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Background & objectives: Evaluation of liver and renal function before and after administration of methotrexate (MTX) is recommended in the treatment of molar pregnancy, but the necessity of performing these tests during treatment of ectopic pregnancy (EP) is not clear. The aim of this study was to evaluate the changes of creatinine and AST levels before and after treatment with double (DD) and multiple (MD) doses of MTX in patients with Ep.
Methods: This retrospective cross-sectional study performed on 152 patients with an EP during 2007-2013 in Al-Zahra hospital (Rasht). Seventy six patients received DD and 76 cases were treated with MD of MTX. The success rate, side effects of MTX and changes in creatinine and AST levels were compared between the two groups.
Results: The mean changes in creatinine level was 0.06±0.08 and 0.16±0.13 in DD and MD groups, respectively and the difference between the two groups was statistically significant (p=0.002). The mean changes in AST level was 5.06±2.47 and 9.63±5.5 in DD and MD groups, respectively which was statistically significant (p=0.002). The success rates were 65.8% and 86.8% in DD and MD groups, respectively with statistically significant difference (p=0.002). The side effects rates were 13.2% and 32.9% in DD and MD groups, respectively with statistically significant difference (p=0.004).
Conclusion: It seems that administration of MD of MTX in EP patients leads to an increase in success rate of treatment but also it causes considerable increase in creatinine and AST levels.
 

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Background & objectives: Chlamydia trachomatis is a gram negative bacterium and chlamydia infection, as a curable infection, is one of the most common sexually transmitted diseases (STD). With regard to the essential role of chlamydia in infertility, the study of the prevalence of asymptomatic cases is precious. The aim of this study was to determine of the prevalence of chlamydia trachomatis in endocervical samples in infertile women with PCR method.
Methods: In this cross sectional descriptive-analytical study, a total of 135 women between 20-40 years old with chief complaint of infertility that referred to Alzahra-Rasht hospital and private clinics were randomly selected. The endocervical specimen was prepared using a sterile swab and was transferred to the laboratory in PBS for performing PCR. . The results of PCR and collected data from checklists were statistically analyzed using SPSS16.
Results: Chlamydia trachomatis was detected in 19.3% of infertile women. There were no statistically significant differences between PCR results and the patient's age, type of infertility, obstruction in salpingography, family history and duration of infertility.
Conclusion: The results of this study revealed that chlamydia infection has a high prevalence and in order to reduce the complications of this disease, screening tests can be used as a   part of the country's health programs.
 

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Background & objectives: Low birth weight is considered one of the most serious health problems in the world that puts tremendous pressure on the health care system and family. The aim of this study was to investigate the relationship between some maternal risk factors and low birth weight.
Methods: The present study was a cross- sectional study performed on 264 cases. The data gathering tool was a checklist with two parts to compare two groups in this research. The first part was related to the infant's characteristics (sex, weight, and gestational age of the newborn), and the second part related to maternal characteristics. Data were analyzed using SPSS software. Inferential statistics including Mann–Whitney u, chi-square, fisher exact test and logistic regression were used to investigate the relationship between the variables.
Results: In this study, the level of education was lower in mothers with term low birth weight neonates (p=0.024), also normal delivery was reported more frequently among mothers with low birth weight infants (p=0.0001). Also, the mean BMI and the weight at the beginning of pregnancy and overweight in mothers with term neonates and normal weight were greater (p=0.0001, in all). The first minute Apgar score and the fifth minute Apgar score were lower in mothers with low-birth term infants (p=0.002 and p=0.0001). Also distinguished that the gestational age (week) was lower in mothers with low-birth term infants (p=0.0001).
Conclusion: According to the results, increasing progress the pregnancy per week makes it possible to increase the normal weight of newborns by 3.11%.

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Background & objective: Diabetes causes chronic problems in the structure and function of tissues, such as apoptosis and fibrosis in addition to glycemic disorders. In this study the effect of 8 weeks of endurance and resistance training on various signaling pathways of apoptosis and tissue fibrosis of the heart of diabetic rats was investigated.
Methods: Thirty Wistar rats, approximately 8-10 weeks old, weight about 210-250 grams, received intraperitoneal injection of diabetic streptozotocin and were randomly divided into three groups: endurance training, resistance training and control group. The rats of the endurance training group were trained on the treadmill for 8 weeks, 5 days a week with intensity of vo2Max 60-80%. The resistance training group was trained on the ladder with a slope of 85 degrees and with a weight equals to 30-100% of their body weight. Forty eight hours after the last training session, blood samples were collected and ventricular tissues of mice were extracted. Glucose, insulin, serum insulin resistance index and Bcl-2, Bax, caspase 8 gene expression levels and Bax to Bcl-2 ratio were evaluated. Masson's trichrome and hematoxylin-eosin staining methods were used for histological examination of diabetic rat's heart structure to detect fibrosis.
Results: There was a significant decrease in Bax gene expression and the ratio of Bax to Bcl-2, and also  there was a significant increase in Bcl-2 and caspase 8 in the endurance and resistance training groups in comparison with the control group. The rate of cardiomyocyte fiber rupture in the endurance and resistance groups was less than the control group, and the presence of lymphocyte cells was observed in some fibers in the control group. (p≤0.05).
Conclusion: The results showed that high-intensity resistance training and moderate-intensity endurance training can prevent tissue fibrosis caused by collagen deposition in diabetes, and these two types of training can reduce the factors involved in apoptosis both in the internal and external pathways. On the other hand, this training intensity can be used as an effective non-pharmacological method to reduce the problems of apoptosis and fibrosis caused by diabetes in the heart tissue.
 

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Background & Objective: Hepatitis B virus [HBV] infection is one of the most important public health concerns. The present study was conducted to provide a descriptive analysis of detected HBV infection in Ardabil province.
Methods: In this retrospective longitudinal study, the hepatitis B surveillance database of Ardabil province was examined from 2014 to 2018. The frequency of hepatitis B virus infections was presented based on age, gender, marital status, place of residence, primary symptoms, and reporting sources. Also, the trend of changes in the number of detected cases over time was investigated using time series analysis.
Results: A total of 817 positive cases with a mean age of 43.1 years were reported. Most of them were male [n=503, 61.5]. The Frequency of identified positive cases decreased over time. Most of the infections were asymptomatic [87.5%]. Almost 90.0% of patients with HBV were married and the majority of the identified patients were resided in urban settings [n=598, 73.2%]. Most diagnostic tests were done voluntarily [n=219, 26.8%] or during prenatal care [n=109, 13.3%]. Most cases were identified and reported by the health network [n=292, 35.7%] and blood transfusion organization [n=190, 23.2%].
Conclusion: Decision-makers of the health sector of the province can use this information as a source for evidence-based decision-making in the effective management of the disease.

Corresponding Author:
Eslam moradi-Asl, Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
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