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  Background & Objective : Palpable thyroid nodules are found in almost 5% of the adults. Regarding the high prevalence of this condition, recognizing and evaluating them are important for physicians. Fine Needle Aspiration (FNA) is the first easy and cost-effective way for recognizing pathologic nature of the nods. The present research was an attempt to investigate the epidemiology and evaluate the pathological findings among patients using FNA.

  Methods : This is a descriptive study conducted on all 145(113 female and 32 male) patients referring to the endocrinology clinic of Ardabil in the period between October 1999 to October 2002. The data were collected using a questionnaire, the physical examination of the patients, noting down the clinical finding, doing FNA and its report presented by a pathologist. The data were then analyzed with descriptive statistics and frequency tables using SPSS software.

  Results : Most of the patients (36.5%) were 30-40 years old. FNA of 115 patients (79.4%) was reported as benign and that of 6 patients (4.1%) was malignant, 16 patients (11%) had a doubtful FNA, and in 8 patients (5.5%) the sample was not enough. Among patients with benign FNA, 102 cases (70.6%) had nodular goiter, 8 cases (5.5%) had colloid cyst, 3 cases (2%) had follicular adenoma and 2 cases (1.3%) had thyroiditis. Among patients with malignant FNA 1 case (0.7%) had follicular carcinoma and 5 cases (3.4%) had papillary carcinoma.

  Conclusions : The results indicated that most of the malignant lesion is papillary carcinoma, which has a lower prevalence compared to similar studies. Regarding the higher prevalence of thyroid carcinoma in middle ages it seems necessary to investigate the thyroid nodules in this age- group.

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  Background & Objective :Depression is one of the most common disorders which can affect every individual. However some individuals (including the students of medical sciences) who are involved in health issues are more vulnerable in this regard. The early diagnosis of this disorder among the students can lead to primary prevention and avoid any further progression and deteriration. This in turn can result in mental health among these students as well as the society. The present study set out to investigate the rate of depression among the students of Ardabil university of medical sciences.

  Methods : This research is an analytic-descriptive study conducted on 324 students from Ardabil University of Medical Scinces. A questionnaire including two sections was used to collect the data. The first section was about the demographic information and the second section included questions about depression based on Beck depression test. The data were analyzed by SPSS soft waire using descriptive and analytical statistics.

  Results : The results showed that 57.4% of total subjects (186 students) suffered from various degrees of depression. 128 of these students were suffering from clinical depression. The prevalence of depression among midwifery students was 21.4 %. Chi- square test showed a significant relationship among prevalence of depression in these students with their educational semester , the number of their siblings, any kind of major physical disorder in the subject or, a serious psychological problem among their family members , as well as any significant event during the previous year.

  Conclusions : According to obtained results there was a high degree of depression among medical university students and serious measures should be taken in the future in order to prevent this social concern.

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 Background & Objectives: Different studies have reported conflicting results on increased rate of early mortality after acute myocardial infarction (AMI) in females compared to males after adjustment for age and other confounding factors. The female gender plays a crucial role in early mortality after AMI. The aim of this study was to assess the role of gender as an important key factor in early mortality after acute myocardial infarction.

 Methods: In this research, patients (80 females and 174 males) with acute myocardial infarction were studies for six months (2003-2004) in terms of risk factors of coronary artery diseases, clinical conditions at admission, treatment modalities in the hospital and at the time of discharge, clinical accidents at the hospital and mortality and during one month after acute myocardial infarction and after being discharged.

 Results: Intrahospital mortality odds ratio for females compared to males was 2 (confidence interval 95%: 0.951-4.208). Mortality odds ratio during one month after acute myocardial infarction and discharge for females compared to males was 4.586 (confidence interval 95%: 1.294-16.252). This rate after adjustment for age was 3.15 (confidence interval 95%: 0.857-11.579) and after adjustment for confounders was 5.387 (confidence interval 95%: 1.296-22.393). In severe clinical conditions females referred to hospitals with more delay compared to men. Females were treated less than males with streptokinase, aspirin, betablockers and invasive diagnostic and treatment procedures. They received calcium channel blockers and nitrate much more than males.

 Conclusions : Females in comparison with males were at higher risk for early mortality (during one month after acute myocardial infarction and discharge). Age was not considered as the most important and potential factor for this higher rate.

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  Background & Objective: Perineal trauma usually occurs during childbirth and associates with short and long term complications for women. B lood loss, urinary, faecal and sexual incontinence are effects of after childbirth complications of perinal trauma. These can cause maternal and newborn morbidity. This study wanted to compare the effectiveness of two techniques for perineum protection " hands off" versus "hands on"(Ritgen) during childbirhtfrom view points of frequency, degree and suture of perineal trauma .

  Methods: This r andomized clinicaltrial study carried out on 70 nulliparous women thatexpecting normal birth of a singleton . They were randomly selected and divided in hands offand hands on (N = 35) groups. In the 'hands on' method, midwife put pressure on the baby's head and support ('guard') the perineum then lateral flexion is used to facilitate delivery of the shoulders, and in the 'hands off' method, midwife keep her hands poised, not touching the head or perineum, allowing spontaneous delivery of the shoulders . We analyzed data with descriptive statistical methods, t-test, chi-squer, mann whitney and non parametric tests by SPSS.

  Results: Rates of intact perineum was significantly higher in the 'hands off' group (50%, 40%, p = 0.48). The f irst and seconddegree tears were significantly lower in the 'hands off' group (40.6%, 50%, vs, 9.4%, 10%, p = 0.48). We did not observe any significant differences in the rate of lacerations in the anterior regions of the perineum and frequency of suture between the two groups

  Conclusions: The hands off technique in the second stage of�labour increases the likelihood of an intact perineum.

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  Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period.

  Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables.

  Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant

  Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.

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Background & objectives: Epilepsy is a chronic neurological disorder that disrupts normal brain activity due to abnormal electrical discharge of brain cells. Mood swings, depression and anxiety are the common complications in epilepsy. The aim of the present study was to compare alexithymia in patients with Tonic-clonic epilepsy, Juvenile Myoclonic Epilepsy (JME), and healthy individuals.
Methods: In this casual-comparative study, sampling was performed by convenience sampling method. The study population consisted of all epileptic patients and the study sample included 134 participants (N= 74 Patients and N= 60 healthy people) individuals aged 18-35 years. Among the patients, 14 were excluded due to lack of selection criteria and 60 samples (N= 29 with myoclonic and N= 31 with Tonic-clonic epilepsy) remained.
Data regarding alexithymia was gathered by Toronto Alexithymia Scale, and analyzed by ANOVA, Scheffé post - hoc test and t-test were performed for independent groups.
Results: Findings showed that the mean of Alexithymia in those with JME,  tonic-clonic epilepsy and normal individuals were 64.44, 61.41, and 54.24, respectively. The difference between the two groups with myoclonic and tonic-clonic epilepsy was not statistically significant. However, there was a significant difference found between those with tonic-clonic epilepsy and normal individuals (T= 6.82; p<0.01). In addition, patients with  JME  and tonic-clonic epilepsy had more difficulty in identifying and describing emotions, and external thought direction compared to normal ones, while no such a difference was observed between the two groups with epilepsy.
Conclusion: Epilepsy is accompanied by reduced processing of emotional information such as alexithymia. Individuals with tonic-clonic and juvenile myoclonic epilepsy are less qualified for recognizing and describing emotional information, and their intellectual orientation is mostly external. Also, since the location of discharge in both types is widespread and similar, no significant difference in alexithymia was observed between the patients with tonic-clonic and myoclonic epilepsy