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Proximal humerus fractures became one of the most prevalent upper extremity fractures during recent decades. The use of scoring systems has been taken under consideration to estimate the surveillance, prognosis, and post-operative outcomes. During this study, we investigated the outcome measure of proximal humerus fracture treated by open reduction and internal fixation (ORIF) with plate based on oxford shoulder score (OSS). Furthermore, we tried to propose a new classification system for OSS that could be of prognostic value.Patients with proximal humerus fracture treated by open reduction enrolled in the study. Persian version of the OSS was completed by the patients. Data were analyzed using SPSS-22.Forty-four patients including 24 women and 20 men were assessed. The mean age was 54.61 (SD ± 19.371) years. The use of a spoon and fork at the same time had the best score and hanging the clothes up in a wardrobe with the operated hand had the worst score in the questionnaire. Comparison of OSS and number of physiotherapy session showed that patients with best outcome had least number of physiotherapy's session, but it was not statistically significant.OSS is useful to evaluate the function of the traumatized shoulder. We suggest classifying the OSS score into three range groups, good (total score 12-28), moderate (total score 29-44), and bad (total scores 45-60).

Background Osteoporosis and osteopenia are common diseases in every population. Type 2 diabetes mellitus (T2DM) can lead to the development of various complications, such as bone disorders especially among elderly individuals. Studies suggested that ectonucleotide pyrophosphatase/phosphodiesterase1 (ENPP1) is contributed in insulin resistance and also the inhibition of bone mineralization. In this study, association of K121Q (rs1044498) polymorphism of the ENPP1 gene with T2DM and bone disorders is evaluated. Methods Four-hundred-and-ninety females who were classified based on bone mineral density (BMD) at lumbar spine and femur were included in this study. In addition, participants were classified according to their diabetes status. K121Q polymorphism was evaluated by the PCR-PFLF technique. One-way ANOVA was used for comparison of various analyzed factors in diseases subgroups and K121Q genotypes. Association of K121Q polymorphism with diabetes and bone disorders was evaluated by logistic regression. Results Significant association was observed between K121Q polymorphism with osteoporosis and osteopenia (p = 0.041, p = 0.029, respectively), but a similar pattern was not observed in T2DM status (p = 0.723). Moreover, in diabetic patients, K121Q polymorphism showed a better prediction potential for the development of bone disorders in comparison to non-diabetic subjects (p = 0.018; OR = 4.63, p = 0.540; OR = 1.31). There were no significant differences between K121Q genotypes with FBS, Ca, P, vitamin D, PTH and BMD status. Conclusions The present study implies that K121Q polymorphism of ENPP1 gene is able to modulate the development of bone disorders in T2DM. Therefore in diabetic patients screening of this polymorphism is suggested for the monitoring of these persons.

Background: Sexual function is an essential component of life and yet very little is known about the relationships between the female sexuality and the mode of delivery. Objective: To compare sexual outcomes after vaginal delivery and cesarean section. Methods: A cross-sectional study was conducted on women in two stages; early pregnancy and 3 to 6 months after delivery in health centers. Female sexual outcomes evaluated were female Sexual Function Index scores and the time required to resume sexual activities after delivery. Results: Sexual function did not differ significantly among two groups vaginal delivery n=90 and cesarean section n = 113 with regard to duration of marriage, educational level, contraception methods, and occupational status p = 0.8.The mean timing of the resumption of sexual activity was 8.9 ± 1.3, and there was no substantial conflict between the two groups. Mean frequency of intercourse in the post-partum period was 1.8±1.2 times per week with significant difference compared to pre pregnancy P

Introduction: Sexual function is undoubtedly an important dimension of adult life. Due to all the conflicting results with regard to sexual function after the normal vaginal delivery (NVD) or the Cesarean Section (CS), in the present study, we aimed to compare the sexual function in women pre-pregnancy and postpartum and also after the NVD and CS. Materials and Methods: In this cohort study, two groups of healthy women, with antenatal normal pregnancies, who underwent NVD (n = 90) and CS (n = 113), were prospectively studied. The sexual function of the participants was assessed through a Female Sexual Function Index (FSFI) questionnaire in two stages: once before pregnancy and then within 3 to 6 months after delivery, which lasted from June 2011 to September 2012. The data were analyzed by descriptive and inferential statistics. Data were analyzed using chi-square test, Mann-Whitney test, and T Test. Results: Based on the data gathered from 206 women who completed the FSFI questionnaire in two stages, the mean (±SD) self-reported timing of the resumption of sexual activity was 8.9 ± 1.3. There was no significant statistical difference found between the two groups by timing of the resumption of sexual activity in NVD and CS groups. There was also no statistically significant difference found in the overall sexual function scores between the two groups (NVD vs. CS). The average score for female sexual function in desire, arousal, orgasm, and satisfaction within 3 to 6 months after delivery was significantly lower than that of their pre-pregnancy period (p < 0.004). The mean coitus in postpartum period was 1.84 ± 1.20 per week. Conclusion: Based on the findings of this study, there was no significant relationship between the mode of delivery and changes in sexual function. Therefore, it can be claimed that CS is not preferred to NVD with regard to preserving normal sexual functioning.

Background: Acute otitis externa, an inflammatory condition of the external auditory canal, is a common clinical problem in general medicine. Objectives: This study aimed to determine the etiology of otitis externa in patients from the Mazandaran province, north of Iran, which has a humid climate, as humidity can affect the prevalence of pathogenic microorganisms. Patients and Methods: This cross-sectional study involved 116 patients with otitis externa. Two sets of samples were collected from their ears; one set was used for slide preparations, and the other for microbial culturing. After culturing, the microorganisms were identified by conventional methods. Results: Patients between 35 and 44 years of age were most frequently affected (25.00%) by otitis externa (average age, 43.87 ± 18.08 years). Moreover, women (54.31%) were more frequently affected than men (45.69%). Upon direct investigation, Gram-positive bacilli were the most commonly identified microorganisms (22.41%). Furthermore, Bacillus spp. and coagulase-negative staphylococci (22.41% and 19.83%, respectively), were the organisms most frequently identified from cultures of otitis externa samples. Conclusions: Direct examination and culture showed that a mixed infection of fungi and bacteria is the most common cause of otitis externa. The present study revealed that Bacilli spp. were the most abundant bacteria isolated from patients with otitis externa. Thus, it is recommended that both organisms should be considered as etiologic agents in protocols for treatment of otitis externa.

Background and Objectives: The present study aimed to evaluate the effect of classical and azithromycin-containing triple therapy eradication regimen against H. Pylori in children, and to determine the level of patients’ tolerance. Patients and Methods: This single clinical trial was performed in 2014 on 2 to 15 years old children. All children, in whom H. Pylori infection was confirmed through multiple biopsies of the stomach and required treatment, were enrolled in the study. H. Pylori-positive patients were treated alternately with two different drug regimens; Group OCA received clarithromycin 7.5 mg/kg/day every 12 hours for 10 days, amoxicillin 50 mg/kg/day every 12 hours for 10 days, and omeprazole 1 mg/kg/day every 12 hours for two weeks, and Group OAA received azithromycin 10 mg/kg/day once a day (before meal) for 6 days along with amoxicillin and omeprazole. Four to six weeks after completion of treatment, patients’ stool was tested for H. Pylori through the monoclonal method using the Helicobacter antigen quick kit. Results: There were no significant differences between the two groups regarding gender and age of patients. Based on ITT analysis, the therapeutic response in the OAA and OCA groups were 56.2% and 62.5%, respectively (P = 0.40). Drug adverse effects were 15.6% in the OCA and 3.1% in the OAA group (P = 0.19). Conclusions: The therapeutic response was seen in more than half of the patients treated with triple therapy of H. Pylori eradication regimen including azithromycin or clarithromycin, and there was no significant difference between the two treatment groups.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency may cause severe hyperbilirubinemia with bilirubin encephalopathy unless intervention is initiated. The aim of this study was to assess the efficacy of clofibrate in full term G6PD deficient neonates with jaundice. A randomized clinical trial study was performed in two groups of full-term G6PD deficient jaundiced neonates (clofibrate treated group, n = 21; control group, n = 19). Infants in the clofibrate group received a single oral dose of 100 mg/kg clofibrate, whereas control group received nothing. Both groups were treated with phototherapy. Serum total and direct bilirubin levels were measured at the onset of treatments, 16, 24 and 48 hours later. On enrollment, the mean total serum bilirubin (TSB) level in the clofibrate treated group was 18.40 +/- 2.41 and in the control group was 17.49 +/- 1.03 (p = 0.401). At 16, 24 and 48 hours of treatment, the mean TSB in the clofibrate group were 15.2 +/- 1.9, 12.6 +/- 2.4, and 10.1 +/- 2.4 and in the control group were 16.5 +/- 1.2, 13.3 +/- 2.2 and 11.4 +/- 2.4, respectively (p = 0.047). At 48 hours, 7 (33%) cases in the clofibrate group and one (5%) case in the control group were discharged with a TSB10 mg/dl (p = 0.031). No side effects were observed on serial examinations during hospitalization, or on the 1st and 7th days after discharge. The results show that clofibrate induces a faster decline in serum total bilirubin level, a shorter duration of phototherapy, and hospitalization with no side effects in full-term G6PD deficient neonates with jaundice.

Hyperbilirubinemia is a common problem in newborn infants. It can progress to kernicterus in severe forms, unless an intervention is initiated. The objective of this study was to determine the therapeutic effect of clofibrate in full-term neonates with nonhemolytic jaundice.A randomized clinical trial was performed on two groups of full-term jaundiced neonates: the clofibrate-treated group (n = 30) and the control group (n = 30). Infants in the clofibrate group received a single oral dose of 100 mg/kg clofibrate while the neonates in the control group received distilled water (same color and volume); both groups received phototherapy. Serum total and direct bilirubin levels were measured at the beginning, 16, 24, 48, and 74 hours, after the start of the trial.The mean+/-SD total serum bilirubin level of the control and clofibrate groups at enrollment was 17.5+/-2.3 and 18.2+/-1.9 mg/dL, respectively (P = 0.199). The mean+/-SD total serum bilirubin in the control and clofibrate groups after 48 hours was 11.4+/-2.4 and 10.1+/-2.4 mg/dL, respectively (P = 0.047). After 72 hours of intervention, 25 (83%) neonates of the clofibrate group and 16 (53%) of the control group were discharged with a total serum bilirubin of10 mg/dL (P = 0.026). No side-effect was observed on serial examination during hospitalization, and on the first and seventh day after discharge.Clofibrate results in a faster decline in TSB, shorter duration of hospitalization and had no side effects in jaundiced full-term neonates.

Preeclampsia is one of the most common complications of pregnancy. It is a trophoblastic disorder. Since human chorionic gonadotropin (hCG) is secreted by trophoblast, the purpose of the study was to determine the levels of beta (hCG) in preeclampsia and normal cases.This study was conducted on 40 term pregnant women with preeclampsia (case group) and 40 normal pregnant cases (control group) in the Department of Obstetrics and Gynecology, Medical University, Babol, Iran, from 2004 to 2005. Serum beta-hCG in all cases were measured by radioimmunoassay. The mean beta-hCG level in preeclampsia (mild and severe) was compared with normal cases.The maternal serum, beta-hCG level in patients with preeclampsia (39840 +/- 24630 IU/L) was higher than in the control group (27460 +/- 25862 IU/L) (p=0.031). In mild preeclampsia (34 cases), the mean serum beta-hCG level was 31991 +/- 16758 IU/L while in severe preeclampsia (6 cases) 84312 +/- 9257 IU/L (p0.0001). The mean serum beta-hCG level in mild and severe preeclampsia was higher compared to the normal cases.The results of this study show that the levels of beta-hCG in severe form of preeclampsia is higher compared to the milder ones.

From March 1998 to September 2001, 64 children and from October 2001 to December 2004, 66 children < or = 15 years with brucellosis in Babol, Iran, were treated with cotrimoxazole and rifampin for 6 or 8 weeks, respectively. Cure rate for 6 weeks was 89.1% and for 8 weeks it was 95.5%. Six weeks of therapy with cotrimoxazole plus rifampin is sufficient for treatment of childhood brucellosis.

The main goal of the present study is to examine the health effects of high natural background radiation among the residents of Ramsar, one of the inhabited areas with highest natural background radiation. This report summarizes the data obtained from 402 residents of high background radiation area and 374 residents from an adjacent normal radiation area. Overall data showed no significant differences in the frequencies of any mental and physical disabilities as well as malignancies between residents of normal and high background radiation areas. Results also showed no significant increase in the frequency of death, abortion and mental depression among inhabitants in high background radiation area. We plan to extend our work, using more clinical and paraclinical tests on these populations in the next phase of the study.