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Abstract Background Depression has rapidly progressed worldwide, and the need for an efficient treatment with low side effect has risen. Melissa officinalis L and Lavandula angustifolia Mill have been traditionally used in Asia for the treatment of depression. Many textbooks of traditional Persian medicine refer to these herbs for the treatment of depression while there are no adequate clinical trials to support this claim. The present study aimed to evaluate the efficacy of M. officinalis and L. angustifolia compared to fluoxetine for the treatment of mild to moderate depression in an 8-week randomized, double-blind clinical trial. Methods Forty-five adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) for major depression, were randomly assigned to 3 groups to daily receive either M. officinalis (2 g) or L. angustifolia (2 g) or fluoxetine (20 mg) and were assessed in weeks 0, 2, 4 and 8 by the Hamilton Rating Scale for Depression (HAM-D) including 17 items. Results Our study showed that M. officinalis and L. angustifolia effect similar to fluoxetine in mild to moderate depression. (F = 0.131, df = 2,42, p = 0.877). Conclusion Due to some restrictions in this study including absence of placebo group, large-scale trials are needed to investigate the anti-depressant effect of these two herbs with more details. Trial registration IRCT2014061718126N1 . Registration date: 2015-06-04-“Retrospectively registered”.

Background: Acute myeloid leukemia (AML) may originate from the combination of genetic susceptibility factors and environmental exposure. The aim of this study was to investigate the association of GSTM1 and GSTT1 null genotypes and CYP1A1*2A allele with susceptibility to AML in an Iranian population. Method: In this case-control study, 200 patients with AML and 200 normal individuals as controls were included. GSTM1 and GSTT1 null genotypes were amplified using multiplex PCR and CYP1A1*2A polymorphisms were genotyped by PCR-RFLP. Result: The frequency of GSTM1 null genotype was significantly higher in the control group compared to the case group. The frequency of GSST1 null genotype was significantly lower in the controls. No association was observed between the studied CYP1A1*2A variant and the risk of acute myeloid leukemia. The combination of GSTT1 null genotype and CYP1A1 *2A AA and AC alleles further increased the risk of AML. Conclusion: GSTT1 null genotype can increase the risk of AML, particularly when combined with CYP1A1*2A allele. GSTM1 null genotype can also play a protective role and reduce the risk of AML. However, further studies are required on a larger number of patients.

Introduction: Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). The current study was conducted to determine the effect of a protocol using a Richmond Agitation-Sedation Scale (RASS) on some clinical outcomes of patients under mechanical ventilation (MV) in 2017. Methods: This single-blind clinical trial was conducted on 79 traumatic patients in the ICU who were randomly allocated into the intervention (N=40) and the control groups (N=39). The sedation was achieved, using a sedation protocol in the intervention group and the routine care in the control group. The clinical outcomes of the patients (duration of MV, length of staying in ICU, final outcome) were measured. As the participants had different lengths of MV and staying in ICU, the data were restructured, and were analyzed, using proper statistical methods. Results: The patients’ level of sedation in the intervention group was significantly closer to the ideal score of RASS (-1 to +1). The duration of MV was significantly reduced in the intervention group, and the length of stay in the ICU was also significantly shorter. There was no difference in terms of final outcome. The ICU cost in the control group was twice as high as the cost in of the intervention group. Conclusion: The applied sedation protocol in this study would provide better sedation and could consequently lead to significantly better clinical outcomes, and the cost of caring as a result.

Background and purpose: Spirituality is considered as one of the factors influencing physical and mental health of individuals. The aim of this study was to determine the effect of spirituality counseling on coping patterns with pregnancy challenges in primigravida women. Materials and methods: In a randomized clinical trial, the coping patterns were assessed in 60 eligible women. The intervention group attended 8 counseling sessions on the basis of spirituality approach, while the control group received routine care. The data were collected using the Revised Prenatal Coping Inventory before and two months after the study. Data analysis was done applying descriptive statistics, Chi-square, independent t-test, and paired t-test. Results: After the intervention, the mean score for total coping patterns and its domains in the intervention group (1.94 ± 0.24) was significantly different from that of the control group (1.81 ± 0.22) (P= 0.03). The difference was not significant before the intervention (P= 0.15). In experimental group, the pre and post intervention mean scores for total coping patterns and its domains were significantly different (1.78 ± 1.30 and 1.94 ± 0.24, respectively) (P= 0.001). The scores in control group did not show any significant changes (1.87 ± 1.20 to 1.81 ± 0. 22) (P= 0.17). But, a significant decrease was seen in the mean score for avoidance (P= 0.02). Conclusion: The study showed that spiritual counseling is an acceptable approach that could improve women's coping patterns with pregnancy challenges and can be used as a basis in designing similar interventions. (Clinical Trials Registry Number: IRCT20150731023423N12)

Background: Application of technology for education accounts for an important aspect of expansion of the information technology in the present century. Objectives: This study aims to examine the degree of readiness of the faculty member of Zanjan University of Medical Sciences for e-Teaching. Methods: This descriptive-cross-sectional study focused on the degree of readiness of 70 faculty member of Zanjan University of Medical Sciences in 2014. It followed the simple randomized sampling method. The readiness of faculty member was assessed from five dimensions, including organizational support, perceived value, and time commitment, working skill, access to computer, internet and attitude towards e-Teaching, using a standard questionnaire. The data were analyzed using descriptive statistics indices, Pearson correlation coefficient and Logistic Regression Model at 95% confidence interval. Results: The university faculty member were in adequate level of readiness in terms of organizational support (46.4%), positive attitude towards e-Teaching (49.3%); the skill of work with computer (49.3%), time commitment (44.9%), access to computer (49.3%) and positive perceived value (45.6%). The predictive variables of the university faculty member’ readiness were appropriate in terms of organizational support, access to computer and in term of, perceived value, age and gender of the university faculty member in term of, perceived time obligation, skill in work with computer and organizational support. Conclusion: The results showed that readiness of the the faculty member of Zanjan University of Medical Sciences for e-Teaching was in a relatively appropriate level. Expanson of the technological infrastructure, holding empowerment workshops in order for improvement of the required skill and changing attitude of the university faculty member for e-Teaching are suggested

Objective (s): The study was conducted to investigate the effectiveness of training of Iranian traditional medicine principles on health workerschr('39') lifestyle in Kashan, Iran. Methods: This was a quasi-experimental study on a sample of 54 health workers. The educational intervention was performed through 5 weeks and 25 educational hours during which, principles of health maintenance (weather, exercise and resting, sleep and awakeness, eating and drinking, maintaining essential materials and repelling unnecessary materials, psychological health) were taught to health workers. Data collection was conducted before and three months following the educational intervention. Results: According to the statistical analysis significant improvement was observed in five principles (weather, sleep and awakeness, eating and drinking, maintaining essential materials and repelling unnecessary materials and psychological health). Conclusion: The findings indicated that training Iranian traditional medicine principles for maintaining health could improve the lifestyle of health workers.

Introduction: Preterm birth is one of the most important complications of pregnancy, which has a significant impact on the health and mortality of neonates, so early diagnosis and prediction is vital. This study was performed with aim to investigate the relationship between amniotic fluid alpha-fetoprotein (αFP), alkaline phosphatase (ALP) and ferritin in the second trimester of pregnancy and preterm birth. Methods: This cross-sectional analytical study was performed on 60 subjects with gestational age of 15-20 weeks (mean of 17 weeks) who had performed amniocentesis due to positive first-trimester screening from September 2014 to February 2015. The levels of αFP, ALP and ferritin were tested using spectrophotometric and ELISA method in freeze samples of 40 subjects with term birth and 20 subjects with preterm birth. Data were analyzed by SPSS software (version 22) and t-test and Chi-square test. P

The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) spread rapidly all over the world in late 2019 and caused critical illness and death in some infected patients. This study aimed at examining several laboratory factors, especially inflammatory and immunological mediators, to identify severity and mortality associated biomarkers. Ninety-three hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) were classified based on disease severity. The levels of biochemical, hematological, immunological, and inflammatory mediators were assessed, and their association with severity and mortality were evaluated. Hospitalized patients were mostly men (77.4%) with an average (standard deviation) age of 59.14 (14.81) years. The mortality rate was significantly higher in critical patients (85.7%). Increased serum levels of blood sugar, urea, creatinine, uric acid, phosphorus, total bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, C-reactive protein, ferritin, and procalcitonin were significantly prevalent (p=0.002, p

Background: Drug addiction is known as one of the health, medical and social problems of the present century. Beyond the harmful physical and mental consequences for addicts, drug abuse can cause serious social problems. The aim of this study was to evaluate drug and alcohol abuse in individuals aged 15 yr and over in Iran in 2015. Methods: This descriptive cross-sectional study was done on individuals aged 15 yr and older who lived in urban and rural areas of Iran. Overall, 36,600 individuals were selected by systematic and cluster random sampling. The postal code was used to access the samples in 31 provinces of Iran. In each province 1200 individuals (50% men, 50% women) were evaluated. The used instrument was the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and data were analyzed using SPSS software. Results: The results showed 4.6% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.4% used Amphetamine stimulants, 6.1% used Sedative drugs, and 2.6% used Alcoholic beverages on a regular basis. Within the last 12 months, 3.9% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.3% used Amphetamine stimulants, 5.8% used Sedative drugs, and 1.9% used Alcoholic beverages. With the exception of Sedatives drugs men used more drugs than women and residents of rural areas used more opium and its derivatives than other groups of drugs. Based on the provincial distribution, Kerman and Qom used the highest and lowest prevalence percentage of Opium and its derivatives respectively. Conclusion: Overall, 2340000 individuals were addicts used Opium and its derivatives in 2015, therefore, medical and health officials should take all necessary measures to deal with these serious social problems.

Background and Objectives: Performing physical activity is one of the inexpensive and available interventions in the field of self-care of gestational diabetes. Changing and modifying health behaviors in individuals can lead to preventing or delaying the disease and its complications. The aim of this study was to determine the effect of physical activity counselling based on the theory of planned behavior (TPB) on glycemic indexes in women with gestational diabetes. Methods: In a randomized clinical trial, the effect of counselling based on TPB was investigated in 50 women with gestational diabetes. The eligible subjects were assigned to two groups (control and intervention) using randomized block design; then, glycemic indexes were measured (pre- and post-intervention). Data were analyzed using independent and paired t-test. Results: In this study, the mean FBS (p=0.028), hemoglobin A1C (p=0.008), 2-hour postprandial blood sugar (p=0.002) and the number of admission (p

Statement of the Problem: Dental caries is a common chronic disease. Mouthwashes and other preventive approaches play an important role in caries prevention. Finding the most efficient mouthwash in the market is always a concern for dentists and patients. Purpose: This study aimed to assess the effect of chlorhexidine (Behsa, Iran) and xylitol plus 920 ppm fluoride (FX) (Fuchs, Germany) mouthwash on salivary Streptococcus mutans (S. mutans), which is the main microorganism responsible for dental caries. Materials and Method: This single-blind randomized clinical trial was conducted on 30 dental students, divided into two groups. The salivary count of S. mutans was measured at the beginning of the study. Group 1 students used chlorhexidine mouthwash while group 2 used FX mouthwash for two weeks. Saliva samples were collected again and salivary count of S. mutans was determined. Data were analyzed using Mann Whitney and Wilcoxon signed rank tests Results: Salivary count of S.mutans significantly decreased in the two groups after using the mouthwashes (p< 0.05) and no significant difference was noted in the mean colony count between the two groups after the use of mouthwashes (p> 0.05). Conclusion: Within the limitations of this study, the results showed that both mouthwashes could decrease S. mutans count.

Introduction: Department of theology and Islamic studies is one of the most important departments in the universities whose services affects students' religious attitudes. Therefore, this study aimed to determine the students' attitudes and satisfaction with the quality of educational services from this department at Zanjan Islamic University of Medical Sciences during 2015-16. Methods: This study was a Descriptive-cross sectional survey. The population consisted of the undergraduate and PhD students at Zanjan University of Medical Sciences. The sample size was determined using Cochran formula, so 315 people were selected using Stratified sampling. To collect data, a questionnaire was used that had combined a self- made questionnaire and the standard questionnaire of SERVQUAL attitude and satisfaction. The data was analyzed using descriptive statistics and one sample T-test. Results: A total of 283 students participated in the study, 167 (60.7%) male and 108 (39.3%) female. Most of the participants were in the age group of 21-24 One-sample t-test results showed that the average satisfaction of Educational Services form Islamic studies department is higher than the criterion. Also regarding the quality of service satisfaction, the mean differences were observed in the following hypothetical average: (t>1.97, Pvalue

Background and objective Aside from direct toxic effects, Sulfur Mustard (SM) induced serum hormone abnormalities may aggravate ocular complaints, including Ocular Surface Discomfort (OSD) (burning, itching, and redness), dry eye sensation, photophobia, blurred vision, foreign body sensation, and pain. The aim of the current study was to investigate the possible association of ocular complaints with serum hormone concentrations in chronic phase of Sulfur Mustard (SM) exposure. Methods:As a part of Sardasht Iran Cohort Study (SICS), 372 SM-exposed patients and 128 non-exposed participants were enrolled. Ocular complaints and ocular surface biomicroscopic conditions and serum hormones were compared. Results:The exposed with tearing group had significantly higher mean serum levels of testosterone and prolactin (ng/mL) than controls (5.75 vs. 4.75, P=0.031; 11.71 vs. 8.42, P=0.009). The exposed with OSD group had significantly higher mean serum levels of prolactin than controls (12.48 vs. 6.90, P=0.002). The exposed with photophobia group had significantly higher mean serum levels of testosterone than the matched exposed (6.25 vs. 5.65, P=0.013). The exposed with blurred vision group had significantly higher mean serum levels of Thyroglobulin (Tg) (ng/mL) than the matched exposed (65.73 vs. 32.6, P=0.003). Conclusion: Higher mean serum levels of testosterone (in exposed with tearing and photophobia) and prolactin (in exposed with tearing and OSD) may play protective roles against SM effects. Higher mean serum levels of Tg may deteriorate the tear film integrity and optical surface, which causes blurred vision. In the chronic phase of SM toxicity, some ocular surface problems are associated with alterations in the serum concentrations of testosterone, prolactin, and Tg.

Objective: Menopausal is one of the crisis’s of women life and the signs women experience in this period is one of important care challenges and one of its most important consequences could be known as the concealed anxiety came out the menopausal. So the present study is aimed to evaluate the effect of valerian on the anxiety of menopause women. Methods: This study is the kind of observational and clinical random traits studies. Sample cases of this study divided into two 72 individual groups of treatment and control randomly and a cross over design was done between two groups in the second phase of study. In the each period of experiment the treatment group received 530 mg valerian contained capsules two times per day and the control group received placebo capsules with the same apparent features. To measure the females’ anxiety, Espiell Berger concealed anxiety questionnaire was used and the paired sample mean compare test and repeated measure tests were used to analyze data in the statistical software SPSS. Results: Results showed that using valerian has no significant effect on decreasing anxiety but its effect in the second test level and after receiving placebo was found significant that shows the effective role of cure period time on the efficiency of this drug. Conclusion: It seems that the cure period has elementary role in valerian effectiveness on the decrease of postmenopausal women’s anxiety. ‎

Background and aims: Diabetes is the most common medical complication of pregnancy. This disease is a growing health problem in the world. Self-care is the most important factor in the control of chronic diseases such as diabetes. Several factors include biological factors, psychological, economic, social, cultural and health care system. Community Treatment is effective directly and indirectly on self-care behaviors in patients with diabetes.The aim of this study was to assess mothers, experiences with gestational diabetes on the factors influencing self-care. Methods: This study is a qualitative conventional content analysis research. In this study, data were collected by semi-structured individual interviews. Interviews were performed based on interview guidance. Participants were pregnant women diagnosed with gestational diabetes in 24th-36th week of pregnancy who referred to the clinics affiliated to Shahid Beheshti University of Medical Sciences. After 12 interviews with participants, data were saturated. Conventional content analysis was done for data analysis. To assess the accuracy and reliability of data, four criteria provided by Lincoln and Guba, including dependability, credibility, confirmability and transferability were used. For the analysis of qualitative data in this study, the conventional qualitative content analysis methods and software MAXQDA 10 was used. Results: Perception of pregnant women led to the extraction of two themes: barriers and facilitators to self-care. The former was featured with four main categories: insolvency, perceived problems, admission disease and support from others. 13 sub- categories were also classified in the main form. Results showed that mothers for self- care actions, need to get further information via health-care provider and get more support from their relatives. It was also found barriers and facilitators to take care of mothers in most societies is almost the same. Conclusion: According to the results of this study, it is needed to do appropriate proceedings to promoting culture, providing appropriate information and higher quality services, and promoting healthlevel and self-care of mothers with gestational diabetes.

Sulfur mustard (SM) exposure injures different organs such as the lungs and leads to short and long term complications Transforming growth factor beta (TGF-β) has the main role in altering fibroblast activities linked to airways remodeling. Latency TGF beta binding proteins 1 (LTBP1 facilitates localization of TGF-β in the extracellular matrix. Mothers against decapentaplegic homolog 6 (Smad6) negatively regulates TGF-β signaling, thus establishing a main negative feedback loop. In this study, we investigated the expression of LTBP1 and Smad6 in the lung tissues of SM-exposed and control individuals. Lung formalin-fixed paraffin-embedded (FFPE) blocks of SM-exposed (20 samples) and control groups (20 samples) were collected from archival pathology department of several general hospitals. The total mRNA of lung FFPE tissues was extracted. Quality of the extracted mRNA was evaluated by an Agilent Bio analyzer and RNA was quantified using a Nano Drop. LTBP1 and Smad6 expression levels were evaluated by real-time PCR. LTBP1 expression levels did not change between the two groups (p=0.626), howeverSmad6 expression levels were significantly higher (2.6 fold) in SM-exposed individuals compared to the control group (p=0.001). Our results revealed that Smad6 may be involved in lung tissue remodeling process in SM-exposed patients. Smad6 regulates fibrotic alterations in lung tissue and its function as negative feedback mechanisms in TGF-β.

Sulfur mustard (SM)-exposed individuals develop late pulmonary complications, which are associated with chronic inflammation and fibrotic changes in the lung tissue. MicroRNAs are known to act as important regulators of inflammatory responses, including inflammation and fibrosis-related cytokine signaling. In this study, we investigated the expression miR-15b-5p and miR-21-5p, two regulators of TGF-β signaling, as well as their target molecule, SMAD7, in lung tissues from SM-exposed and control individuals. Total RNA was extracted from formalin-fixed paraffin-embedded (FFPE) lung tissue biopsies obtained during surgery from SM-exposed (n=20) or control (n=20) cases. Quality of the extracted RNA was evaluated by an Agilent Bioanalyzer and RNA was quantified using a NanoDrop. MiR-21-5p, miR-15b-5p and SMAD7 expression levels were measured by real-time RT-PCR. miR-21-5p expression levels were significantly decreased (2.7 fold) in the lung tissues from SM-exposed individuals compared with tissues obtained from the control group (p=0.02). There were no significant differences in miR-15b-5p expression levels between the two groups (p=0.94). Interestingly, SMAD7 expression levels were significantly higher (5.8 fold) in SM-exposed individuals’ lung tissues compared with the control group (p=0.045). Our data indicate that exposure to sulfur mustard affects the expression of miR-21-5p as well as its target, SMAD7, in lung tissues many years after exposure. Considering the role of SMAD7 in the regulation of TGF-β signaling, these changes might point to a potential mechanism by which SM-exposure regulates inflammatory/fibrotic alterations in lung tissue.

Background: Despite several reports on the clinical manifestations of sulfur mustard (SM) intoxication, there is no study on serum concentrations of thyroid hormones long-term after SM exposure. In this study, the changes in thyroid functioning parameters 20 yr after SM exposure were evaluated. Methods: This study is a part of a larger historical cohort study conducted in 2007 following 20 years of the exposure to SM, called Sardasht–Iran cohort study (SICS). We (SICS) comprised an SM–exposed group from Sardasht City, West Azerbaijan Province, Iran (n=169 as hospitalized group and n=203 as non-hospitalized exposed group); and control participants were selected from Rabat, a town near Sardasht (n=126). Peripheral blood samples were taken in fasting state and then the sera were separated. T4, T3, TSH, antithyroglobulin (anti–Tg), and antithyroid peroxidase (anti–TPO) concentrations in the sera were measured by the ELISA method. Results: The mean of T3 concentration was significantly higher in the exposed than control group (0.88 ± 0.26 nmol/L vs 0.8 ± 0.25 nmol/L, P

Hyperglycemia is a hallmark of diabetes, which is associated with protein glycation and misfolding, impaired cell metabolism and altered signaling pathways result in endoplasmic reticulum stress (ERS). We previously showed that L-lysine (Lys) inhibits the nonenzymatic glycation of proteins, and protects diabetic rats and type 2 diabetic patients against diabetic complications. Here, we studied some molecular aspects of the Lys protective role in high glucose (HG)-induced toxicity in C2C12 myotubes and 3T3-L1 adipocytes. C2C12 and 3T3-L1 cell lines were differentiated into myotubes and adipocytes, respectively. Then, they were incubated with normal or high glucose (HG) concentrations in the absence/presence of Lys (1 mM). To investigate the role of HG and/or Lys on cell apoptosis, oxidative status, unfolded protein response (UPR) and autophagy, we used the MTT assay and flow cytometry, spectrophotometry and fluorometry, RT-PCR and Western blotting, respectively. In both cell lines, HG significantly reduced cell viability and induced apoptosis, accompanying with the significant increase in reactive oxygen species (ROS) and nitric oxide (NO). Furthermore, the spliced form of X-box binding protein 1 (XBP1), at both mRNA and protein levels, the phosphorylated eukaryotic translation initiation factor 2α (p-eIf2α), and the Light chain 3 (LC3)II/LC3I ratio was also significantly increased. Lys alone had no significant effects on most of these parameters; but, treatment with HG plus Lys returned them all to, or close to, the normal values. The results indicated the protective role of Lys against glucotoxicity induced by HG in C2C12 myotubes and 3T3-L1 adipocytes.

Introduction: Diabetes is the most common medical complication of pregnancy. It can be associated with many complications for mother and fetus. Gestational diabetes is also one of the main health issues in Iran. Therefore, the present study is aimed at a deeper understanding of women’s experiences of gestational diabetes and their perceived needs to inform future lifestyle interventions. Methods: This qualitative content analysis study was carried out in 2015. Participants were pregnant women diagnosed with gestational diabetes in the 24th to 36th week of pregnancy, who were referred to the clinics affiliated with Shahid Beheshti Medical Science University in Tehran, Iran. In-depth interviews were conducted with participants, using semi-structured questions. Interviews were audio taped and transcribed verbatim. Conventional content analysis was carried out for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). Results: Content analysis highlighted two themes; educational needs and need to support. The former was featured with five main categories: information sources, education process, unknown and known, weaknesses of public information system, and eagerness to learn. The latter was featured with two main categories: family support and social support. Conclusion: Clarifying the needs of the mothers with gestational diabetes, leads to better and proper education planning and a program toward the improvement of health, self-care, and prevention of diabetes.

Background and Objectives: Pregnancy and transition to parenthood lead to major psychological and social changes in women and men. This study was conducted with the purpose of determining the fathers' anxiety level in the first 8 weeks after mothers' delivery. Methods: In a descriptive cross-sectional study with stratified random sampling method, the anxiety level was evaluated in 403 fathers. The data collection tools were demographic characteristics questionnaire and standard State-Trait Anxiety Inventory (STAI-S) with cutoff of 45, which were completed after obtaining a written informed consent from each participant. Data were analyzed using Chi-square test and logistic regression model at 95% level of confidence. Results: The mean state and trait anxiety scores of fathers' were 34.04±9.24 and 34.57±9.80, respectively. Approximately 14% of the fathers had state and 15% had trait anxiety. There was a significant relationship between state anxiety of fathers and their income, and between trait anxiety and age, occupation, and having insurance. Fathers' anxiety level decreased with increasing age. the odds of having trait anxiety was higher in men with low education and no insurance. Conclusion: Considering the increasing level of fathers’ anxiety after mothers' delivery compared to the general population and its relationship with individual and social factors, it seems necessary to improve social supports, especially for young men.

Background and Objectives: Oral care is a fundamental activity in nursing care. Providing oral care for ill patients, who are not able to keep their oral care, would provide comfort for patients and prevented them from oral lesions. This study was conducted to compare of the effect of Ozone water with Chlorhexidine in prevention of oral lesions in patients in critical care units. Materials and Methods: This randomized controlled trial was carried out on 74 patients under mechanical ventilation in intensive care unit of Mousavi hospital in Zanjan. The participants were selected preliminary using convenience sampling, and then allocated randomly to two groups of intervention (n=39) and control (n=35) groups. Data was collected using the Beck Oral Assessment Scale (BOAS) scale. The data were analyzed using univariate statistical analysis (independent t statistical tests, Fisherchr('39')s exact test, and Cochran Q (in SPSS16. Results: The results of the study showed that the mean score of oral lesions according to BOAS in intervention group was almost the same as control groups by the third day of intervention. However, the mean score of oral lesions in the intervention group was reduced statistically compared to control group (P=0/013) on the fourth day. Conclusion: The results of the current study revealed that Ozone water is more effective than chlorhexodone in prevention of oral lesions.

Background and Objectives: Menchr('39')s participation in family care programs is one of the important strategies in maternal and child health care. The present study aimed to evaluate the fatherschr('39') function after the transition to fatherhood stage and its related factors. Materials and Methods: The study was a cross-sectional design that conducted in Zanjan between 2012-2013. The function of 403fatherswere investigated whose wives had delivered in last 8 weeks. The samples were selected randomly, and the data was collected using the Inventory of Functional Status- Father (IFS-F) scale, which in the fatherschr('39') function were categorized according to the median cut-off point. The content validity and reliability of the scale was approved using Content Validity Ratio (CVR=0.89) and Cronbach’s Alpha in the function of the components were 0.52- 0.90, respectively. Data were analyzed using descriptive statistics and kruskal-Wallis H test (Acceptable P value

Background and Objectives: Several studies have shown that nurses working in the ICUs experience high levels of anxiety. Anxiety can not only negatively affect them, but may decrease the quality of care provided by them. The present study aimed to assess the effect of Valerian on anxiety among nurses working in the ICUs of Zanjan teaching hospitals. Materials and Methods: In this clinical trial, nurses working in morning and evening shifts were recruited to the study. A dose of 530 mg Herbal Sedamin capsules containing dried roots of Valeriana Officinallis were consumed by the nurses in the intervention group twice a day for one week. The control group received placebo. The Speilbergerchr('39')s State-Trait anxiety inventory was completed by the nurses at baseline and after the intervention. The independent t-test and paired t-test were used to analyse data. Results: After the intervention in two groups (Valerian and Placebo), the trait and state anxiety scores were significantly lower than before of the intervention. But there were no significant differences in the trait and state anxiety scores of the questionnaire between the experimental group and control groups after the intervention (P=0.846). Conclusion: It seems that the special and different nature of the ICUs has hampered the effectiveness of this herbal medicine. Further studies with higher doses, or in other settings is suggested.

Background: In order to select a better antibiotic choice for treatment of Pseudomonas aeruginosa infections, this study was conducted to determine the frequency of resistance to some antipseudomonal β-lactams in P. aeruginosa isolates from patients in Tehran, Iran. In addition, the relation between presence of genes known to be responsible for resistance to β-lactams (ampC, mexC1,2,and mexC3,4 genes) and resistance phenotype among P. aeroginosa isolates was evaluated. Methods: P. aeruginosa strains were isolated and identified by routine methods and PCR for oprL gene. Disk diffusion method was employed to determine the antimicrobial susceptibility pattern according to CLSI recommendations. PCR was used to detect the resistance genes. Results: Among 100 isolates of P. aeruginosa, 82% had ampC, 86% mexC1,2and 89% mexC3,4 genes and combinations of these genes were seen in most of isolates and only 3% of isolates had none of these genes. Resistance to mezlocillin, cefepime, ceftazidime and piperacillin/ tazobactam was seen in 46%, 41%, 36% and 29% of isolates, respectively. Significant relation (P value ≤0.05 by Chi-square or Fisher Exact test) was observed between the presence of ampC gene and resistance to all the studied β-lactams in this study. No relation was observedfor mexC genes,although many ofisolates containing these two genes were phenotypically resistant. Conclusion: This study had shown for the first time, the presence of ampC and mexC genes in significant percent of clinical isolates of P. aeruginosa in Tehran, Iran, and relation between presence of ampC gene and resistance to β-lactams.

Background: Sexual dysfunction is a complication of transurethral resection of prostate (TURP). There is a lack of knowledge of the effect of discharge programs aiming at improving sexual function in older patients undergoing TURP. Objective: To investigate the effect of the nurse-led sexual health discharge program on the sexual function of older patients undergoing TURP. Methods: This randomized controlled clinical trial was conducted on 80 older patients undergoing TURP in an urban area of Iran. Samples were selected using a convenience method and were randomly assigned into intervention and control groups (n = 40 in each group). The sexual health discharge program was conducted by a nurse in three sessions of 30−45 min for the intervention group. Sexual function scores were measured using the International Index of Erectile Function (IIEF) Questionnaire, one and three months after the intervention. Results: The intervention significantly improved erectile function (p = 0.044), sexual desire (p = 0.01), satisfaction with sexual intercourse (p = 0.03), overall satisfaction with sexual function (p = 0.01), and the general score of sexual function (p = 0.038), three months after the program. In the first month after the intervention, except in sexual desire (p = 0.028), no statistically significant effect of the program was reported (p > 0.05). Conclusion: The nurse-led sexual health discharge program led to the improvement of the sexual function of older patients undergoing TURP over time. This program can be incorporated into routine discharge programs for the promotion of well-being in older patients.

Background and Objectives: Preeclampsia is the third leading cause of death in pregnant women. This study was conducted to evaluate the ability of longitudinal hematocrit data to predict preeclampsia and to compare the accuracy in longitudinal and cross-sectional data. Materials and Methods: In a prospective cohort study from October 2010 to July 2011, 650 pregnant women referred to the prenatal clinic of Milad hospital in Tehran were selected. The hematocrit level was measured in the first, second and third trimester of pregnancy and the participants were followed-up to delivery. The preeclampsia cases were recorded. The Covariance pattern and linear mixed effects models were applied for discriminant analysis of the longitudinal data. Statistical analyses were performed in the SPSS-20 and SAS-9.1. Results: The prevalence rate of preeclampsia was 7.2% (47 out of 650 women). The women with preeclampsia had a higher meanhematocrit values (difference=0.99 P=0.014). The sensitivities for longitudinal data and cross-sectional data in three trimesters were 91%, 54%, 72%, 51% and the specificities were 61%, 51%, 51%, and 47%, respectively. The positive predictive values were 70%, 52%, 59%, 49% and the negative predictive values were 87%, 53%, 64%, and 49%, respectively. Conclusion: The levels of hematocrit can be used to predict preeclampsia and to monitor the pregnant women. Measuring the hematocrit during the three trimesters regularly can help to identify women at risk for preeclampsia.

Background & aim: This study aimed to determine the relationship between lipid and apolipoprotein B-100 (apo B-100) levels in maternal and umbilical cord sera as well as the effects of these components on anthropometric measurements of newborn infants. Methods:This correlational study was performed on 85 appropriate for gestational age (AGA) newborns and their mothers. For analysis, 5 ml of maternal blood and 5 ml of umbilical venous cord blood were obtained during labor and immediately after delivery, respectively. Sera were separated by centrifugation and analyzed on the same day for estimation of lipid profile including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B-100. Also, anthropometric indices of newborn infants were measured and recorded. Pearson’s correlation coefficient was used to determine the relationship between variables. Results: There was a positive correlation between maternal and neonatal serum TC levels (r=0.23, P=0.042). Maternal LDL-C level was positively correlated with neonatal HDL-C (r=0.24, P=0.035), TC (r=0.29, P=0.01), and apolipoprotein B-100 levels (r=0.25, P=0.031). A significant positive correlation was observed between maternal apolipoprotein B-100 level and neonatal TC (r=0.26, P=0.019), HDL-C (r=0.23, P=0.043), and apolipoprotein B-100 levels (r=0.24, P=0.038). Maternal TG level was positively correlated with neonatal crown-heel length (r=0.27, P=0.018) and birth weight (r=0.23, P=0.039). However, maternal HDL-C level was negatively correlated with neonatal birth weight (r=-0.29, P=0.01) and chest circumference (r=-0.27, P=0.019). A significant negative correlation was found between cord blood TG level and newborn’s head circumference (r=- 0.23 P=0.046). Conclusion: Maternal lipid profile can affect neonatal lipid level and anthropometric measurements.

Background This study aimed to assess sexual functioning among women with polycystic ovary syndrome (PCOS) in Iran. Materials and Methods A cross-sectional study was conducted to ascertain factors re- lated to sexual functioning in 300 PCOS patients attending to the private practice centers in Kashan, Isfahan Province, Iran, from May to October 2012. The Female Sexual Function Index (FSFI) was used to measure sexual functioning. Moreover, the socio-demo-graphic details and clinical information of PCOS including obesity, hirsutism, acne, mestrual cycle disturbances, infertility and endocrine profile were recorded for each patient. Results Overall the prevalence of female sexual dysfunction (FSD) was 16.6%. In particular patients indicated poorer sexual functioning for the desire (48.3%) and the arousal (44.7%) subscales. Multiple logistic regression analysis suggested patients with lower educational level (OR: 2.94; 95% CI: 1.46-5.92) and irregular menstrual status (OR: 4.61; 95% CI: 1.93-11) were more likely to report sexual dysfunction. Conclusion The findings suggest that desire and arousal were the most prevalent sexual disorders reported in this patient population. In addition, findings suggested that women with limited or no formal education and a history of menstrual irregularities were the most likely to report female sexual dysfunction. Further investigations are needed to examine female sexual functioning among women with PCOS, to educate their health care providers, and to develop therapeutic interventions.

Objective (s): Sexual dysfunction (SD) in patients with multiple sclerosis (MS) is common, but often overlooked. The purpose of this study was to determine prevalence of sexual dysfunction and its predisposing factors in women with multiple sclerosis. Method: This was a cross sectional study. Participants were recruited from two MS clinics in Tehran.Sexual function and disability status were quantified by the Female Sexual Function Index-FSFI and Expanded Disability Status Scale(EDSS) respectively.Clinical characteristics and the extent of physical disability were examined by a neurologist .Data were analyzed by univariate and multivariate logistic regression.Results: In all 226 MS patients were studied.The mean age of participants was 35.77 years (SD = 8.07). Sexual dysfunction were diagnosed in 125(55/3%) of participants. The most common sexual problem in women was arousal dysfunction (44/2%) and the lowest frequency of the dysfunction was sexual pain (12/8%).Results obtained from multiple logistic regression analysis showed that MS patients with sexual dysfunction had lower educational status (Odds ratio=1.95 CI 95%= 1.957-0.998), insufficiency low (Odds ratio=3.94 CI 95%= 1.614-90619), more than 3 children (Odds ratio=4.659 CI 95%= 1.517-14.314) and Secondary Progressive MS-(SPMS) (Odds ratio=3.034 CI 95%= 1.447-6.362). Conclusion: Awareness of sexual problems and related factors for the management and treatment of women with MS is necessary .It is suggested that sexual rehabilitation programs compiled as part of the comprehensive care of patients with MS.

Diabetes mellitus type Ι is a metabolic disorder that affects multiple systems including the inner ear. Patients with diabetes mellitus commonly complain about dizziness, floating sensation, tinnitus and sweating. The aim of this study was to compare vestibular evoked myogenic potentials (VEMPs) between diabetic patients with or without neuropathy. Subjects included 14 patients with diabetes mellitus type Ι with polyneuropathy, 10 patients with diabetes mellitus type Ι without polyneuropathy and 24 healthy volunteers. Range of age in participants was 15-40 years old. The VEMPs were recorded with 500 Hz tone bursts with intensity at 95 dB. There was statistically significant difference between the groups in P13 and N23 latencies (P

Background: Epilepsy is a common, chronic neurological disorder that affects more than 40 million people worldwide. Epilepsy is characterized by interictal and ictal functional disturbances. The presence of interictal epileptiform discharges (IEDs) can help to confirm a clinical diagnosis of epilepsy, and their location and characteristics can help to identify the epileptogenic zone or suggest a particular epilepsy syndrome. The aim of this study is to determine the factors that affect IEDs. Materials and Methods: Poisson marginal model was done on 60 epileptic patients who were referred to Shefa Neurological Research Center, Tehran, for Video-Electroencephalogram (V-EEG) monitoring from 2007 to 2011. The frequency of IEDs was assessed by visual analysis of interictal EEG samples for 2 h. Results: The results show that among age, epilepsy duration, gender, seizure frequency and two common anti-epileptic drugs (Valproic acid and Carbamazepine), only age and epilepsy duration had statistical significant effect on IED frequency. Conclusion: Investigating the factors affecting IED is not only of theoretical importance, but may also have clinical relevance as understanding the evolution of interictal epileptogenesis may lead to the development of therapeutic interventions. Generalized estimating equation is a valid statistical technique for studying factors that affect on IED. This research demonstrates epilepsy duration has positive and age has negative effect on IED which means that IED increases with epilepsy duration and decreases with increasing age. So for monitoring IED, we should consider both age and epilepsy duration of each patient.

Background: Tibolone is frequently used as a hormone-likealternative to traditional HRT. Therefore, it is valuable tocompare the effects of tibolone and HRT on cardiovasculardiseases risk factors.Methods: A total of 156 healthy non-surgical postmenopausalwomen were included in an open randomized study. They wereassigned to receive daily 2.5 mg tibolone plus one Cal+D (500mg calcium and 200 IU vitamin D) tablet (n=52), 0.625 mgconjugated equine estrogen and 2.5 mg medroxy progesterone(CEE/MPA) plus one Cal+D tablet (n=52), or one Cal+D tablet(n=52). The latter group was used as control. The women werefollowed for six months. The body mass index (BMI), bloodpressure (BP), serum levels of high density lipoprotein (HDL),low-density lipoprotein (LDL), and triglyceride (TG), C reactiveprotein (CRP), sex hormone binding globulin (SHBG), freetestosterone index (FTI), and free estradiol index (FEI) weredetermined before and after the interventions.Results: Compared to baseline values, BMI, BP, CRP, SHBG,HDL, FTI, and FEI were significantly different after thetreatments in the tibolone and CEE/MPA receiving groups(P

Background:Inequalities in health are ever increasing among different communities of either affluent or disadvantaged especially in urban areas.To identify and address inequalities in health and its determinants among societies, urban health equity assessment and response tool (Urban HEART) in four 'policy domains' related to social determinants of health, has been developed by WHO Kobe Centre (WKC) and piloted in several countries. The tool was extended to six policy domains in Tehran and the number of indicators was doubled. This paper describes the concept of Urban HEART, its development, study protocol and pilot implementation in Tehran. Methods/Design: Sixty five indicators in 6 domains related to inequalities in health and social determinants of health (SDH) namely 'physical and infrastructure','human and social', 'economic','governance', 'health',and'nutrition', were developed and approved in an international workshop held in Tehran in April 2008. Acomprehensive questionnaire with 12 sections was developed to be administered in a large population based survey in Tehran.Discussion: This is the first report of urban health equity assessment and response tool (Urban HEART) project which was conducted in Tehran. Year 2010 has been devoted to 'Urbanisation and Health' by the World Health Organisation, when 1000 cities are supposed to join a global plan to raise health in the urban areas. The Urban HEART project is supposed to play an important role henceforth.

Background:Low back pain causes disuse and physical deconditioning, and increases disability, and may turn simple low back pain into a chronic low back pain. Methods: Twenty subjects who suffered from low back pain entered to the study and were randomly divided in Case (low back pain group) and control group. Also 10 healthy subjects were entered to the study as a sham group. After ten minutes rest and recording of rest, cardiovascular responses of studied subjects in two exercises: Straight Partial Sit-Up (SPSU) and Oblique Partial Sit-Up (OPSU) were studied. Then the case group went through a four week regime of the exercises and cardiovascular responses of the exercises were recorded in three groups. Findings: Systolic and diastolic blood pressure changes of LBP subjects in comparison to healthy people (p < 0.05) but heart rate changes of LBP subjects are not significantly different (p > 0.05). After the 4 weeks of training period, cardiovascular responses in low back pain test group in comparison to the beginning of the study reduced. Conclusion: It seems that the differences between cardiovascular responses of low back pain patients and healthy subjects are due to deconditioning theory. These patients during the same exercise activity like healthy peoples use more efforts that lead to more cardiovascular responses. The reduction of exercise cardiovascular responses after the training period in the case group indicates an increase of muscle strength and decrease in central comments for motor units' recruitments, which show cardiovascular adaptation and conditioning procedure in these subjects. Key words: Low back pain, Physical deconditioning, Cardiovascular responses, Training.

Payesh2009; 8: 181-190Accepted for publication: 26 December 2007[EPub a head of print-20 Apr. 2009] Objective(s): To determine application of the PRECEDE model for increasing coping behaviors against anxiety in Tehran firemen.Methods: This was a quasi experimental study. 118 firemen (59 in experimental group and 59 in control group) from Tehran fire stations were selected as the subjects of the study through a multistage sampling. Data collection tool was a questionnaire developed by author including demographic characteristics and PRECEDE model components.Results: Comparing to the control group, after educational intervention in the study group, the mean scores of knowledge, attitude, self efficacy (predisposing factors), skill of the relaxation (enabling factor), behavior increased significantly (P

Background The aim of this study was to evaluate copper status in women with preeclampsia. Materials and methods Sixty preeclamptic, sixty normotensive pregnant and sixty healthy nonpregnant women were enrolled in a cross sectional study. The 24-hour urine copper was compared among the women. Results There was significant difference in the copper concentration of 24-hour urine among the three groups due to the difference between preeclamptic and normotensive pregnant women (12.19±3.71 vs. 5.69±2.05, p

Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient;aposs life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P

Background & Aim: Adverse childbirth experiences as a trauma can evoke fear and post-traumatic stress disorder in some women. This study was conducted to investigate the effect of counseling on post traumatic stress disorder after a traumatic childbirth. Methods & Materials: This research was a clinical trial which was conducted at Kamaly hospital in Karaj. Samples (300 women) who had experienced a traumatic childbirth were selected by a convenient sampling method and were randomized into an intervention (n=150) and a control (n=150) group. The intervention group received face-to-face counseling within 72 hours of birth for forty to sixty minutes in a session. The control group just received usual care after childbirth. The data collection tool was questionnaire, which was completed via interview. The measuring variables were demographic characteristic, reproductive history, maternity social support, and post-traumatic stress disorder. Data were analyzed using descriptive statistics and inferential tests (Chi-square, Fisher;aposs exact test, and generalized Fisher;aposs exact test) by SPSS v.13 software. Results: After 4-6 weeks of follow-up there was no significant difference regarding post-traumatic stress disorder between two groups (P=0.295). At 3-month of follow-up, the intervention group reported less post-traumatic stress disorder comparing with the control group (P=0.001). Conclusion: A midwife-led counseling plan is effective in reducing post-traumatic stress disorder during a long term.

Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient's life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process. Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software. Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P

Background & Aim: Adverse childbirth experiences as a trauma can evoke fear and post-traumatic stress disorder in some women. This study was conducted to investigate the effect of counseling on post traumatic stress disorder after a traumatic childbirth. Methods & Materials: This research was a clinical trial which was conducted at Kamaly hospital in Karaj. Samples (300 women) who had experienced a traumatic childbirth were selected by a convenient sampling method and were randomized into an intervention (n=150) and a control (n=150) group. The intervention group received face-to-face counseling within 72 hours of birth for forty to sixty minutes in a session. The control group just received usual care after childbirth. The data collection tool was questionnaire, which was completed via interview. The measuring variables were demographic characteristic, reproductive history, maternity social support, and post-traumatic stress disorder. Data were analyzed using descriptive statistics and inferential tests (Chi-square, Fisher's exact test, and generalized Fisher's exact test) by SPSS v.13 software. Results: After 4-6 weeks of follow-up there was no significant difference regarding post-traumatic stress disorder between two groups (P=0.295). At 3-month of follow-up, the intervention group reported less post-traumatic stress disorder comparing with the control group (P=0.001). Conclusion: A midwife-led counseling plan is effective in reducing post-traumatic stress disorder during a long term.

Background: Breast cancer is one of the most prevalent cancers and significant causes of mortality in women. An important problem is the cancer cell metastasis in other organs.Different mechanisms in the beginning, progression, and metastasis of breast cancer makes it difficult to determine patients’ ultimate fate (prognosis) and lifespan specifically although events ahead of the patients can be estimated using probabilities. This study was conducted to estimate the probability for the co-occurrence of metastasis and death at certain intervals of 5 years after surgery and 5 years after metastasis in patients with breast cancer. Methods: In this retrospective study, the data were collected from 608 women having breast cancer and going to the Breast Disease Center of ACECR in 2009-2001. The patients were studied from the time of surgery, and the two events were metastasis anddeath, respectively. The interval between the surgery and metastasis and that between the metastasis and death caused by cancer or end of follow-ups (for patients who did not die) were measured and analyzed in month. The probability for co-occurrence of the two intervals was estimated using the semiparametric method suggested by Una-Alvarez (2011)and R statistical software. Results: Median time for the occurrence of metastasis after surgery and duration of followup were 34 months and 66 months, respectively. In total, 93 metastases and 46 deaths occurred. The co-occurrence probability interval for all samples was 0.087-0. It was found that the probability for co-occurrence of the two events in patients with more than 50 years old, a tumor larger than 5 cm, lymph node involvement, high stage of the disease, positive HER2, negative ER, and without radiotherapy was greater than that in other groups. Conclusion: Considering the estimated co-occurrence probabilities, it seemed that factors such as the age over 50 years, tumors larger than 5 cm, lymph node involvement, higher stages, positive HER2, and negative ER increased the probability for the co-occurrence of metastasis and death in breast cancer patients.

Objective: Zinc is the second main element in the body after iron. Its importance in pregnancy is related to role in DNA and protein synthesis and consequently the necessity of its availability for the appropriate growth and development of the fetus and neonate. The purpose of this study was to assess the effect of zinc supplement on fetal outcomes (height, weight, head and chest circumference of the fetus, low birth weight, and pre-term birth) in pregnant women with lower-than-median serum zinc. Materials and methods: Participants of this experimental double-blind clinical trial study were 263 healthy singleton pregnant women with a mean age of 26.46 (±4.52) years and gestational age of 14.52 (±4.51) weeks whose (non-fasting) serum zinc levels were lower than median of the study population. All eligible individuals were randomly divided into two groups of zinc supplement and placebo. Individuals in the zinc supplement group (128 participants) took one zinc supplement capsule including 25 mg elemental zinc and participants in the placebo group (135 people) took one placebo capsule per day until the end of pregnancy. All women were under control and supervision until the end of the pregnancy and their information about labor, delivery, and neonate measures were collected through their obstetric records and then compared. Results: Findings of this study showed no significant difference in fetal measures at birth (weight, height, head and chest circumference), pre-term delivery, and low birth weight between zinc supplement and placebo groups. Conclusion: According to our findings, administration of 25mg elemental zinc per day does not improve fetal measures in pregnant women with lower-than-median serum zinc concentration; however, more in-depth studies with larger sample sizes are recommended to achieve more reliable results.

Objective: To evaluate the prevalence of gestational diabetes mellitus (GDM) and its risk factors in Tehran. Materials and Methods: From March 2002 to October 2004, screening for GDM was performed on 1804 women in Tehran. All pregnant women were referred for a 50 g oral glucose challenge test (OGCT) between 24th and 28th week of gestation. All subjects with an abnormal GCT (blood glucose level ≥130 mg/dl) underwent an oral glucose tolerance test (OGTT) within 1 week after the abnormal screening test. The prevalence of GDM was estimated. Results: The glucose challenge test was positive in 38.1% of cases .The prevalence of GDM for the whole cohort was 6.8%. About 78.6% of our population were at medium or high risk for GDM and, therefore, would have been screened. The rate of GDM was significantly higher in women with a positive family history of diabetes, positive history of GDM, older age, multiparity, pre-pregnancy obesity, greater weight gain during pregnancy, history of infertility, chronic hypertension, history of stillbirth pregnancies and abortion. After logistic regression analysis, GDM diagnosis was significantly correlated with age (P