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Papers by Karimollah Hajian-Tilaki

Medical Oncology, Apr 3, 2010

Diabetes and Metabolic Syndrome: Clinical Research and Reviews, Apr 1, 2016

AIMS The health-related quality of life (HRQoL) is a matter of concern in elderly people with chr... more AIMS The health-related quality of life (HRQoL) is a matter of concern in elderly people with chronic diseases. The objective of this study was to investigate the impact of obesity, hypertension and diabetes on HRQoL among elderly. METHODS A population based cross sectional study was conducted with 750 representative sample of elderly people aged 60-90 years in Babol, the northern Iran. The demographic data and the measurement of blood pressure and other anthropometric measures were collected. The validated short form (SF-36) questionnaire was used to assess the HRQoL. A multiple linear regression model was applied to assess the impact of obesity, abdominal obesity, hypertension and diabetes on QoL. RESULTS The mean age (SD) of participants was 68.0±7.6 and 67.7±7.9 years for men and women respectively. Diabetes exerted the most negative effect on QoL score (adjusted coefficient=-9.2, 95% CI: -11.7, -6.5 points) followed by abdominal obesity and hypertension. Whereas a combination of three conditions was associated with a greater significant reduction in QoL scores in both sexes(adjusted coefficient=-14.5, 95% CI: -19.0, -9.9 points). However, the negative influence of obesity and hypertension on QoL was significant only in women. CONCLUSION Most components of the QoL is affected by diabetes, obesity and hypertension particularly in women. Diabetes alone or in combination with other conditions has a negative influence in both sexes with greater effect in women. These findings justify further professional support to compensate the negative influences chronic conditions on health-related QoL especially for older obese diabetic women.

PubMed, 2023

Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic pati... more Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly-diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group. Methods: Thirty patients aged 36.76±12.91 years with newly-diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 ±12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 ±12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits. Results: Plasma level of TCII in the newly-diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls [14.89 ±3.24 and 21.84± 2.73 vs. 9.55±1.24, (n=30)], respectively. Plasma level of Zn was decreased in the newly-diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group [69.28± 6.41 and 80.56 ±6.12 and vs.75.80±1.59, (n=30)], respectively. Conclusion: This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly-diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes.

BMC Medical Research Methodology, Jul 6, 2023

Introduction The length of hospital stay (LOHS) caused by COVID-19 has imposed a financial burden... more Introduction The length of hospital stay (LOHS) caused by COVID-19 has imposed a financial burden, and cost on the healthcare service system and a high psychological burden on patients and health workers. The purpose of this study is to adopt the Bayesian model averaging (BMA) based on linear regression models and to determine the predictors of the LOHS of COVID-19. Methods In this historical cohort study, from 5100 COVID-19 patients who had registered in the hospital database, 4996 patients were eligible to enter the study. The data included demographic, clinical, biomarkers, and LOHS. Factors affecting the LOHS were fitted in six models, including the stepwise method, AIC, BIC in classical linear regression models, two BMA using Occam's Window and Markov Chain Monte Carlo (MCMC) methods, and GBDT algorithm, a new method of machine learning. Results The average length of hospitalization was 6.7 ± 5.7 days. In fitting classical linear models, both stepwise and AIC methods (R 2 = 0.168 and adjusted R 2 = 0.165) performed better than BIC (R 2 = 0.160 and adjusted = 0.158). In fitting the BMA, Occam's Window model has performed better than MCMC with R 2 = 0.174. The GBDT method with the value of R 2 = 0.64, has performed worse than the BMA in the testing dataset but not in the training dataset. Based on the six fitted models, hospitalized in ICU, respiratory distress, age, diabetes, CRP, PO2, WBC, AST, BUN, and NLR were associated significantly with predicting LOHS of COVID-19. Conclusion The BMA with Occam's Window method has a better fit and better performance in predicting affecting factors on the LOHS in the testing dataset than other models.

Immunopathologia Persa, Feb 9, 2023

Introduction: Chronic kidney disease (CKD) may increase morbidity and mortality. Therefore, early... more Introduction: Chronic kidney disease (CKD) may increase morbidity and mortality. Therefore, early detection of inflammation in kidney transplant recipients with a high risk of transplant rejection is important. Objectives: This study was conducted to compare serum levels of pentraxin-3 (PTX-3), mannose binding lectin (MBL) and high sensitivity C-reactive protein (hs-CRP) in patients with chronic renal failure before and after transplantation. Patients and Methods: This cross-sectional study was carried on 18-80 years old patients receiving immunosuppressive therapy who underwent kidney transplantation in Shahid Beheshti hospital of Babol in 2016. Before transplantation, one week later and two months after transplantation, the serum levels of PTX-3, MBL and hs-CRP were determined. Complications including acute transplant rejection and urinary tract infection were recorded since inflammatory markers were evaluated and compared at the time of complication. Results: The mean age of the patients was 42.07±12.47 years. Transplant rejection and urinary tract infection occurred in 3 (10%) and 4 (13.3%) of patients, respectively. Patients over 55 years of age and those with hypertension had significantly more complications (P = 0.03 and P = 0.02 respectively). Two months after transplantation, PTX-3 and MBL levels were significantly lower (PTX-3; 10.84 ± 15.88 versus18.75 ± 24.31 ng/dL, P = 0.001 and MBL; 764.3 ± 771.35 versus 1157.9 ± 1299.75 ng/dL, P = 0.006). In patients with complications, PTX-3, MBL and hs-CRP levels were 16.73 ± 27.98 ng/dL, 710.0 ± 613.19 ng/dL and 8.43 ± 12.10 mg/L, respectively. No significant difference was found between inflammatory markers in complicated and uncomplicated patients. Comparison of changes in PTX-3, MBL and hs-CRP levels before and after transplantation showed a significant difference two months following transplantation compared to pre-transplantation and also one week after it for PTX-3 and MBL (PTX-3: P = 0.001 and P = 0.009, respectively; MBL: P = 0.006 and P = 0.03, respectively). Conclusion: Based on the results of this study, PTX-3 and MBL levels can be considered for determining the inflammatory status of kidney transplant patients and the prognosis of transplantation.

International Health, Mar 27, 2020

Taiwanese Journal of Obstetrics & Gynecology, Mar 1, 2011

Objective: The aim of this study was to assess uterine artery Doppler ultrasonography efficiency ... more Objective: The aim of this study was to assess uterine artery Doppler ultrasonography efficiency in prediction of adverse pregnancy outcome in high-risk pregnancies. Materials and Methods: We selected 70 pregnant women who were high risk for development of preeclampsia, abruption, low birth weight (LBW), and preterm delivery during their pregnancy, and Doppler ultrasonography was performed for them in 18e24 gestational weeks for evaluation of uterine artery notching. Absence of diastolic flow in uterine artery waves was defined as notching. The women were divided into two groups: with notching (Group A) and without notching (Group B), then they were compared for complications such as preeclampsia, abruption, LBW, and preterm delivery. Results: In 70 high-risk pregnant women, 27 women (39.2%) were in Group A and the others were in Group B. The birth weight in Groups A and B was 2,897.5 AE 757.15 and 3,248.39 AE 374.27, respectively. In our study, 15 patients were delivered before 37 gestational weeks (preterm labor). Preeclampsia, abruption, and LBW were significantly higher in the group with positive notching, but preterm delivery did not show any statistical difference between the two groups. Conclusion: According to the results, uterine artery Doppler ultrasonography had high negative predictive value for prediction of preeclampsia, abruption, and LBW. Therefore, absence of uterine artery notching in mid-trimester evaluation of high-risk pregnant women may predict better pregnancy outcome. We recommend Doppler ultrasonography for all high-risk pregnant women in second trimester for prediction of pregnancy outcome.

International journal of women's health and reproduction sciences, Mar 11, 2023

DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2015

Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as... more Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as abdominal obesity, hypertension, diabetes and dylipedemia. It has been a growing health problem in Iranian adults in recent decade. The objective of this article was to review the prevalence of MetS and the corresponding risk factors among Iranian adults. Methods: We conducted a systematic review to extract the published articles regarding metabolic syndrome and its risk factors among Iranian adults aged >19 years by searching in PubMed, Google Scholar, SID, Magiran and Iranmedex databases. The forty-three published articles were selected regarding MetS among Iranian adults in this review during 2005-2014. Results: From the 43 studies, the rate of MetS varied from 10% to 60% depending on sex, age and region. The highest rate reported among postmenopausal women in Shiraz was over 60%. There was almost a consistent finding that the rate of MetS was higher among women compared with men across national level except in one study. A very sharp difference (43.3% vs. 17.1%) was observed in western Iran (Kordestan province) between sexes. MetS was significantly more prevalent among older adults, postmenopausal women, less-educated people, those living in urban areas and those with low physical activity and unhealthy eating habits across national level consistently. Conclusion: An emerging high rate of MetS across national level highlights the lifestyle modification as preventive measures in Iranian population by focusing primarily on high risk profiles such as low socioeconomic background, low level of education, older age and postmenopausal women.

PubMed, 2019

Background: Because of the importance of thyroid function and its effect on different organs, suc... more Background: Because of the importance of thyroid function and its effect on different organs, such as the heart, this study was aimed to evaluate the effect of levothyroxine on cardiac function in children with subclinical hypothyroidism. Methods: This quasi-experimental study was performed on children aged 4-12 years old with diagnosis of subclinical hypothyroidism in Amirkola Children's Hospital during 2018-2019. Cardiac functional parameters, including ejection fraction (EF), fractional shortening (FS), ratio of early filling velocity to early diastolic mitral annulus velocity (E/E'), myocardial performance index (MPI), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD), were measured by echocardiography at baseline and 6 months after levothyroxine treatment. Results: Out of the 30 subjects, 19 (63.3%) were boys and 11 (36.7%) were girls. The mean age was 6.60±2.13 years old. The mean EF index was 63.13±3.01 percent before treatment, which increased to 69.07±4.50 percent after treatment (p<0.001). Also, the mean FS was 31.83±1.62 percent before treatment, which improved to 35.10±1.13 percent after treatment (p<0.001). The mean MPI was 0.28±0.02 before treatment, which increased to 0.33±0.03 after treatment (p<0.001). On the other hand, no significant difference was found in the mean E/E' before and after treatment. The mean LVEDD decreased from 3.47±0.46 cm before treatment to 3.05±0.40 cm after treatment (p<0.001), whereas LVESD non-significantly decreased after treatment versus before treatment. Conclusion: The results showed that treatment with levothyroxine may improve cardiac functional parameters in children with subclinical hypothyroidism.

Journal of Cancer Research and Therapeutics, 2021

Aims: The study aims at evaluating the effects of the combinatory famotidine/cimetidine diet on r... more Aims: The study aims at evaluating the effects of the combinatory famotidine/cimetidine diet on radiated mice's survival. Materials and Methods: Two hundred and seventy male mice were categorized into 11 groups, a number of which were comprised of subgroups too. The groups under analysis were posed to varying doses of gamma-radiation, including 6, 7, 8, and 9 Gy, followed by treatments using various drug doses 2, 4, and 8 mg/kg, with survival fractions as long as a month after irradiation being measured and recorded. Results: LD50/30 was calculated as 7.47 Gy for the group with radiation only. Following mouse treatment with a concentration of 4 and 20 mg/kg for famotidine and cimetidine, respectively, the survival fraction for the mice grew significantly compared to LD50/30. The combinatory famotidine/cimetidine diet had a higher dose-reduction factor (DRF) than single doses of the drug in radioprotection. The DRF for combinatory famotidine/cimetidine, famotidine, and cimetidine diets was 08.09, 1.1, and 1.01, respectively. Conclusions: Results imply that the combined regimen of famotidine + cimetidine in radioprotection had no significant higher DRF than with regimens including each of them separately. In addition, we did not find a synergic effect of combined oral famotidine and cimetidine on irradiated mice.

PubMed, 2018

Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associat... more Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA. Methods: Non-adherent RA taking < 7.5 mg daily PRED without DMARDs for > 6 months, and RA patients taking methotrexate +PRED (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA was assessed by comparing PRED users RA and RA control,versus non-RA controls. Results: Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (P=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls. Conclusions: These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate +PRED.

Diabetes and Metabolic Syndrome: Clinical Research and Reviews, Nov 1, 2017

Introduction: The clustering of components of metabolic syndrome (MetS) is a major concern in a t... more Introduction: The clustering of components of metabolic syndrome (MetS) is a major concern in a transition population because of dramatic changing toward modern life styles. The objective of this study was to determine the prevalence of clustering of various combinations of MetS and its association with obesity. Methods and Subjects: In a population-based cross-sectional study, a representative samples of 1000 adults were recruited in Babol, the north of Iran. The demographic data, blood pressure, body mass index and waist circumference (WC) were measured with standard method. Fasting blood sugar, serum levels of triglycerides, high density lipoprotein were measured with enzymatic method. Results: A quarter of population had only one component of MetS. The prevalence of just two components was 30.7% and 26.2% in men and women respectively and about 67.1% of men and 73.3% of women had ≥2 risk factors (P=0.001). While the joint prevalence of three and four components were 22.0% and 12.0% in male and 27.3% and 16.5% in female respectively. The combination of high WC with any of other four components of MetS were significantly higher compared with any other joint combinations in particularly among women (P=0.001). The adjusted odds ratio for having clustering (≥2 risk factors) increased 5.6 times (95%CI: 2.15, 6.04) in obese subjects and remained at significant level after adjustment for age, sex, level of education. Conclusion: An emerging high rate of clustering of joint combination of cardio metabolic risk factors highlights an urgent intervention for life style modification in public health management.

PubMed, 2018

Background: Coronary artery disease (CAD) is one of the most progressive and life-threatening dis... more Background: Coronary artery disease (CAD) is one of the most progressive and life-threatening diseases and is the first leading cause of death affecting both genders in Iran. The present study aimed to determine the extent of coronary vessel involvement and relevant relationship with several underlying risk factors. Methods: In this cross-sectional study, 1452 patients undergoing angiography who met the inclusion criteria were recruited consecutively in Babol, Iran during 2016. Data collection was performed through a questionnaire including demographic and clinical characteristics and information on underlying diseases via an interview with the patient and looking into the patients' records. Results: Of these patients, 459 (31.6%) had normal coronary arteries, 220 (15.1%) suffered from non-obstructive CAD and 773 (53.3%) had one, two or three-vessel obstructive involvement. The results of multiple logistic regression showed that the chances of having coronary artery involvement in patients with diabetes (OR=1.55, p=0.012), age> 60 years old (OR=3.52, P=0.001), male gender (OR=2.54, P=0.001), history of heart attack (OR=3.16, P=0.001), and history of hospitalization because of cardiac problem (OR=1.51, P=0.021) significantly increased. Conclusions: Diabetes, male gender, age over 60 years old, history of myocardial infarction and history of hospitalization due to cardiac problem were related to the extent of coronary vessels involvement. Therefore, it is recommended to practice preventive measures more extensively in this regard.

PubMed, 2018

Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity s... more Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups. The first group of 20 patients received 200 mg of lidocaine, and the second group, 200 mg of lidocaine with 20 mg of ketorolac. In both groups, the drug was diluted to 40 ml. In both groups, the onset of sensory block, onset of tourniquet pain, the onset of pain after opening the tourniquet, score of postoperative pain and analgesic prescription in the first 24 hours, during 1, 6, 12 and 24 hours were studied. A measure of the quality of analgesia was evaluated by VAS. Results: The mean onset of tourniquet pain in the two groups was not significantly different (P=0.443). In the ketorolac group, the onset of pain after opening the tourniquet was significantly longer than lidocaine group (p<0.001). The mean postoperative pain score during the first 24 hours after surgery in the ketorolac group was significantly lower than lidocaine group (p<0.001). The average number of analgesia prescription during the 24 hours after operation was significantly lower in ketorolac group than lidocaine group (p<0.001). Conclusions: Adding ketorolac to lidocaine for regional anesthesia can reduce the postoperative pain for up to 24 hours after opening the tourniquet.

PubMed, Jun 1, 2019

Background/aim: Vitamin D displays an immunologic effect which can modulate function of Th17-rela... more Background/aim: Vitamin D displays an immunologic effect which can modulate function of Th17-related cytokines and thereby prevent perpetuation of inflammation in chronic disorders like rheumatoid arthritis (RA). This review aims to conduct a literature review to provide a summary of recent studies addressing the relationship between vitamin D deficiency and RA based on epidemiological, immunological and therapeutic aspects. Methods: PubMed, Scopus and Google scholar were searched for relevant papers published between 2000-2018. Results: Low intake of vitamin D increases the risk of incident RA, and vitamin D deficiency has been shown to be inversely associated with RA activity in most of these studies. However, characteristics of RA and serum vitamin D status differ across the studies. The results of studies on the effect of supplemental vitamin D in RA vary, from no efficacy to significant improvement in disease activity, as well as quality of life. This should be attributed to variations in dosage of vitamin D, duration of treatment, baseline serum vitamin D in RA patients and characteristics of RA across diverse studies. Conclusion: Current data indicate a therapeutic potential for vitamin D in RA. However, further studies are needed to identify an optimal and effective dosage, duration of treatment and patients who will get the best benefit from the treatment.

PubMed, 2020

Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter... more Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. Methods: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. Results: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p=0.091) at optimal cutoff value of 3.4 produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95% CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles. Conclusion: Both TG/HDL-C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.

PubMed, Jun 19, 2008

This cross-sectional study was carried out on 2246 girls born between 1985 and 1989 to determine ... more This cross-sectional study was carried out on 2246 girls born between 1985 and 1989 to determine the age of menarche in Mazandaran province, northern Islamic Republic of Iran. Six cities were selected randomly and cluster sampling used to select high-school students in urban and rural areas. Students with malnutrition, anaemia and chronic infections such as tuberculosis were excluded. The mean (standard deviation) age of menarche was 12.5 (1.1) years, 95% CI: 12.45-12.55 years. The most frequent occurrence of menarche was in summer and least frequent in winter. Menarche age was significantly higher in girls living in rural areas and with fathers with lower education.

Annals of Human Biology, 2005

The health benefits of breastfeeding to infants and mothers have been well established. Its patte... more The health benefits of breastfeeding to infants and mothers have been well established. Its pattern varies between populations and the differences may originate from varying social and cultural factors. The aims of this study were to determine the pattern of breastfeeding and to assess its determinants in a population-based study in Babol, in the north of Iran. A cross-sectional study of 600 randomly selected mothers with infants 12-24 months old was conducted in the north of Iran in 1998. Data concerning breastfeeding status, breastfeeding duration and social and demographic factors were collected through interviews with the mothers. The probability of continuation of breastfeeding (i.e. survival probability) was estimated by using the non-parametric Kaplan-Meier method of survival analysis. The Cox regression analysis was applied to determine the factors associated with duration of breastfeeding. The results showed that the incidence of breastfeeding was 87 and 89% at 12 months in urban and rural areas and 18 and 53% at 24 months, respectively. The difference in the pattern of breastfeeding between urban and rural areas was significant after 12 months (p=0.04). The Cox regression model analysis showed that living in a rural area, increment of birth order, higher education level of mothers, and being housewife mothers were associated with longer duration of breastfeeding. Although, in the univariate analysis, women with high education appeared to have shorter duration of breastfeeding in comparison with illiterate mothers, after controlling the effect of mother&#39;s working status and other variables using the Cox regression model, high level of education had a positive association with longer duration of breastfeeding, i.e. the risk of weaning was decreased in comparison with illiterate women. Also, the risk of shorter duration of breastfeeding was increased significantly among mothers with a high level of stress. The results did not show a significant difference in pattern of breastfeeding in relation to age of mothers and sex of infants. Although the rate of breastfeeding among mothers in Babol was increasing, greater health education efforts are needed to support and promote the healthy practice of breastfeeding, especially among the young, less educated, nullipara, in urban areas and among women who are employees.

DOAJ (DOAJ: Directory of Open Access Journals), 2022

Background: Placenta accreta is one of the known causes of maternal mortality and morbidity. If d... more Background: Placenta accreta is one of the known causes of maternal mortality and morbidity. If diagnosed before delivery, appropriate actions can be taken. The aim of this study was to investigate the role of scaling combination of risk factors in predicting placenta accreta spectrum (PAS). Methods: In this cross-sectional study, 120 pregnant women with two criteria and more of placenta previa in their ultrasound, underwent MRI. Clinical scores (history of surgery, cesarean section, previa, etc.) and paraclinical scores (ultrasound and MRI) were recorded and combined. In cases of hysterectomy, pathological examination was performed. The results were compared and analyzed using SPSS Version 22. The significance level was less than 0.05. Results: Of the120 studied patients, 90 (75%) women were diagnosed with placenta previa in which, 32(36%) patients had placenta accreta and 12 patients had placenta accreta without placenta previa. The mean ultrasound score in women without and with placenta accreta were 0.05±0.32 and 2.43±1.83 (p<0.001). The mean MRI score in women without and with placenta accreta were 0.05±0.27 and 2.07±2.02, respectively. The cut-off point, sensitivity and specificity were 0.50, 100% and 93.4%, respectively. The mean clinical score without and with placenta accreta were 1.97±1.32 and 4.89±3.21, respectively. The cut-off point, sensitivity and specificity were 2.50, 70% and 80%, respectively. The cut-off point of combination score, sensitivity and specificity were 3.50, 89%, 83%. Conclusion: The results of the present study showed that the most specific test to confirm the definitive diagnosis of placenta accreta is paraclinical score, alone.

Medical Oncology, Apr 3, 2010

Diabetes and Metabolic Syndrome: Clinical Research and Reviews, Apr 1, 2016

AIMS The health-related quality of life (HRQoL) is a matter of concern in elderly people with chr... more AIMS The health-related quality of life (HRQoL) is a matter of concern in elderly people with chronic diseases. The objective of this study was to investigate the impact of obesity, hypertension and diabetes on HRQoL among elderly. METHODS A population based cross sectional study was conducted with 750 representative sample of elderly people aged 60-90 years in Babol, the northern Iran. The demographic data and the measurement of blood pressure and other anthropometric measures were collected. The validated short form (SF-36) questionnaire was used to assess the HRQoL. A multiple linear regression model was applied to assess the impact of obesity, abdominal obesity, hypertension and diabetes on QoL. RESULTS The mean age (SD) of participants was 68.0±7.6 and 67.7±7.9 years for men and women respectively. Diabetes exerted the most negative effect on QoL score (adjusted coefficient=-9.2, 95% CI: -11.7, -6.5 points) followed by abdominal obesity and hypertension. Whereas a combination of three conditions was associated with a greater significant reduction in QoL scores in both sexes(adjusted coefficient=-14.5, 95% CI: -19.0, -9.9 points). However, the negative influence of obesity and hypertension on QoL was significant only in women. CONCLUSION Most components of the QoL is affected by diabetes, obesity and hypertension particularly in women. Diabetes alone or in combination with other conditions has a negative influence in both sexes with greater effect in women. These findings justify further professional support to compensate the negative influences chronic conditions on health-related QoL especially for older obese diabetic women.

PubMed, 2023

Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic pati... more Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly-diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group. Methods: Thirty patients aged 36.76±12.91 years with newly-diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 ±12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 ±12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits. Results: Plasma level of TCII in the newly-diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls [14.89 ±3.24 and 21.84± 2.73 vs. 9.55±1.24, (n=30)], respectively. Plasma level of Zn was decreased in the newly-diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group [69.28± 6.41 and 80.56 ±6.12 and vs.75.80±1.59, (n=30)], respectively. Conclusion: This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly-diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes.

BMC Medical Research Methodology, Jul 6, 2023

Introduction The length of hospital stay (LOHS) caused by COVID-19 has imposed a financial burden... more Introduction The length of hospital stay (LOHS) caused by COVID-19 has imposed a financial burden, and cost on the healthcare service system and a high psychological burden on patients and health workers. The purpose of this study is to adopt the Bayesian model averaging (BMA) based on linear regression models and to determine the predictors of the LOHS of COVID-19. Methods In this historical cohort study, from 5100 COVID-19 patients who had registered in the hospital database, 4996 patients were eligible to enter the study. The data included demographic, clinical, biomarkers, and LOHS. Factors affecting the LOHS were fitted in six models, including the stepwise method, AIC, BIC in classical linear regression models, two BMA using Occam's Window and Markov Chain Monte Carlo (MCMC) methods, and GBDT algorithm, a new method of machine learning. Results The average length of hospitalization was 6.7 ± 5.7 days. In fitting classical linear models, both stepwise and AIC methods (R 2 = 0.168 and adjusted R 2 = 0.165) performed better than BIC (R 2 = 0.160 and adjusted = 0.158). In fitting the BMA, Occam's Window model has performed better than MCMC with R 2 = 0.174. The GBDT method with the value of R 2 = 0.64, has performed worse than the BMA in the testing dataset but not in the training dataset. Based on the six fitted models, hospitalized in ICU, respiratory distress, age, diabetes, CRP, PO2, WBC, AST, BUN, and NLR were associated significantly with predicting LOHS of COVID-19. Conclusion The BMA with Occam's Window method has a better fit and better performance in predicting affecting factors on the LOHS in the testing dataset than other models.

Immunopathologia Persa, Feb 9, 2023

Introduction: Chronic kidney disease (CKD) may increase morbidity and mortality. Therefore, early... more Introduction: Chronic kidney disease (CKD) may increase morbidity and mortality. Therefore, early detection of inflammation in kidney transplant recipients with a high risk of transplant rejection is important. Objectives: This study was conducted to compare serum levels of pentraxin-3 (PTX-3), mannose binding lectin (MBL) and high sensitivity C-reactive protein (hs-CRP) in patients with chronic renal failure before and after transplantation. Patients and Methods: This cross-sectional study was carried on 18-80 years old patients receiving immunosuppressive therapy who underwent kidney transplantation in Shahid Beheshti hospital of Babol in 2016. Before transplantation, one week later and two months after transplantation, the serum levels of PTX-3, MBL and hs-CRP were determined. Complications including acute transplant rejection and urinary tract infection were recorded since inflammatory markers were evaluated and compared at the time of complication. Results: The mean age of the patients was 42.07±12.47 years. Transplant rejection and urinary tract infection occurred in 3 (10%) and 4 (13.3%) of patients, respectively. Patients over 55 years of age and those with hypertension had significantly more complications (P = 0.03 and P = 0.02 respectively). Two months after transplantation, PTX-3 and MBL levels were significantly lower (PTX-3; 10.84 ± 15.88 versus18.75 ± 24.31 ng/dL, P = 0.001 and MBL; 764.3 ± 771.35 versus 1157.9 ± 1299.75 ng/dL, P = 0.006). In patients with complications, PTX-3, MBL and hs-CRP levels were 16.73 ± 27.98 ng/dL, 710.0 ± 613.19 ng/dL and 8.43 ± 12.10 mg/L, respectively. No significant difference was found between inflammatory markers in complicated and uncomplicated patients. Comparison of changes in PTX-3, MBL and hs-CRP levels before and after transplantation showed a significant difference two months following transplantation compared to pre-transplantation and also one week after it for PTX-3 and MBL (PTX-3: P = 0.001 and P = 0.009, respectively; MBL: P = 0.006 and P = 0.03, respectively). Conclusion: Based on the results of this study, PTX-3 and MBL levels can be considered for determining the inflammatory status of kidney transplant patients and the prognosis of transplantation.

International Health, Mar 27, 2020

Taiwanese Journal of Obstetrics & Gynecology, Mar 1, 2011

Objective: The aim of this study was to assess uterine artery Doppler ultrasonography efficiency ... more Objective: The aim of this study was to assess uterine artery Doppler ultrasonography efficiency in prediction of adverse pregnancy outcome in high-risk pregnancies. Materials and Methods: We selected 70 pregnant women who were high risk for development of preeclampsia, abruption, low birth weight (LBW), and preterm delivery during their pregnancy, and Doppler ultrasonography was performed for them in 18e24 gestational weeks for evaluation of uterine artery notching. Absence of diastolic flow in uterine artery waves was defined as notching. The women were divided into two groups: with notching (Group A) and without notching (Group B), then they were compared for complications such as preeclampsia, abruption, LBW, and preterm delivery. Results: In 70 high-risk pregnant women, 27 women (39.2%) were in Group A and the others were in Group B. The birth weight in Groups A and B was 2,897.5 AE 757.15 and 3,248.39 AE 374.27, respectively. In our study, 15 patients were delivered before 37 gestational weeks (preterm labor). Preeclampsia, abruption, and LBW were significantly higher in the group with positive notching, but preterm delivery did not show any statistical difference between the two groups. Conclusion: According to the results, uterine artery Doppler ultrasonography had high negative predictive value for prediction of preeclampsia, abruption, and LBW. Therefore, absence of uterine artery notching in mid-trimester evaluation of high-risk pregnant women may predict better pregnancy outcome. We recommend Doppler ultrasonography for all high-risk pregnant women in second trimester for prediction of pregnancy outcome.

International journal of women's health and reproduction sciences, Mar 11, 2023

DOAJ (DOAJ: Directory of Open Access Journals), Apr 1, 2015

Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as... more Background: Metabolic syndrome (MetS) is a complex clustering cardiovascular risk factors such as abdominal obesity, hypertension, diabetes and dylipedemia. It has been a growing health problem in Iranian adults in recent decade. The objective of this article was to review the prevalence of MetS and the corresponding risk factors among Iranian adults. Methods: We conducted a systematic review to extract the published articles regarding metabolic syndrome and its risk factors among Iranian adults aged >19 years by searching in PubMed, Google Scholar, SID, Magiran and Iranmedex databases. The forty-three published articles were selected regarding MetS among Iranian adults in this review during 2005-2014. Results: From the 43 studies, the rate of MetS varied from 10% to 60% depending on sex, age and region. The highest rate reported among postmenopausal women in Shiraz was over 60%. There was almost a consistent finding that the rate of MetS was higher among women compared with men across national level except in one study. A very sharp difference (43.3% vs. 17.1%) was observed in western Iran (Kordestan province) between sexes. MetS was significantly more prevalent among older adults, postmenopausal women, less-educated people, those living in urban areas and those with low physical activity and unhealthy eating habits across national level consistently. Conclusion: An emerging high rate of MetS across national level highlights the lifestyle modification as preventive measures in Iranian population by focusing primarily on high risk profiles such as low socioeconomic background, low level of education, older age and postmenopausal women.

PubMed, 2019

Background: Because of the importance of thyroid function and its effect on different organs, suc... more Background: Because of the importance of thyroid function and its effect on different organs, such as the heart, this study was aimed to evaluate the effect of levothyroxine on cardiac function in children with subclinical hypothyroidism. Methods: This quasi-experimental study was performed on children aged 4-12 years old with diagnosis of subclinical hypothyroidism in Amirkola Children's Hospital during 2018-2019. Cardiac functional parameters, including ejection fraction (EF), fractional shortening (FS), ratio of early filling velocity to early diastolic mitral annulus velocity (E/E'), myocardial performance index (MPI), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD), were measured by echocardiography at baseline and 6 months after levothyroxine treatment. Results: Out of the 30 subjects, 19 (63.3%) were boys and 11 (36.7%) were girls. The mean age was 6.60±2.13 years old. The mean EF index was 63.13±3.01 percent before treatment, which increased to 69.07±4.50 percent after treatment (p<0.001). Also, the mean FS was 31.83±1.62 percent before treatment, which improved to 35.10±1.13 percent after treatment (p<0.001). The mean MPI was 0.28±0.02 before treatment, which increased to 0.33±0.03 after treatment (p<0.001). On the other hand, no significant difference was found in the mean E/E' before and after treatment. The mean LVEDD decreased from 3.47±0.46 cm before treatment to 3.05±0.40 cm after treatment (p<0.001), whereas LVESD non-significantly decreased after treatment versus before treatment. Conclusion: The results showed that treatment with levothyroxine may improve cardiac functional parameters in children with subclinical hypothyroidism.

Journal of Cancer Research and Therapeutics, 2021

Aims: The study aims at evaluating the effects of the combinatory famotidine/cimetidine diet on r... more Aims: The study aims at evaluating the effects of the combinatory famotidine/cimetidine diet on radiated mice's survival. Materials and Methods: Two hundred and seventy male mice were categorized into 11 groups, a number of which were comprised of subgroups too. The groups under analysis were posed to varying doses of gamma-radiation, including 6, 7, 8, and 9 Gy, followed by treatments using various drug doses 2, 4, and 8 mg/kg, with survival fractions as long as a month after irradiation being measured and recorded. Results: LD50/30 was calculated as 7.47 Gy for the group with radiation only. Following mouse treatment with a concentration of 4 and 20 mg/kg for famotidine and cimetidine, respectively, the survival fraction for the mice grew significantly compared to LD50/30. The combinatory famotidine/cimetidine diet had a higher dose-reduction factor (DRF) than single doses of the drug in radioprotection. The DRF for combinatory famotidine/cimetidine, famotidine, and cimetidine diets was 08.09, 1.1, and 1.01, respectively. Conclusions: Results imply that the combined regimen of famotidine + cimetidine in radioprotection had no significant higher DRF than with regimens including each of them separately. In addition, we did not find a synergic effect of combined oral famotidine and cimetidine on irradiated mice.

PubMed, 2018

Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associat... more Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA. Methods: Non-adherent RA taking < 7.5 mg daily PRED without DMARDs for > 6 months, and RA patients taking methotrexate +PRED (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA was assessed by comparing PRED users RA and RA control,versus non-RA controls. Results: Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (P=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls. Conclusions: These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate +PRED.

Diabetes and Metabolic Syndrome: Clinical Research and Reviews, Nov 1, 2017

Introduction: The clustering of components of metabolic syndrome (MetS) is a major concern in a t... more Introduction: The clustering of components of metabolic syndrome (MetS) is a major concern in a transition population because of dramatic changing toward modern life styles. The objective of this study was to determine the prevalence of clustering of various combinations of MetS and its association with obesity. Methods and Subjects: In a population-based cross-sectional study, a representative samples of 1000 adults were recruited in Babol, the north of Iran. The demographic data, blood pressure, body mass index and waist circumference (WC) were measured with standard method. Fasting blood sugar, serum levels of triglycerides, high density lipoprotein were measured with enzymatic method. Results: A quarter of population had only one component of MetS. The prevalence of just two components was 30.7% and 26.2% in men and women respectively and about 67.1% of men and 73.3% of women had ≥2 risk factors (P=0.001). While the joint prevalence of three and four components were 22.0% and 12.0% in male and 27.3% and 16.5% in female respectively. The combination of high WC with any of other four components of MetS were significantly higher compared with any other joint combinations in particularly among women (P=0.001). The adjusted odds ratio for having clustering (≥2 risk factors) increased 5.6 times (95%CI: 2.15, 6.04) in obese subjects and remained at significant level after adjustment for age, sex, level of education. Conclusion: An emerging high rate of clustering of joint combination of cardio metabolic risk factors highlights an urgent intervention for life style modification in public health management.

PubMed, 2018

Background: Coronary artery disease (CAD) is one of the most progressive and life-threatening dis... more Background: Coronary artery disease (CAD) is one of the most progressive and life-threatening diseases and is the first leading cause of death affecting both genders in Iran. The present study aimed to determine the extent of coronary vessel involvement and relevant relationship with several underlying risk factors. Methods: In this cross-sectional study, 1452 patients undergoing angiography who met the inclusion criteria were recruited consecutively in Babol, Iran during 2016. Data collection was performed through a questionnaire including demographic and clinical characteristics and information on underlying diseases via an interview with the patient and looking into the patients' records. Results: Of these patients, 459 (31.6%) had normal coronary arteries, 220 (15.1%) suffered from non-obstructive CAD and 773 (53.3%) had one, two or three-vessel obstructive involvement. The results of multiple logistic regression showed that the chances of having coronary artery involvement in patients with diabetes (OR=1.55, p=0.012), age> 60 years old (OR=3.52, P=0.001), male gender (OR=2.54, P=0.001), history of heart attack (OR=3.16, P=0.001), and history of hospitalization because of cardiac problem (OR=1.51, P=0.021) significantly increased. Conclusions: Diabetes, male gender, age over 60 years old, history of myocardial infarction and history of hospitalization due to cardiac problem were related to the extent of coronary vessels involvement. Therefore, it is recommended to practice preventive measures more extensively in this regard.

PubMed, 2018

Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity s... more Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups. The first group of 20 patients received 200 mg of lidocaine, and the second group, 200 mg of lidocaine with 20 mg of ketorolac. In both groups, the drug was diluted to 40 ml. In both groups, the onset of sensory block, onset of tourniquet pain, the onset of pain after opening the tourniquet, score of postoperative pain and analgesic prescription in the first 24 hours, during 1, 6, 12 and 24 hours were studied. A measure of the quality of analgesia was evaluated by VAS. Results: The mean onset of tourniquet pain in the two groups was not significantly different (P=0.443). In the ketorolac group, the onset of pain after opening the tourniquet was significantly longer than lidocaine group (p<0.001). The mean postoperative pain score during the first 24 hours after surgery in the ketorolac group was significantly lower than lidocaine group (p<0.001). The average number of analgesia prescription during the 24 hours after operation was significantly lower in ketorolac group than lidocaine group (p<0.001). Conclusions: Adding ketorolac to lidocaine for regional anesthesia can reduce the postoperative pain for up to 24 hours after opening the tourniquet.

PubMed, Jun 1, 2019

Background/aim: Vitamin D displays an immunologic effect which can modulate function of Th17-rela... more Background/aim: Vitamin D displays an immunologic effect which can modulate function of Th17-related cytokines and thereby prevent perpetuation of inflammation in chronic disorders like rheumatoid arthritis (RA). This review aims to conduct a literature review to provide a summary of recent studies addressing the relationship between vitamin D deficiency and RA based on epidemiological, immunological and therapeutic aspects. Methods: PubMed, Scopus and Google scholar were searched for relevant papers published between 2000-2018. Results: Low intake of vitamin D increases the risk of incident RA, and vitamin D deficiency has been shown to be inversely associated with RA activity in most of these studies. However, characteristics of RA and serum vitamin D status differ across the studies. The results of studies on the effect of supplemental vitamin D in RA vary, from no efficacy to significant improvement in disease activity, as well as quality of life. This should be attributed to variations in dosage of vitamin D, duration of treatment, baseline serum vitamin D in RA patients and characteristics of RA across diverse studies. Conclusion: Current data indicate a therapeutic potential for vitamin D in RA. However, further studies are needed to identify an optimal and effective dosage, duration of treatment and patients who will get the best benefit from the treatment.

PubMed, 2020

Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter... more Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. Methods: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. Results: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p=0.091) at optimal cutoff value of 3.4 produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95% CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles. Conclusion: Both TG/HDL-C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.

PubMed, Jun 19, 2008

This cross-sectional study was carried out on 2246 girls born between 1985 and 1989 to determine ... more This cross-sectional study was carried out on 2246 girls born between 1985 and 1989 to determine the age of menarche in Mazandaran province, northern Islamic Republic of Iran. Six cities were selected randomly and cluster sampling used to select high-school students in urban and rural areas. Students with malnutrition, anaemia and chronic infections such as tuberculosis were excluded. The mean (standard deviation) age of menarche was 12.5 (1.1) years, 95% CI: 12.45-12.55 years. The most frequent occurrence of menarche was in summer and least frequent in winter. Menarche age was significantly higher in girls living in rural areas and with fathers with lower education.

Annals of Human Biology, 2005

The health benefits of breastfeeding to infants and mothers have been well established. Its patte... more The health benefits of breastfeeding to infants and mothers have been well established. Its pattern varies between populations and the differences may originate from varying social and cultural factors. The aims of this study were to determine the pattern of breastfeeding and to assess its determinants in a population-based study in Babol, in the north of Iran. A cross-sectional study of 600 randomly selected mothers with infants 12-24 months old was conducted in the north of Iran in 1998. Data concerning breastfeeding status, breastfeeding duration and social and demographic factors were collected through interviews with the mothers. The probability of continuation of breastfeeding (i.e. survival probability) was estimated by using the non-parametric Kaplan-Meier method of survival analysis. The Cox regression analysis was applied to determine the factors associated with duration of breastfeeding. The results showed that the incidence of breastfeeding was 87 and 89% at 12 months in urban and rural areas and 18 and 53% at 24 months, respectively. The difference in the pattern of breastfeeding between urban and rural areas was significant after 12 months (p=0.04). The Cox regression model analysis showed that living in a rural area, increment of birth order, higher education level of mothers, and being housewife mothers were associated with longer duration of breastfeeding. Although, in the univariate analysis, women with high education appeared to have shorter duration of breastfeeding in comparison with illiterate mothers, after controlling the effect of mother&#39;s working status and other variables using the Cox regression model, high level of education had a positive association with longer duration of breastfeeding, i.e. the risk of weaning was decreased in comparison with illiterate women. Also, the risk of shorter duration of breastfeeding was increased significantly among mothers with a high level of stress. The results did not show a significant difference in pattern of breastfeeding in relation to age of mothers and sex of infants. Although the rate of breastfeeding among mothers in Babol was increasing, greater health education efforts are needed to support and promote the healthy practice of breastfeeding, especially among the young, less educated, nullipara, in urban areas and among women who are employees.

DOAJ (DOAJ: Directory of Open Access Journals), 2022

Background: Placenta accreta is one of the known causes of maternal mortality and morbidity. If d... more Background: Placenta accreta is one of the known causes of maternal mortality and morbidity. If diagnosed before delivery, appropriate actions can be taken. The aim of this study was to investigate the role of scaling combination of risk factors in predicting placenta accreta spectrum (PAS). Methods: In this cross-sectional study, 120 pregnant women with two criteria and more of placenta previa in their ultrasound, underwent MRI. Clinical scores (history of surgery, cesarean section, previa, etc.) and paraclinical scores (ultrasound and MRI) were recorded and combined. In cases of hysterectomy, pathological examination was performed. The results were compared and analyzed using SPSS Version 22. The significance level was less than 0.05. Results: Of the120 studied patients, 90 (75%) women were diagnosed with placenta previa in which, 32(36%) patients had placenta accreta and 12 patients had placenta accreta without placenta previa. The mean ultrasound score in women without and with placenta accreta were 0.05±0.32 and 2.43±1.83 (p<0.001). The mean MRI score in women without and with placenta accreta were 0.05±0.27 and 2.07±2.02, respectively. The cut-off point, sensitivity and specificity were 0.50, 100% and 93.4%, respectively. The mean clinical score without and with placenta accreta were 1.97±1.32 and 4.89±3.21, respectively. The cut-off point, sensitivity and specificity were 2.50, 70% and 80%, respectively. The cut-off point of combination score, sensitivity and specificity were 3.50, 89%, 83%. Conclusion: The results of the present study showed that the most specific test to confirm the definitive diagnosis of placenta accreta is paraclinical score, alone.