Conclusion : To treat insomnia, electromagnetic therapy appears to be used as a replacement for sedative medicines. It also has more stability in comparison with other sedative medicines and no side effects have been reported yet.

Background & Objectives: Coronary artery disease is the main cause of mortality in developing and industrial countries. Recently the involvement of infectious agents as a risk factor for Acute Coronary syndrome is drafted. So this study was designed to investigate the probable association between Acute Coronary syndrome and Helicobacter pylori infection. Methods: This case-control study was carried out on 300 hospitalized patients with the diagnosis of Acute Coronary syndrome (UA and MI) and 300 hospitalized patients without the history of coronary heart disease. Anti Helicobacter pylori Antibody level was determined by as an indicator of infection history. Using chi-square and t- test the results were analyzed in SPSS software. Results: Results showed that 79 patients (26.3%) in control group and 122 patients (40.6%) in case group were seropositive and the difference was significant. Relationship between cronory diseases risk factors and levels of IgG was not significant. Also the results showed that the rate of hypertension in seropositive patients in case group was significantly upper than control group. Conclusion: Regarding the findings of this study we can conclude that Helicobacter pylori infection probably is a risk factor for Acute Coronary Syndrome. Thus, further studies are needed to elucidate the association between Helicobacter pylori infection and Acute Coronary Syndrome.

Background & Objectives: Urinary stone disease is one of the common urinary tract complications that can lead to renal failure. It occurs usually in middle-aged and older men The aim of this study was to determine the association between types of urinary stones and risk factors for urinary stone formation in patients referred to Ardabil therapeutic centers. Methods : In this descriptive cross-sectional study, 150 patients with urinary stone were followed from March 2008 to July 2009 in therapeutic centers of Ardabil. Data were collected by a questionnaire include demographic factors such as age, gender, body mass index (BMI), Job and Habitation place. Data were analyzed by chi-square test and ANOVA in SPSS 16 software. The level of significance was p

Background: The aim of this study was to evaluate the results of amblyopia screening in Ardabil Province in three examination levels by kindergarten teacher, optometrist, and ophthalmologist. Methods: In a cross-sectional study, the results of the national amblyopic prevention program in 2-6 years old children in Ardabil Province were investigated in 2012. The results pertained to the examinations of children participating in this research were collected in the national approved forms. The data were entered into the computer and were analyzed using statistical methods in SPSS 18. Results: Around 38,844 children (51.7%) out of 75173 with 2-6 years old qualified children participated in the screening program in Ardabil Province. In the first stage of screening, 1068 children (33.1%) are visually impaired in one eye and 2160 children (66.9%) are visually impaired in two eyes. In the second stage, the results related to the examinations by optometrists indicated that the prevalence of refractive errors, strabismus, and others were 70%, 27.8%, and 2.2%, respectively. Refractive errors problem was most prevalent in Ardabil city (72.6%).The prevalence of refractive errors, strabismus, and other reasons in amblyopic children was 51.3%, 23.9%, and 24.8%; respectively. Conclusions: The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

Background & objectives: Today, the concept of q uality of services is particularly important in health care and customer satisfaction can be defined by comparing the expectations of the services with perception of provided services. The aim of this study was to evaluate the quality of services provided for outpatients in clinic of Ardebil city based on the SERVQUAL model. Methods: This descriptive study was conducted on 650 patients referred to outpatient clinic since July to September 201 3 using a standardized SERVQUAL questionnaire (1988 ) with confirmed reliability and validity. The paired t-test and Friedman test were used for analysis of data by SPSS software. Results: 56.1 % of respondents were male and 43.9 % of them were female . The mean age of patients was 33 ± 11.91 , 68.9 % of patients were in Ardabil and 27.3 % of them had bachelor's or higher. The results showed that there is a significant difference between perceptions and expectations of the patients about five dimensions of the service quality (tangibility, reliability, assurance, responsiveness, and empathy) in the studied clinic (P< 0.001). The highest mean gap and minimum gap were related to empathy and assurance, respectively. Conclusion: Regarding to observed differences in quality , the managers and also planners have to evaluate their performance more accurately in order to have better planning for future actions. In fact, any efforts to reduce the gap between expectation and perception of patients result in greater satisfaction, loyalty and further visits to organizations.