ali bijani

Congenital anomalies can pose challenges during electrophysiology (EP) procedures in patients with tachyarrhythmias, making diagnosis and management of these cases quite difficult. An interrupted inferior vena cava, an uncommon congenital defect, is especially rare without associated congenital heart disease. In this setting, catheter ablation from femoral vein access becomes more challenging.

A 23-year-old male with no cardiovascular risk factors or prior cardiovascular disease presented with atrioventricular reentrant tachycardia that converted to sinus rhythm after adenosine administration. The patient was scheduled for an electrophysiology study with catheter ablation if indicated. During the procedure, catheter advancement into the right atrium was unsuccessful, raising suspicion of an interrupted inferior vena cava (IVC). Radiofrequency ablation was subsequently performed successfully via the subclavian vein approach. Post-procedural computed tomography (CT) imaging confirmed interruption of the IVC.

Accessing via the subclavian vein can facilitate catheter ablation when an interrupted inferior vena cava is present.

Thyroid nodules are among common clinical problems and fine needle aspiration (FNA) sampling is the most important method to diagnose its pathological nature. The frozen section (FS) is also very important in making treatment decisions. The present study was conducted to compare the diagnostic value of these two methods based on pathology findings in the patients with thyroid nodules.

This descriptive-analytical study included patients with thyroid nodule surgery between 2011 and 2019 in Babol City. Information was collected by file reading method. Data analysis was done using SPSS-26 software and a comparative survey of the diagnostic value of pathology methods, FNA biopsy, and FS examination, was performed by calculating the sensitivity, specificity, and positive and negative predictive value (p<0.05).

The majority of patients in this study were female (68.66%) and the patients did not have any family history (70.44%). In the final pathology findings, the rates of benign and malignant lesions were; 54.88% and 45.11%, and in FNA and FS, they were 67% and 88.57%, respectively. Sensitivity, specificity, positive and negative predictive values in FNA were; 0.9582, 0.9896, 0.9950, and 0.9697, respectively. Sensitivity, specificity, positive and negative predictive value in FS were 100%. The two mentioned methods were consistent in 58.8% of the cases in the diagnosis of malignant or benign thyroid nodules (p<0.001).

FNA is a reliable method for detecting malignancy in thyroid nodules due to its high sensitivity and specificity. On the other hand, the FS is considered a precise method due to its high correlation with pathology.

Given the high prevalence of hypertension in older adults, this study was conducted to identify the factors affecting the 5?year survival of older people with hypertension.

In this cohort study, individuals aged 60 and over livingin Amirkola, north of Iran who were diagnosed with hypertension were followed up for 5 years, and the effect of various factors on their survival was analyzed.

Among 1439 older people, 892 individuals (61.99%) had hypertension. Age (adjusted hazard ratio [aHR] =1.052, 95% confidence interval [CI] =1.019–1.086, P = 0.002), diabetes mellitus (aHR = 2.166, 95% CI = 1.398–3.354, P = 0.001), serum creatinine (aHR = 2.163, 95% CI = 1.391–3.363, P = 0.001), female gender (aHR = 0.460, 95% CI = 0.276–0.766, P = 0.003), body mass index ?30 kg/m2 (aHR = 0.386, 95% CI = 0.212–0.701, P = 0.002), physical activity score >150 (aHR = 0.382, 95% CI = 0.162–0.898, P = 0.027), each one unit increase of social support score (aHR = 0.914, 95% CI = 0.861–0.970, P = 0.003), and instrumental functional ability score (aHR = 0.907, 95% CI = 0.843–0.974, P = 0.009) showed a significant effect on 5?year survival of older people.

Multiple factors (such as age, gender, social support, lifestyle  behaviors, and comorbidities including diabetes mellitus and renal function) might predict the 5?year survival of the elderly with hypertension. They should be considered in health?care package of these patients.

Treatment failure after intravesical instillation of Bacillus Calmette-Guerin immunotherapy (BCG) for non-muscle-invasive bladder cancer (BCa) occurs frequently. The exact effects of BCG on cellular redox status and gene expression remain unclear. We assessed oxidative stress biomarkers and changes in miR-155-5p expression in response to BCG. Twenty-seven patients with BCa were recruited for measuring tissue and serum malondialdehyde (MDA) and total antioxidant capacity (TAC) levels, and tissue expression of miR-155-5p at two-time points: pre and 6 weeks post BCG. Recurrence of BCa was observed after 20 months. R statistical software was used for paired comparisons of biomarkers, as well as the correlation between variables. Significant increases in TAC were observed after BCG (P= <0.001). Tissue MDA levels were significantly reduced (P= 0.003). miR-155-5p was slightly overexpressed after BCG (median fold change=1.3, P=0.25). At the 20-month follow-up, it was observed that improved MDA and TAC changes were significant only in patients without recurrence of BCa. In patients with recurrence, the pre-treatment expression ratio of miR-155-p5 was positively correlated with TAC (R=0.63, P= 0.032) and negatively correlated with MDA (R=-0.72, P=0.037). In patients with recurrence of BCa pre-treatment miR-155-5p showed negative correlation with its expression changes after BCG (R=-0.78, P=0.004). Conclusions Treatment with BCG has some beneficial effects on the oxidative stress status, which is probably modulated by miR-155-5p. A well-controlled oxidative balance may enhance overall survival of BCa. Considering its high recurrence rate, our pilot experiment can open a window toward better management of patients with BCa.

This study aimed to measure light transmittance (LT) through various thicknesses of computer‑aided design/computer‑aided manufacturing bleach shade ceramics and to assess the Vickers microhardness (VMH) of underlying light‑cured resin cement.

In this in vitro study, a total of 90 ceramic discs (VITA Mark II [VM], VITA Suprinity, and CELTRA Duo) were prepared in 0.5, 1, and 1.5 mm thicknesses. To measure LT, the Valo light‑curing unit was placed in direct contact with the ceramics on the radiometer. The average LT was recorded after three measurements. In addition, 90 specimens of light‑cured resin cement (Allcem Veneer) were cured in Teflon molds (0.5 mm in depth) beneath ceramic pieces. Ten specimens of resin cement were also cured without the presence of ceramic as a control group. VMH of the cement specimens was reported. The data were analyzed by one‑way analysis of variance and multiple comparison tests (α =0.05) in SPSS version 17.

In each ceramic group, LT was negatively related to ceramic thickness (P < 0.05). At a thickness of 1.5 mm among all ceramic types, the VMH of resin cement was significantly decreased (P < 0.05). In all thicknesses, theVMH of resin cement was lower significantly than the control group, except for the thickness of 0.5 mm of VM.

According to the results of this study, light‑cured cement is not a suitable option for cementing the studied bleach shade ceramics. Furthermore, the thickness of the ceramic has a significant effect on LT (P < 0.05), unlike VMH.

Cardiovascular diseases are the most important diseases of the elderly, and recently the effect of triglyceride glucose (TYG) index as one of the indicators of insulin resistance in type 2 diabetes and coronary artery disease has attracted the attention of researchers. Previous research has shown a link between insulin resistance and coronary artery calcification. Since triglyceride glucose index (TyG) is an index that is easily available, this study aimed to investigate the relationship between triglyceride index and fasting blood sugar and coronary heart disease and diabetes in the elderly of Amirkola.

This cross-sectional study was conducted on the elderly participating in the second phase of the Amirkola Health and Aging Cohort Study (AHAP). The elderly were divided into two groups of 200 people, the first group was diabetics with cardiovascular disease and the second group was diabetic elderly without cardiovascular disease. Patient information including age, sex, body mass index, diabetes, coronary artery disease, history of dyslipidemia, medications, triglycerides, fasting blood sugar, smoking habits, systolic and diastolic blood pressure, cholesterol, creatinine, physical activity, and HbA1c were collected in a checklist. The TYG index was calculated based on the LN formula [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Ultimately, SPSS version 25 software was utilized to describe the data using mean, standard deviation, and percentage. The qualitative variables were compared with the coronary artery disease using the chi-square test, while the quantitative variables were compared using the independent t-test in univariate analysis. Furthermore, the process of adjusting for confounding variables was carried out by using multivariate logistic regression.

In this study, 400 diabetic elderly participants were examined based on the relationship between triglyceride glucose index and coronary artery disease. The average age of the elderly with coronary artery disease was 70.46±6.10 and the elderly without coronary artery disease was 70.50±6.49 years. Triglyceride glucose index in diabetic elderly with and without coronary artery disease was 9.3±0.68 and 9.30±0.65, respectively, which was not statistically significant (P=0.92). Mean creatinine (P=0.004), number of comorbidities (P<0.001), and drugs consumed (P<0.001) were significantly higher in diabetic elderly with coronary artery disease. The probability of coronary artery disease in diabetic elderly with cholesterol above 200 mg/dL (OR=0.549, P=0.018) or use of antilipid drugs (OR=2.050, P=0.002) or more than three underlying diseases (356.4=OR- P=0.0001) had more. The mean cholesterol in diabetic elderly without coronary artery disease was significantly higher than that of elderly with coronary artery disease(P<0.001).

Based on the results of the study on diabetic elderly, glucose triglyceride index cannot be an independent risk factor and a suitable tool for the clinical forecast of coronary artery disease in Type 2 diabetes. Triglyceride glucose index alone cannot help in the prognosis of coronary artery disease and finally, the role of triglyceride glucose index in coronary artery diseases and various types of cardiovascular diseases needs more research.

Vitamin D is a modifiable risk factor in cancer and prostate diseases. In this study, we investigate the relationship between vitamin D and serum PSA in elderly men of Amirkola City.

The current cross-sectional descriptive study was conducted on elderly men participating in the cohort study in Amirkola. Demographic information including age, sex, marital status and occupation were recorded and blood samples (5 cc of blood) were taken to measure PSA and vitamin D. A p -value less than 0.05 is statistically significant.

After applying the inclusion and exclusion criteria, 837 elderly men with mean age of 69.99 ± 7.72 years were included in the study. In terms of marital status, 779 (93.1%) were married and 59 (6.9%) were single. In the study of employment status, 476 (56.9%) self-employed, 331 (439.5%) retired, 8 (1.0 %) housewives, 14 (1.7%) unemployed and 8 (1.0 %) They were in an unknown situation. The mean level of vitamin D was 31.94 ± 28.57 ng / mL and the mean level of PSA was 1.94 ± 3.28 ng / dL. No significant relationship was found between vitamin D level and serum PSA in Pearson Correlation test (P = 0.16). Among the other variables studied, only age was related to PSA levels and PSA level increased with age (P = 0.001).

No significant relationship was found between PSA serum level and vitamin D level, but the existence of vitamin D deficiency in most of the elderly studied needs attention.

Dialysis cuffed catheter dysfunction results in inadequate dialysis, increased sepsis risk, and a shortened catheter life. It may be possible to prolong catheter function by identifying the causes of cuffed catheter dysfunction.

This study was a cross-sectional descriptive study conducted in 2021-2022 on hemodialysis patients with jugular cuff catheters. The catheterizations were performed using the Seldinger technique and were confirmed by fluoroscopy. A 12-month follow-up was conducted with respect to the performance of the cuffed catheter. 

A total of 123 patients underwent hemodialysis over 2 years via a cuffed catheter. Catheters were most commonly inserted into the right internal jugular vein, with lengths of 19 cm (tip to cuff). The rate of dysfunction of cuffed catheters was 27.6%. Catheter-related thrombosis was the most common cause in 10 cases (29.4%), followed by catheter tip fibrin sheath in 8 cases (23.5%) and catheter tip malposition in 8 cases (23.5%). Furthermore, 18 patients (52.94%) of cuffed catheter dysfunction occurred within 3 months of catheter placement, based on our study. The dysfunction of cuffed catheters on the left side 23 (67.64%) is more prevalent than the right side 11 (32.35%) (P=0.043); the malposition of catheter tips is more prevalent on the left side (P=0.023).

Most commonly, cuffed catheter dysfunction is caused by thrombosis, fibrin sheath formation, and catheter tip malposition. Cuffed catheter failure can be reduced by carefully monitoring the catheter's path and tip position, searching for fibrin sheaths when investigating cuffed catheter failure, and preventing thrombotic events.

Coronary heart disease (CHD) is an underlying cardiac condition contributing to increased COVID-19 mortality and morbidity which can be assessed by several diagnosis methods including coronary artery calcification (CAC). The goal of this study was to find out if there were potential links between CAC, clinical findings, severity of COVID-19, and in-hospital outcomes.

This retrospective study evaluated 551 suspected patients admitted to teaching hospitals of the Babol University of Medical Sciences, Babol, Iran, from March to October 2021. Data included previous diseases, comorbidities, clinical examinations, routine laboratory tests, demographic characteristics, duration of hospitalization, and number of days under ventilation were recorded in a checklist.

Findings of current study provide evidence of a significant relationship between coronary artery calcification (CAC) and in-hospital mortality. Additionally, we observed significant correlations between CAC and several clinical parameters including age, duration of hospitalization, pulse rate, maximum blood pressure, erythrocyte sedimentation rate (ESR), blood urea nitrogen (BUN), neutrophil count, white blood cell (WBC) count, and oxygen saturation. However, we did not observe a significant association between CAC and the severity index of COVID-19. In addition, logistic regression tests did not find a significant value of CAC to predict in-hospital mortality.

Our findings showed a significant relationship between CAC and in-hospital mortality.

 Choosing the right teaching method that improves the quality of education requires careful examination and diagnosis of learning styles. When it comes to knowledge acquisition, information processing, memory retention, and recall, students have unique preferences. This study was conducted with the aim of investigating the preferred learning styles of Babol dental students and investigating the effect of gender, academic semester and grade point average (GPA) of the previous semester.

 This cross-sectional descriptive-analytical study was conducted using the VARK learning styles questionnaire (Visual-Aural-Reading/Writing-Kinesthetic) on 165 students from the 5th to 12th semester who passed the basic science and were satisfied to participate. The data was analyzed with SPSS version 26 and CHI-SQUARE and ANOVA tests.

Among 165 students who responded to the questionnaires, 69.1% were tuition-free students and 30.9% were tuition-paying students. The most participants were from the 6th semester and the least from the 7th semester, and the average age was 24.05±3.64. The highest percentage of students had GPA between 16 and 18 in the previous semester ⅔ dental students are more partial to an unimodal learning style, among which the Aural and kinesthetic style was preferred. No significant relationship was found between students' GPA at the end of the semester, academic semester, gender and type of entry(tuition-free/ tuition-paying) with learning style.

The superiority of the unimodal learning style and the greatest preference for the auditory method without the influence of demographic variables on these styles can help professors choose a more effective educational method.

Background and Theoretical Foundations: 

The transformation of the Iranian Navy from a purely defensive force to a strategic force has highlighted it as an influential component in Iran's future position. The presence of this force in international waters, the need for greater interaction with trans-regional countries and the impact of the new mission environment, monitoring and identifying the various trends governing the emerging global patterns, to understand the possible futures ahead and more importantly, build It makes a desirable future necessary.

The current research aims to explain the strategic model and the consequences of the presence of the strategic navy of the army in international waters and Makran coasts. The qualitative research approach was implemented with the grounded theory strategy. For this purpose, after reviewing the specialized texts related to the research subject, semi-structured interviews with 12 experts in the sea domain until data saturation were conducted using targeted sampling.

The findings of the research, which was conducted through international and axial coding, show that the data consists of 65 open codes, 59 axial codes, 10 categories, and finally, by using them, 11 contextual factors (training of expert staff, development Commercial, fishing and military fleets, succession of commanders, port services and wharf construction, equipped with modern equipment - smart, radio and satellite facilities (and 4 intervening factors) comprehensive support of sovereignty, convergence with countries, educational and sanitary environment suitable, supply of parts and special equipment, rights and benefits and welfare affairs), as well as 15 strategic factors (observance of international policies, diplomatic influence, international credibility, formulation of force missions, knowledge of international law, increasing geopolitical and strategic depth, knowledge of the environment and space, increasing the weight of geopolitics and... (9 causal factors) professional development of employees, use of elite talent, holding short-term and future research courses, paying attention to the health of employees and... (and 20 consequences) establishing security, deterrence, Sea-based economy and...)was developed.

nowadays , efforts to improve national security are among the concerns of governments and basic bases of their foreign policy .in this context , the actors in the region are trying to expand their geopolitical realm in recent years this approach has been based on aggressive realist theory and support of militias and people groups in different countries in recent years .in the meantime , the countries of turkey , saudi arabia , qatar and iran have used special tactics and different groups in order to increase penetration and power in these equations . ~~~ in this context , in recent years , lebanon 's hezbollah , which is one of the allies of islamic republic of iran , has been able to achieve victory and its balance can expand its geopolitical position .in this regard , the present study has been conducted with descriptive - analytical and applied approach to the power of ای region in improving the geopolitics of iran .the population of the study consists of all military and geopolitical experts , whose sample size was estimated to be 40 .in order to analyze the data , test - retest , pearson correlation and pearson " s correlation were used .the main question of this research is : what is the relationship between the power of the islamic republic of allah and the promotion of geopolitics of iran ?the results showed that there is a direct relationship between the power of the حزب and the withdrawal of american troops from the middle east and the decline of the influence of the saudi , israeli , uae and qatar intrusions and the increase in the power of the hezbollah party in the syrian crisis and the political equations in the middle east region .

Mizaj is the basis of attention to individual differences in Persian Medicine (PM). Regarding the importance of Mizaj for health preservation and treating diseases, it is necessary to achieve a standard tool for Mizaj identification. The purpose of this study was to design a standard self-reporting Mizaj identification questionnaire for elders.

In this exploratory sequential study, criteria of Mizaj identification were extracted by reviewing PM literatures and interview with PM experts and elders. The primary questionnaire was designed and its validity and reliability were assessed, using weighted Kappa statistics, Pearson correlation coefficient (PCC) assessment, receiver operating characteristic (ROC) curve and determining the specificity and sensitivity of cut-off points.

Among the 101 items in the primary questionnaire, 73 items had acceptable reliability. The final 20-item questionnaire was obtained after the criterion validity and PCC assessment. The sensitivity and specificity of this questionnaire were 83% and 88% for warmness, 49% and 80% for moderate in warmness-coldness, 72% and 91% for coldness, 57% and 78% for wetness, 30% and 79% for moderate in wetness-dryness, and 81% and 67% for dryness, respectively.

The first standard Mizaj identification questionnaire for elders was designed in this study. It is recommended as a supplementary diagnostic tool for clinicians and researchers in PM. Also, the people with age over 60 can use it to identify their own Mizaj and then, choose the suitable PM or Unani medicine lifestyle recommendations based on their Mizaj.

Because migraine is a common headache, finding ways to approach it better would be useful. So, studying the relation of dimensions of general health and personality types and pain severity in patients with migraine will be useful for fulfilling this aim.

In this cross-sectional study, the number of patients with migraine headache studied in this study was 170. The checklists used in this study were migraine disability assessment (MIDAS), visual analog scale (VAS), Neuroticism-Extraversion-Openness (NEO FFI), and General Health Questionnaire (GHQ-28).

The average scores of general health dimensions in migraine sufferers with aura were higher than in migraine patients without aura. But this difference was significant only in the index of physical symptoms (P=0.02). There was a negative correlation between pain intensity and general health dimensions but it was not statistically significan. A positive correlation was observed between headache intensity and extroversion, which was significant (r=0.18 and P=0.01). The score of physical symptoms increases significantly with the increase of disability severity (P=0.007).

According to the results, the severity of migraine disability, general health dimensions, and personality types in patients with and without Aura was not different. Also, general health dimensions and personality types were not associated with pain intensity and the severity of migraine disability.

Low back pain (LBP) is one of the most common complications after lower limb orthopedic surgery, which leads to many significant limitations and problems for patients and society. The aim of the present study was to investigate LBP incidence rate following general anesthesia (GA) and spinal anesthesia (SA) in lower limb orthopedic surgery.

In this randomized clinical trial study, all patients who were candidates for elective orthopedic surgery referred to Shahid Beheshti Hospital in Babol, entered the study with informed consent.
Patients were divided into two groups and LBP incidence rate following spinal anesthesia and general anesthesia was evaluated.

Out of 110 patients, 46 (41.8%) complained of LBP as a postoperative complication and 64 cases (58.2%) did not report it. The mean pain decreased over time in patients with LBP. Results also showed that LBP intensity was higher in spinal anesthesia group one day and one week after surgery. One month after surgery, the general anesthesia group did not report LBP, but the spinal anesthesia group still complained of LBP. There was no significant relationship between sex, age, BMI, duration of surgery, type of surgery and cause of fracture with LBP incidence.

According to the present study, the mean LBP intensity in the general anesthesia group is significantly less than spinal anesthesia group one day, one week and one month after surgery. patients should receive necessary explanations about the complications of both types of anesthesia preoperatively so that they consciously choose the method of anesthesia.

 Sertraline is one of the most commonly used selective serotonin-reuptake inhibitors for patients with major depressive disorder. The prevalence of sexual dysfunction among patients who use selective serotonin-reuptake inhibitors is 40%–45% for women and 20%–30% for men. A strategy to prevent this side effect is combination therapy with medications such as buspiron and Ritalin. The aim of this study was to compare the effects of bupropion and Ritalin on sexual dysfunction among patients who use sertraline.

 This single-blind randomized controlled trial was conducted in 2018. Fifty eligible women aged 20–45 years old were purposefully selected from the psychiatric clinics of Yahyanejad and Ruhani hospitals, Babol, Iran. Structured interview was used to screen participants for major depressive disorder, sertraline use, and sexual dysfunction. All participants completed the Arizona Sexual Experience Scale and were randomly allocated to the bupropion and the Ritalin group through block randomization. All participants re-completed the Scale one month after the intervention. Data were analyzed through SPSS software by repeated measure analysis of variance.

 All fifty participants (25 in each group) completed the study. The mean of participants’ age was 36.38±5.64 years and the mean score of their sexual dysfunction was 23.44±3.14 at pretest and 19.52±4.92 at posttest. Between-group differences respecting the mean scores of sexual dysfunction and all its items were insignificant both at pretest (P= 0.886) and posttest (P= 0.872). However, within-group comparisons revealed that the mean score of sexual dysfunction significantly decreased in both groups (P<0.001).

 This study concludes the same efficacy of sustained release bupropion and Ritalin in significantly reducing sexual dysfunction among patients who used sertraline.

Practical Implications: 

 According to the results of the present study and the similar efficacy of slow-release bupropion and Ritalin in improving sexual dysfunction caused by sertraline, it seems that Ritalin, due to its effectiveness in treatment, is an easier drug to use. It is more cost-effective and a better alternative to bupropion in improving sexual dysfunction in patients who are candidates for treatment with serotonin- reuptake inhibitors.

Endometriosis is a chronic and promising yet benign disease in women of reproductive age. Some genetic markers in endometrial have a key effect in the pathogenesis of endometriosis. MicroRNAs are small molecules involved in several biological processes. The aim of this study was to investigate the differential expression of microRNAs, including miRNA451, during the secretory phase in patients with endometriosis.

The present study was conducted as a case-control study. Twenty infertile women with endometriosis who were referred to the Center for Research on Reproductive Health and Infertility of Babol University of Medical Sciences and Fatima Al-Zahra Infertility Specialized Treatment Center in Babol and were diagnosed by sonography or laparoscopy or laparotomy and tissue histology and after exclusion of individuals with other causes of female infertility were included in this study. Also 20 healthy women who had no female factor infertility were selected as the control group. The relative expression levels of mir451 in the endometrium of women in both groups were identified using Real-time PCR.

The mean level of mir451 expression in the endometrium of the endometriosis group was 0.46306 ± 0.71740 and in the control group it was 2.11621 ± 3.32579, which was significantly lower in the endometriosis group (P < 0.001).

The results of this study showed a significant reduction in the expression of mir451 in the endometriosis group compared to the control group. This could be investigated as a potential causative factor or indicator of endometriosis. Therefore, with further studies, it may be possible to use these microRNAs as diagnostic biomarkers for patients with endometriosis.

Tennis elbow or lateral epicondylitis is a common complaint involving about a 3-5% cases in a community. Non-surgical treatment is effective in 80% of cases. Recent studies have shown the effect of autologous blood on improving the pain and function of affected patients. The present study aimed to compare the effectiveness of steroid and autologous blood local injection in controlling pain and disability in the short and long term.

The present study was a clinical trial conducted in Shahid Beheshti Hospital of Babol. A total of 60 patients were divided into 3 groups; A group injected at the site of lateral epicondylitis with steroid (methylprednisolone acetate-40mg) and another group with autologous blood (2ml of venous blood), and the other group used a brace for 3 weeks. Patients were followed-up for 15, 30, and 90 days, and the PRTEE assessment questionnaire assessed their pain and disability.

On the 15th day, there was no statistically significant difference in pain and function in the three groups, although the injectable groups were relatively more effective. On the 30th day, the local corticosteroid was significantly better than the autologous blood group, while on the 90th day, autologous blood was significantly better than the local corticosteroid. The average day, in which 25% improvement was gained, was lower in the autologous blood transfusion group.

Regarding the long-term effect of autologous blood on corticosteroid injections, it was recommended as a lateral epicondylitis treatment.

Rapid economic progress and cultural-social changes have led to lifestyle changes and increased risk of breast cancer all around the world, including Iran. This study aims to investigate the 30-year incremental pattern of breast cancer in patients of Shahid Rajaei Radiation Therapy Center in Babolsar, North of Iran.

In this cross-sectional study, the data were retrospectively extracted from the physical and electronic files of patients diagnosed with breast cancer from 1992 to 2021 every 5 year by census method, during the study, overall, 1326 patients' information out of 6199 patients was analyzed using SPSSV.22 software at the level of p-value ≤ 0.05.

The average age of patients was 49.84 ± 11.26 years, which has been increasing over the years of study. 6143(99.13%) patients were women, the mean and standard deviation of their BMI was 29.63 ± 6.00, the number of patients with stage 1 is increasing, and patients with stage 3 is decreasing. 871(65.70%) people went through Radical Mastectomy (MRM), 261(19.68%) people experienced metastasis. There was a statistically significant relation between the type of surgery, stage of cancer, metastasis, and local recurrence within the years of study (p<0.001).

Breast cancer and the age of getting it have increased in recent years. However, advanced stages as well as metastasis and local recurrence have decreased during the investigated years. Therefore, it is recommended to continuously warn women about the risk factors and develop suitable disease screening programs and implement them effectively.

Tourism has a significant impact on the economic, social, and political dimensions of a country; it creates employment and stimulates economic capital. Many experts believe that the growth or recession of this industry in any country is largely due to the domestic and foreign policies of the government. With this introduction, the present research aims to improve the process of attracting tourists to Iran in the1404  vision, with an emphasis on the role of foreign policy. This research is applied and was conducted using qualitative and quantitative methods. The data collection method in this research is based on library and field studies (questionnaires). The research population consists of experts in the field of tourism and foreign policy, and a sample size of 50 people was estimated. Data analysis was performed using the average test and one-sample t-test method in SPSS software and the numerical taxonomy model in MATLAB software. The results of the research show that cultural, political, and development policies of the Islamic Republic of Iran's 1404vision in the field of tourism are less effective, and economic policies have no significant impact on the success of tourism.

Sleep disorders are more common in diabetes mellitus (DM) cases rather than normal ones. In addition, this condition could be associated with diabetic retinopathy (DR) development with more inflammatory indices in circulation. In the present study, we have evaluated the association between DR and sleep quality. This cross-sectional study is a part of the second phase of the study of the elderly cohort of Amirkola City, which was conducted in 2015-2016 on all people aged 60 and higher. Of all diabetic cases, 44 cases had retinopathy and were selected as the case group. To compare two control groups, 135 diabetic patients without retinopathy and 135 people without diabetes were randomly selected. The presence and type of retinopathy were determined based on an eye physical examination by an ophthalmologist. In addition, sleep quality was evaluated based on the Pittsburgh Questionnaire. The obtained data were analyzed by ANOVA, t-test, and linear regression tests. In the present study, there was a significant difference in the score of the Pittsburgh questionnaire between people with DR (45.5±68.2) compared to diabetic people without retinopathy (76.5±48.2) and people without diabetes (95.4±36.2) (P=0.470), but diabetic people without retinopathy had significantly worse sleep quality than people without diabetes (P=0.019). Also, sleep quality in women with DR was worse than in men (P=014). In the linear regression analysis, it was observed that age, gender, diabetes, and history of depression significantly affect the sleep quality of the evaluated cases (P<0.05 for all). According to the results of the present study, DR does not negatively influence the quality of sleep, and DR is not related to sleep disorders.

Electroconvulsive therapy (ECT) is commonly used in the treatment of psychiatric patients. However, it may cause cognitive disorders in patients undergoing the procedure. The aim of this study was to investigate the effect of memantine on the alleviation of cognitive impairments in patients undergoing ECT.

In this triple-blind clinical trial, 60 patients with depression phase of unipolar or bipolar non polycystic disorder were randomly divided into two groups of 30. In the treatment group, the patients received memantine for the whole period of treatment starting 24 hours before ECT (starting dose 10 mg/day, increased to 20 mg/day within one week) and continuing until the sixth session of ECT. In the control group, the patients received the placebo. The cognitive performance of patients was assessed using the Mini Mental Status Examination (MMSE) and the Addenbrooke's Cognitive Examination (ACE) 24 hours before the first ECT session, 24 hours after the sixth ECT session, and one month after the end of the ECT sessions. The study lasted 1.5 years.

The MMSE score at the end of the study period (one month after the completion of ECT) in the memantine group was significantly higher than the control group (P=0.008). However, there was no significant difference between the scores of ACE-R between the two groups after ECT. No significant relationship was found between the two groups in any of ACE-R items.

According to the MMSE test, it seems that memantine reduces cognitive disorders in patients receiving ECT, but this finding was not observed in ACE-R.

The risk of hypertension is increased as people get older. Hypertension and overweight/ obesity are highly prevalent in Iranian older adults and there are limited studies on the association between high blood pressure and visceral fat in this population. This research was conducted to evaluate the correlation between hypertension and visceral fat in older adults.

This case-control study was carried out using the records of people aged ≥ 60 years who enrolled at Phase II of the Amirkola Health and Ageing Project (AHAP). People with hypertension (case group) and those without hypertension (control group) were matched for age and gender. Physical activity was measured using the Physical Activity Scale for Elderly. Visceral fat level was measured by a density meter device.

Out of 700 senior adults, half were found with hypertension. No significant difference was observed between the two groups in age (P=0.684), body shape index (P=0.691), and physical activity (P=0.308). But, a significant difference was observed in mean waist circumference (P<0.001), body mass index (P<0.001), waist circumference to weight ratio (P<0.001), and visceral fat (P<0.001) between the two groups. There was a significant positive correlation between blood pressure and the levels of visceral fat, body mass index, waist circumference, and waist to height ratio in older males and females. Body mass index in male (P<0.001, AUC=0.710) and visceral fat level in female participants (P<0.001, AUC=0.626) were considerably correlated with hypertension.

This study revealed a significant direct correlation between blood pressure and visceral fat level, body mass index, waist circumference, and waist to height ratio in older male and female population. Body mass index in male and visceral fat level in female older adults were strongly associated with hypertension.

Recurrent aphthous stomatitis (RAS) is one of the most common recurrent ulcers in the oral mucosa and its etiology is not yet elucidated, but the immune system dysfunction and oxidative stress may play a role in the pathogenesis of RAS. Selenium has regulatory role in the immune system and oxidative stress. This study aims to compare serum levels of selenium between patients with RAS and healthy controls.

This case-control study was performed in 50 patients with minor RAS and 53 healthy controls that were matched for age and sex. Blood samples were obtained from all participants and selenium serum levels were measured. Data were analyzed in SPSS V17 applying independent sample t-test and Chi-square.

The average age of the controls and case group was 34.77±8.21 and 37.68±9.69 years, respectively and women included 67.9% and 74%, respectively .The mean serum level of selenium in the control group (49.16±17.03 µg/L) was significantly higher than that of the case group (31.09±17.74µg/L) (P<0.001).

Serum levels of selenium are lower in patients with RAS than healthy controls.