Background and Objectives: Low back pain is one of the most common complaints in pregnancy which interferes with work, daily activities and sleep. The aim of this study was to determine the effect of Sitting Pelvic Tilt Exercise on physical disability in primigravidas with low back pain during the third trimester. Materials and Methods: This quasi-experimental study was carried out on 60 primigravidas who attended in 3 prenatal clinics of Zanjan university of medical science. At first, 60 primigravidas were selected by simple sampling and randomly divided into two groups: case and control. Only the experimental group did the sitting pelvic tilt exercise program for 8 weeks during the third trimester. Data was collected for both groups by interview using VAS scale and Disability Rating Index (DRI) on the days 0 and 56 (pre and post intervention). Results: There was no significant difference between the two groups in terms of age, occupation, education and BMI and intensity of physical disability before the intervention. However, intensity of physical disability significantly decreased (p<0.0001) in the experimental group after the exercise program. Adversely, the intensity of physical disability increased in the control group as pregnancy proceed (p<0.0001). Intensity of low back pain was also reduced in the experimental group after the sitting pelvic tilt exercise program comparing to pre treatment stage and also in comparison with the control group (P<0.0001). Conclusion: It seems that use of exercise programs such as “sitting pelvic tilt exercise” is an effective method in pregnant women who suffer from low back pain and related disabilities but do not want to use aggressive treatments and chemical pain relief drugs.

Background and Objective: Abortions are the most common complications of pregnancy. This study was conducted to figure out primary outcomes of surgical and conservative management of incomplete abortions in early pregnancy.
Materials and Methods: This study was carried out in Mousavi and Vali Asr hospitals of Zanjan in 2008-2009.
48 women with incomplete abortions were divided into two groups based on their own preferences: conservative management (n=25) and surgical management (n=23). In the conservative group, the patients were granted with a two-week interval for spontaneous resolution and then a sonoghraphy was performed. In the surgical group curettage was done and after two weeks patients were visited. In both groups, we compared satisfaction, time taken to do normal activities, bleeding days, pelvic pain and the need for follow up care after two weeks.
Results:  In the conservative group, spontaneous resolution occurred in 19 patients (76%) after two weeks. In this group satisfaction was higher and time taken to return to the normal activities was shorter than the surgical group, but bleeding days was longer in the conservative group and more patients needed follow up care after 2 weeks. There was no significant difference in pelvic pain between two groups.
Conclusion: Conservative management is a superior alternative method in the management of incomplete abortions in early pregnancy. However, further researches are necessary in order to attribute these results to all patients.

Background and Objective: Caesarean sections are the most common surgery in obstetrics and gynecology. However, like any other surgical procedures, they have some disadvantages. Nowadays, unfortunately, Caesarean sections are not carried out necessarily to save the mother and/or the baby, and due to excessive applications they have become a problem worldwide. The aim of this study was to determine the related causes of Cesarean delivery in Zanjan. Material and Methods: In this descriptive cross-sectional study, a total of 697 mothers were selected through random sampling. A questionnaire was completed by each participant and the collected data were analyzed using descriptive statistical methods, including chi-square test, Fisher exact, ANOVA, and multivariate logistic analysis. Results: According to our analysis, the recent rate of the Cesarean in Zanjan was about 43%, out of which 43% were elective. The majority of the cases (57.8%), were repeated Cesarean sections and most mothers chose Cesarean because of either fear of pain or for termination of the pregnancy (43.3%). In the present study, the Cesarean section rate correlated significantly with the level of education in mothers (P<0.0001) and family financial status (P=0.01). Conclusion: According to our analysis, promoting public awareness and also efforts towards applying Cesarean sections in only necessary cases could reduce the rate of cesarean in general.

Background and Objective: Self-efficacy is defined as a belief in one’s capabilities to cope with stressful situations and execute a specific coping behavior. Previous researches verify the efficiency of childbirth preparation classes as one of the convenient methods in helping women to deal with labor pain the most severe pain that women may experience in their lifetime. This study was carried out to determine the effectiveness of childbirth preparation classes on self-efficacy of pregnant women in coping with labor pain in Zanjan province. Materials and Methods: This quasi-experimental case –control study was carried out on 60 subjects who were randomly assigned to two equal groups of 30. The case group comprised 30 pregnant women who attended to childbirth preparation classes whereas the control group received only standard antenatal care. Questionnaires were completed through face to face interviews one hour after the delivery in postpartum delivery room. To determine the effect of childbirth preparation classes on self-efficacy in delivery of pregnant women, childbirth self-efficacy inventory and attitude questionnaire was used. Results: Mean scores of self-efficacy in the control and case groups were 221.5±65.86 and 241.7±61.68 respectively. Despite higher self-efficacy scores in the case group, the difference between the two groups was not significant as indicated by independent t-test. Conclusion: This study supports the substantial effect of childbirth preparation classes in perceived self- efficacy of pregnant women in delivery.

Background and Objective: Most of the studies emphasize increasing PCT in septic shock. The aim of this study was to determine the level of CRP in children suffering from bacterial infection and compare it with PCT in children hospitalised in Mousavi Hospital. Materials and Methods: This study was carried out with 81 children aged 3 months to13 years old hospitalised in pediatrics ward and the PICU of Mousavi Hospital in 2011-2012.Venous sampling was obtained for the tests and for blood cultures before starting the antibiotic treatment. In special cases, urine and CSF cultures were done. The chest radiography was carried out for children suspected of having the pneumonia and sepsis. Patients who had received parenteral antibiotics one week before their admission to the hospital, were excluded from the study. Results: The level of PCT was equal or less than 0.5 ng/ml, 0.5 to 10 ng/ml and 10 ng/ml in 41.7%, 36.9% and 20.2 % of patients, respectively. The increase in the rate of serum PCT in patients with septic shock was significantly higher than patients infected with SIRS and sepsis. CRP was found higher than 10 in 71.4% of patients. The kappa agreement rate of PCT and CRP was 0.46 and meaningful (p < 0.0001). Conclusion: Despite the high diagnostic sensitivity of PCT, measuring the CRP is also convenient and affordable in differentiating different stages of infection.

Background and Objective: Allergies can present with involvement of different organs. In this study symptoms and signs of patients with defined allergy to pollens were investigated. Materials and Methods: Patients who had positive skin tests to at least one allergen were enrolled to study. They were visited and evaluated for symptoms and accompanying disorders. The season of symptom appearance or exacerbations were also assessed. Then associations of symptoms and complications with skin test results were analyzed by SPSS soft ware. Results: Four hundred and six patients from 502 cases were accepted to take part in our study. Pollens were common allergens (82%) among them weeds (61.3%) was the most common. After nasal symptoms that is most common, otitis media, urticaria and conjunctivitis in patients who were sensitive to weed, tree and grass respectively, were more common problems. There was significant association between weed allergy and rhinitis and conjunctivitis especially in late spring and summer. Tree allergy was seen in 60.1% of patients and there was positive association between tree allergy and ocular symptoms especially in spring and early summer. Two hundreds and forty three (59.9%) patients had positive skin tests to grass. It was the most common in children and youth and it was significantly associated with ocular symptoms in spring and summer. Conclusion: Considering the high prevalence of sensitization to outdoor allergens in our area instructions for pollen avoidance and appropriate medication in pollen seasons, could be beneficial for disease control.

Background and Objective: Hepatitis B virus is one of the hepadnaviruses which is an important cause of acute and chronic hepatitis, cirrhosis and hepatocellular carcinoma. Currently, prenatal transmission is the most important spreading route of hepatitis B in Iran and probability of its conversion into asymptomatic carrier in newborns of these women is high. Thus, this study was designed in order to have more accurate information about its prevalence among pregnant women in Zanjan city. Materials and Methods: In this cross-sectional descriptive study, from 1317 pregnant women who referred to healthcare centers, 2 mL blood sample was taken and after centrifugation the serums were kept frozen in -20℃. ELISA kit was used for measuring HBs-Ab and Immuno affinity chromatography was used for HBs-Ag measurement. Results: In this study, the prevalence of HBs-Ag and HBs-Ab was 0.4% and 38.4%, respectively. There was no correlation among the HBs-Ag positive individuals, history of jaundice, different age groups, and location. However, a statistically significant relationship was found between education level and positive HBs-Ag, as well as the history of vaccination against hepatitis B and the positive HBs-Ab. Conclusion: According to the results, it seems that parrallel to increase in education and awareness level, especially in pregnant women, the incidence and consequences of the chronic form of this disease has been reduced.

Background and Objectives: Obesity is a major risk factor of cardiovascular diseases. Visceral adipose tissue (VAT) plays an important role in complications obesity. Although the measurement of waist circumference is a useful index for evaluating obesity and its complications, always increasing of waist circumference is not associated with VAT accumulation. HTGW (Hypertriglyceridemic waist circumference) phenotype is a useful marker for visceral adipose tissue accumulation. The purpose of this study is comparison of sdLDL-c serum level and LDL-c particle size as risk factors for cardiovascular diseases in middle aged woman with HTGW phenotype and without it. Materials and Methods: For this purpose, 90 volunteer women between 40 and 60 years old based on the four common definitions of HTGW phenotype, were divided into two groups with and without this phenotype. It was used precipitation method for measurement of serum levels of sdLDL-c. LDL-c particle size also was measured by the gradient gel electrophoresis technique. Results: Although in all of definitions, LDL-c particle size significantly was smaller in group with this HTGW phenotype, sdLDL-c serum level was statistical significant different in both definitions of HTGW-L and HTGW-H. Conclusion: According to significant difference in diameter of LDL-c particles and sdLDL-c concentrations grouped based on the definitions HTGW-L and HTGW-H as well as the role of sdLDL-c particles in cardiovascular diseases, therefore mentioned definitions are useful inexpensive screening tools to identify individuals at risk for cardiovascular diseases. References 1- Després J-P. Cardiovascular disease under the influence of excess visceral fat. Critical Pathways In Cardiology. 2007 6: 51-9. 2- Sarrafzadegan N, Kopaei SA. The Association between hypertriglyceridemic waist phenotype, menopause, and cardiovascular risk factors. Arch Iran Med. 2012 16: 161-6. 3- Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004 84: 379: (3)79. 4- Lemieux I, Poirier P, Bergeron J, et al. Hypertriglyceridemic waist: a useful screening phenotype in preventive cardiology? Can J Cardiol. 2007 23: 23B-31B. 5- Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA. 1998 280: 1843-8. 6- Hamdi O, Porramatikul S, Al-Ozairi E. Metabolic obesity: the paradox between visceral and subcutaneous fat. Curr Diabetes Rev. 2006 2: 367-73. 7- Frayn KN. Visceral fat and insulin resistance causative or correlative? Br J of Nutr. 2000 83: S71-S7. 8- Cornier M-A, Dabelea D, Hernandez TL, et al. The metabolic syndrome. Endocr Rev. 2008 29: 777-822. 9- Leroith D. Pathophysiology of the metabolic syndrome: implications for the cardiometabolic risks associated with type 2 diabetes. Am J Med Sci. 2012 343: 13-6. 10- Therond P. Catabolism of lipoproteins and metabolic syndrome. Curr Opin Clin Nutr Metab Care. 2009 12: 366-71. 11- Superko HR, Gadesam RR. Is it LDL particle size or number that correlates with risk for cardiovascular disease? Curr Atheroscler rep. 2008 10: 377-85. 12- Rizzo M, Berneis K. Low-density lipoprotein size and cardiovascular risk assessment. QJM. 200699:1-14. 13- Gazi IF, Milionis HJ, Filippatos TD, et al. Hypertriglyceridaemic waist phenotype criteria and prevalent metabolic triad in women. Diabetes Metab Res Rev. 2008 24: 223-30. 14- Jellife DB .The assessment of the nutritional status of the Community. Monogr Set World Health. 1966: 53: 3-271. 15- Hirano T, Ito Y, Koba S,et al. Clinical significance of small dense low-density lipoprotein cholesterol levels determined by the simple precipitation method. Arterioscler, Thrombosis, Vasc biol. 2004 24: 558-63. 16- Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985 28: 412-9. 17- Esteghamati A, Ashraf H, Esteghamati A-R, et al. Optimal threshold of homeostasis model assessment for insulin resistance in an Iranian population: the implication of metabolic syndrome to detect insulin resistance. Diabetes Res Clin Pract. 2009 84: 279-87. 18- Rainwater DL, Moore P, Shelledy W, Dyer TD, Slifer SH. Characterization of a composite gradient gel for the electrophoretic separation of lipoproteins. J Lipid Res. 1997 38: 1261-6. 19- Ghassab RK, Gohari LH, Firoozray M, Yegane MN. Determination of low density lipoprotein particle size by polyacrylamide gradient gel electrophoresis in patients with coronary artery stenosis. Lab Medicine. 2010 41: 164-6. 20- Gazi IF, Filippatos TD, Tsimihodimos V, et al. The hypertriglyceridemic waist phenotype is a predictor of elevated levels of small, dense LDL cholesterol. Lipids. 2006 41: 647-54. 21- Bos G, Dekker JM, Heine RJ. Non-HDL cholesterol contributes to the “Hypertriglyceridemic Waist” as a cardiovascular risk factor. The Hoorn study. Diabetes care. 2004 27: 283-4. 22- Nikolic D, Katsiki N, Montalto G, Isenovic ER, Mikhailidis DP, Rizzo M. Lipoprotein subfractions in metabolic syndrome and obesity: clinical significance and therapeutic approaches. Nutrients. 2013 5: 928-48. 23- Group UPDS. UK prospective diabetes study 27: plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex. Diabetes care. 1997 20: 1683-7. 24- Hosseini Gohari L, Karimzadeh Ghassab R, Firoozray M, Zavarehee A, Basiri HA. The association between small dense low density lipoprotein, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio and coronary artery stenosis. Med J I.R.Iran. 2009 23: 8-13.

Background and Objective: Ischemic heart disease implies reduction of oxygen and blood supply in the myocardium. The most common cause of ischemia is atherosclerotic coronary artery disease. While numerous risk factors lead to coronary diseases, the mechanism of infectious agents in CAD remains unidentified.

Materials and Methods: In this study, 360 patients with and without coronary disease underwent evaluation in terms of cytomegalovirus (CMV) and herpes simplex virus (HSV) seroprevalences. Serology was performed by means of ELISA assays. 

Results: Of 360 patients, positive serology was reported for CMV and HSV in 91.7 % and 93.3% with CAD as well as  66.1 % and 57.5 % without  CAD (P<0.001). The risk of coronary disease by cytomegalovirus and herpes simplex in people who had positive serology were 1.5% and 6.81% times, respectively. The risk in regard to the control of other significant variables was statistically significant (P<0.001). The risk of coronary disease pointed out an increase by 3% per age which was statistically significant. In men at risk of coronary artery disease, positive HSV serology was 4.8 times more than women and in patients  with a history of myocardial infraction, this risk was reported 6.47 % times more than the patients without  this history (P<0.001). 

Conclusion: Owing to possible association of viruses and bacteria in the process of atherosclerosis, furthur research is recommended to find out  the relationship of  other infectious agents with CAD   and the presence of microorganisms in the coronary atherosclerotic specimens.