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Back ground and Purpose: Low birth weight (LBW) is one of the main cause of mortality in neonates. The prevalence and the risk factors differ in different countries. The objective of this study was to determine the prevalence of LBW in neonates and some of its risk factors in Babol.
Materials and Methods: This research was designed for a limited span of time, 1087 cases of neonates from all the deliveries of Babol were selected in First 3 months of the year1989. The data were collected by measuring the birth weight and interviewing the mothers.Statistical analysis was done by logestic regression method.
Results: The ratio of LBW was 6.2% with 95% confidence interval (7.6 and 4.8%). The odd ratio (ÔR) of LBW in females was 84% more than males (ÔR= 4) (ÔR= 1.84 and P = 0.09). The risk factor with twins or multiparity was 15.9 times more and of neonates less than 37 weeks was 9.8 times more (P= 0.0001). This risk was reduced to 40% in mothers with 2-4 parities compared with mothers of single parity (P= 0.07 and ÔR = 0.60), while for the fifth and higher parities this risk increased significantly(P = 0.0001 and ÔR= 3.89). Âge of less than 19 years and illiteracy of mother have increased the risk LBW , but was not significant. Ïn the stepwise multiple regression analysis, the effect of gestation age i.e.< 37 weeks ÔR= 10.1, begin twin (ÔR= 16.61) and being a female child. (ÔR= 1.99) have increased the risk of LBW significantly.
Çonclusion: Therefore prevention of preterm deliveries and conducting the health education program in high risks, especially illiterate mothers, young mothers of age less than Nineteen years and the first parity contribute to the prevention of LBW.

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Background and purpose: The evaluation of growth monitoring in children is one of the important sources of information to detect malnutrition. The objective of this study was to determine the trend of infant growth from birth to two years in rural communities of Babol and to compare it with NÇHS standard.
Materials and methods: This study was based on the existing data in growth monitoring system available in Babol communities under coverage of health centers. 429 registered births between 1996 to 1998 were selected using cluster sampling technique. Percentiles of height and weight were calculated and compared with NÇHS standard.
Results: Results show that, the weight in 67.5% of infants was between 50th and 97th percentile of NÇHS standard at first month. This figure declined by increasing the age in such a way that, in the weight percentile was between 50th and 97th NÇHS 45.2% at 6 months, 42.6% at 12 months and 44.2% at 24 months. When these figures were compared between boys and girls, 5% to 20% were less in girls than the boys. The results also show that the 50th percentile of weight for boys up to 12 months and for girls up to 6 months is higher than 50th percentiles of NÇHS standard, but then after, up to the age of 2 years becomes lower than 50th percentile of standard. Âlso height growth disorder starts at the age under 1 to 3 months, in such a way that at first month, the 50th percentile of height is close to NÇHS, but after 3 months deviates from NÇHS. Â significant difference was observed between 50th percentile of height and weight of the cases under our study and NÇHS (P<0.05).
Çonclusion: The results indicate that Ïranian infants growth can not be evaluated with NÇHS standard. Hence it is necessary to provide national and local growth curves for Ïranian children.

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Background and purpose: Today sexually transmitted diseases (STD) are the most common infectious disease in the Ünited States infecting 13 million new cases annually. Çonsidering their wide distribution and complications, knowledge about STD transmission, common symptoms and treatment methods are important in their prevention. Hence this study was undertaken to investigate the knowledge and health behaviour of married women about transmission of STD.
Materials and methods: This cross sectional study was conducted by simple sampling and standard questionnaire on 200 married women being referrd to the health service clinics of babol town ship. Questionnaire comprised of demographic, knowledge and performance questions about the reasons of not using condom and regular STD check up. Knowledge and performance were scored using likert scale. X2 and analysis of variation were used for determination of correlation between variables.
Results: The mean age of participants was 28.8 years. 72.5% of the individuls in case group did not have good knowledge. The most familiar STD disease was HÏV (88.5%), and the least were genital wart (40%) and chlamdia (28.5%). The most improper answers were about the ways of transmission, complications and methods of prevention. 60.5% of the cases did not have good practice about the prevention of STD. Ïn other words only 18.5% of women used them as part of pregnancy prevention. 23% of women had regular referring to STD clinics for check up. Level of knowledge showed significant correlation with age, level of education, profession of couples,number of family members,method of prevention and level of performance.
Çonclusion: Despite high prevalence rate of STD in the society, knowledge and practice of women about STD and their prevention methods are weak. Ëstablishment of STD clinics to meet the need of screening, treatment, health education and concepts related to STD is recommended. Ât the same time education should include public and also health workers.

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Background and purpose : Ünwanted birth is a major consequence of improper implementation of family planning programme. This study was aimed to determine the unwanted birth rate and its predisposing factors among married women in Babol population.
Materials and methods : Â cross-sectional study was conducted on 508 married women referred to a private and a public hospital in Babol city in 2001. Â questionnaire was designed to collect information during interview of mothers at the time of the delivery. The logistic regression model was applied to estimate the odds ratio of various factors on the risk of unwanted child using SPSS software.
Results : Results showed that the prevalence rate of unwanted birth was 19.5% and the chance of having unwanted children was significantly increased with increasing mothers' age as in women aged 20-29, 2.1, 30-39 ≥ 40, the odds ratio were 4.55 and 9.65 times greater than women aged <20 years respectively (P<0.0001). The odds ratio of unwanted children was decreased with increasing the marriage age as the odds ratio for marriage at 20-24, 25-29, and ≥ 30 years were 0.79, 0.63 and 0.19 respectively compared with age <20. By increasing the level of mothers' education, the odds ratio had a decreasing trend where the related odds ratio for mothers with education at level of primary school was 0.46 (P=0.09) while for mothers with education at bachelor or higher levels it was 0.12 (P=0.002). For increment of one pregnancy, the chance of unwanted birth was increased by 84% (ÔR=1.84, P<0.0001). Ïn multivariate analysis of logistic regression model using stepwise method, an increment of a child to the family, the odds ratio was significantly increased but rural residence and an increment of the history of abortion, the odds of unwanted child was significantly decreased (P<0.05).
Çonclusion : The number of children, the history of pregnancies and abortions, the low level of women's education and lower marriage age and the higher age of mothers reflecting the experience of chance of unwanted child could be used as indicators of recognizing the women need for appropriate contraceptive consulting for prevention of unwanted child.

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Background and purpose: Obesity is an undesirable outcome of changing of life style and behavior. In order to control obesity associated diseases, this study was aimed to determine the prevalence of obesity and its associated factors in population aged 20 to 70 years in urban areas of the province of Mazandaran, in North of Iran.
Materials and Methods: A population based cross-sectional study with a sample of 3600 subjects using cluster sampling techniques, was conducted in urban areas of four cities: Sari, Gaemshahr, Babol and Amol. In each city, 30 random clusters were selected based on cumulative family health number under coverage of different urban health centers using systematic sampling techniques. In each cluster, 15 men and 15 women aged 20 to 70 years were selected and assessed. The anthropometric measures (height, weight) were measured with standard methods and the social, demographic and some life style data were collected with interview using a designed questionnaire. In assessment of obesity, a standard recommended WHO method based on BMI distribution was used. The logistic regression model was used to estimate the age adjusted odds ratio and its 95% confidence interval and the P-value <0.05 was considered as significant level.
Results: The mean (±SD) age of men and women were 38.5±14.2 and 37.5 ±13.0 years respectively. The overall prevalence of obesity and overweight were 18.8% and 34.8% respectively (27.8%, 33.5% for men and 9.9% and 36.2% for women). The pattern of obesity was significantly different with age in both genders. The results of logistic regression model showed that the odds ratio of obesity for age increased up to 60 years and then it tended to decrease slightly (P<0.0001). The age adjusted odds ratio for obesity was greater roughly 3.6 times in women compared with men (P<0.0001). The adjusted odds ratio decreased with increasing the level of education (P<0.0001) while the odds ratio was 0.19 for education at university level (P<0.0001). The adjusted odds ratio was tended to decrease with occupational activities, physical activity level in leisure time and exercise level.
Conclusion: The results of this study indicate an increased rate of obesity and overweight in urban population. With respect to these findings, low level of physical activity and education, parity, family history of obesity, marriage at earlier age, gender and aging were responsible for obesity. Therefore, community based multiple strategies are required to combat the increasing rate of obesity and its subsequent complications.

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Background and purpose: Birth spacing has become a main strategy within health promotion programs for mothers and their children during the past two recent decades in the Islamic Republic of Iran. The present study was aimed to determine the patterns and factors associated with birth intervals in Multi-Para women residing in Babol.
Materials and methods: We conducted a cross-sectional study with samples consisting of 500 Multi-Para women, who were referred to the hospital and the Health Center for delivery in Babol, Northern Iran, during 2007. The data was collected using a designed questionnaire, including birth intervals between index child and prior, demographic and fertility variables, such as maternal education, maternal age at birth of index child, sex before index child, still birth, child status before index child, parity, duration of breast feeding, residence area, contraception methods, and attending family planning clinic. The data was analyzed using the logistic regression model.
Results: The mean (SD) of birth intervals was 61±25.7 months. Birth interval in 3.8% of mothers was less than 2 years and 41.7% of mothers had 4 to 6 years, while 28% had ≥6 years. In the majority of women, (76.8%) pregnancies were from 20 to 34 years of age. In spite, pregnancy was observed in 22.4% cases in age 35 or over, while 0.8% of pregnancies were in the age range less than 20 years. Maternal age, duration of breast feeding, child sex before index child, still birth, history of infant mortality before index child, type of contraception, attending family planning clinics and parity showed a significant relation with birth intervals.
Conclusion: Maternal age, parity, duration of breastfeeding, still birth, history of infant mortality, attending family planning clinics and using modern contraceptive methods are shown to be determinants of birth intervals. Although our findings indicated that in the majority of Multi-Para women, birth intervals was within the accepted range previously recommended by the Ministry of Health in Iran, over a quarter of women had birth intervals of ≥6 years. Due to increasing maternal age associated with high risk pregnancies (aged >35yeras) by long birth intervals, it is necessary to revise educational programs for prevention of long birth intervals, that would induce the subsequent pregnancies in becoming high risk.

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Background and purpose: Because of the importance of early diagnosis of cervical cancer and high false negative results of conventional smear method, several studies have been performed to find a more appropriate test in recent years. Fluid-based methods especially thin prep are considered to have the highest potential to reduce the false negative results and to increase the adequacy of specimens. The purpose of this study was to compare the Papanicolaou fluid-based thin layer smear with conventional pap smear in term of adequacy of specimen.
Materials and methods: Ïn this prospective study, the results of 120 thin layer smears were compared with 120 conventional pap smears. Çervix brush was used to prepare the samples of papanicolao and thin prep. The smears were interpreted using Bethesda system.
Results: The number of SBL (Satisfactory but limited) in thin layer method and conventional pap smear were 11.9% and 39.2%, respectively. The number of unsatisfactory was 4.2% in the thin layer method compared with 9.2% in the conventional method. The reduction of satisfactory in thin layer method was not statistically significant (P>0.05), but the reduction of SBL (P<0.05) and increasing of satisfactory in thin prep method was statistically significant (P<0.05).
Çonclusion: The results demonstrated that fluid-based thin layer method may improve the adequacy of specimen and in turn lead to reduction of unsatisfactory and SBL cases.

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Background and purpose: TB is a serious infectious disease in kidney recipients causing high morbidity and mortality. The prevalence of this disease varies in different countries depending on socio-economic levels. The aim of this study was to investigate the occurrence of TB after kidney transplant in kidney transplant center of Shahid Beheshtei Hospital in city of Babol. Materials and methods: This cross-sectional study was done on 363 kidney recipients since the establishment of the kidney transplant center of Shahid Beheshtei Hospital in Babol. Data including the age, sex, duration of dialysis, PPD test, time of TB diagnosis, pulmonary and extra pulmonary presentation, immunsuppression and anti-TB regimen, cyclosporine level after and before TB diagnosis, rejection and function of kidney after transplantation were recorded through a questionnaire. Pulmonary tuberculosis diagnosis was made based on the positive culture of bronco alveolar lavage fluid. Results: From 363 renal allograft recipients, there were 10 (2.75%) documented cases of TB of whom six patients were male and four were female. The mean age was 47.2 years. The mean time for dialysis before transplantat was 30.5 months and the mean time to diagnose TB was 8.1 months after transplant. The most common complaints included coughing, fever and weight loss. The most frequent radiologic findings were diffuse infiltration. Immunsuppressive regimen was changed from azatioperin to mycofenolat in two patients. Anti-TB regimen was four drugs in six patients. Rejection was seen in five patients before the diagnosis of TB. Also, mortality (without autopsy) was observed in four patients. Conclusion: The frequency of TB after kidney transplant in kidney recipients in this centre was lower than other centers but mortality rate of the disease was higher.

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Background and purpose: Attention deficit hyper activity disorder (ADHD) is a serious disorder for childhood and adolescents that disables and retards the patient in social relationship. This research aimed to determine the prevalence of ADHD in High-School Students of Sari, Iran. Materials and methods: In this cross-sectional description-analytical study, the study population was 14-17 years old students of high-schools in Sari town. The data-collection tool was Conners parent questionnaire completed by the students’ parent after sending their home. The collected data were analyzed using SPSS software. Results: The mean age of the cases was 15.8 ± 2.1 years. The prevalence of the ADHD prevalence was 14.2% the prevalence in boys was more but the difference was not significant. Conclusion: Considering the prevalence of ADHD in Sari, the screening, treatment and follow-up programs should be planned to improve the situation.

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Background and purpose: Nonalcoholic fatty liver disease is one of the most common causes of chronic liver disease and is a major public health problem worldwide. In recent years, the prevalence of nonalcoholic fatty liver disease has increased in children and adolescents. This study aimed to investigate the effect of silymarin on children with nonalcoholic fatty liver disease.

Materials and methods: In this randomized crossover clinical trial, 40 children with nonalcoholic fatty liver disease were divided into two period treatment groups. Patients in group A received 140 mg silymarin capsules, three times a day in the first three months, and after one-month washout period they received placebo for three months. Group B received placebo at first and then silymarin. Liver enzymes, LDL, HDL and triglyceride levels were measured at baseline and after the first and second stages. At the end of three months, the patients underwent ultrasonography.

Results: The study included 36 boys and 4 girls. After treatment with silymarin no significant changes were seen in weight, AST, ALT, HDL, LDL and TG levels of patients compared with those of the control group (P>0.05). However, fatty liver grade decreased significantly after treatment with silymarin (P=0.02).

Conclusion: As previous studies on adults, our results showed beneficial effects of silymarin on reducing fatty liver grade in children with nonalcoholic fatty liver disease. Larger studies with longer treatment periods are recommended in order to achieve comprehensive results.

(Clinical Trials Registry Number: IRCT2015012520781N1)

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Background and purpose: Carpal tunnel syndrome is the most prevalent neuropathy caused by trapping and median nerve compression in the wrist. This study aimed at comparing the effects of minimal incision and double incision in treatment of patients with carpal tunnel syndrome.
Materials and methods: This randomized controlled trial was performed in 50 patients with carpal tunnel syndrome attending Shahid Beheshti and Ayatollah Rouhani hospitals in Babol, Iran, candidates for surgery. The patients were divided into two groups using random number table to have either minimal incision (n=25) or double incision (n=25). All patients completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and Visual Analogue Scale (VAS) before and three months after the surgery.
Results: The patients included 40 (80%) males and 10 (20%) females. The mean age of the patients was 51.78±8.22 years old. The mean scores for paresthesia, numbness, pain, weakness, nighttime symptoms and functional status (according to BCTQ), and also mean VAS score significantly reduced after the intervention in both groups (P<0.001). The mean scores for these parameters were not significantly different between the two groups neither before nor after the treatment.
Conclusion: The results of treatment with minimal incision and double incision were not different, but minimal incision is suggested as a selective therapeutic approach due to smaller cut.
 
(Clinical Trials Registry Number: IRCT20160508027797N5)

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Background and purpose: Postoperative nausea and vomiting is a common complication of anesthesia. The aim of this study was to compare the effect of midazolam, ondansetron and their combination in prevention of nausea and vomiting after strabismus surgery.
Materials and methods: In this randomized double-blind clinical trial, 140 patients undergoing strabismus surgery were divided into four groups (n=35 per group). The patients received midazolam 0.75 mg/kg (M), ondansetron 4 mg (O), midazolam 0.75 mg/kg + ondansetron 4 mg (MO), and saline 0.9% iv. (S) before anesthesia. Follow-up was done in the first 24 hours after surgery and incidence and severity of nausea and vomiting and other postoperative complications were compared between the four groups.
Results: In this study, 10 patients (37%) in group S, 6 (19.4%) in group O, 8 (28.6%) in group M, and 2 (6.3%) in group MO developed nausea indicating significant differences between the four groups (P=0.019). The study showed no significant differences between the groups in incidence of vomiting (P= 0.18); 6 patients (22.2%) in group S, 5 (16.1%) in group O, 4 (14.3%) in group M, and 1 patient (3.1%) in group MO had vomiting. The severity of postoperative nausea and vomiting was significantly different between the four groups and group MO was found to have less severe nausea and vomiting two hours (P= 0.009) and 24 hours after surgery (P< 0.001).
Conclusion: Combination of midazolam and ondansetron reduces the incidence of postoperative nausea and vomiting compared to midazolam or ondansetron alone and leads to greater patient satisfaction. According to the higher effect of MO and lack of adverse effects on hemodynamic parameters it is recommended in patients undergoing strabismus surgery.

(Clinical Trials Registry Number: IRCT20180416039326N8)