Investigating the Rate of the Use of Persian Traditional Medicine Services in Tehran.

Background: Despite all the advancements and publicity made in regard to classical medicine, every day more and more people are interested in complementary medicine. This study was designed and conducted to determine the relative frequency of the use of Persian traditional medicine services by the people of Tehran. Methods: This cross-sectional study was conducted using the telephone survey method in Tehran. A total of 1824 samples were included in the study based on Cochran's formula. At first, by searching databases, including Google Scholar, PubMed, Embase, and internal sources, including the Iran Medex database, numerous medical texts and articles were reviewed in the field of using traditional medicine services. Then, interview guide questions were designed and asked over the phone. Finally, the data were extracted and subjected to quantitative analysis. Frequency and percentage of relative frequency were used to describe the study data. Results: In the study, 62% (n = 1131) of the participants were women, and 60.5% (n = 1103) of the participants have turned to modern medicine for treatment and have also used traditional medical treatments. Also, 43.5% (n = 864) of the participants have used herbal medicines and their products; 43% (n = 616) of the participants have used Persian traditional medicine treatments as self-treatment based on their personal information; and only 46.5% (n = 666) have evaluated the therapeutic effect of Persian traditional medicine methods as "good." Conclusion: The results of the study indicate the need for more emphasis on Persian traditional medicine alongside modern medicine, more organization and supervision of traditional medicine service providers in the country, and the creation of coherent and integrated management in this field.

Efficacy of Plantago major seed in management of ulcerative colitis symptoms: A randomized, placebo controlled, clinical trial.

OBJECTIVE: Evaluation of the effect of Plantago major (P. major) seed on ulcerative colitis (UC) symptoms. METHODS: In this randomized double-blind clinical trial, 61 subjects received 3600 mg/day roasted P. major seed in intervention group (n = 31) and roasted wheat flour in control group (n = 30), for 8 weeks, as a complementary to standard medications. Variables were assessed using the Lichtiger Colitis Activity Index (LCAI) at baseline, week 4, and week 8. RESULTS: 51 patients completed the trial (n = 28 in Plantago and n = 23 in placebo groups). Abdominal tenderness (p = 0.011), gastroesophageal reflux and gastric pain (p = 0.049 for both), were significantly less severe in P. major group. Visible blood in stool (p = 0.001), distension (p = 0.001), and anal pain (p = 0.051), decreased significantly in P. major group, although no significant difference was observed between the two groups: (p = 0.224), (p = 0.283), and (p = 0.455) respectively. CONCLUSION: P. major seems to be effective in complementary management of UC.

Useful Medicinal Plants for Vision Impairment in Traditional Iranian Medicine.

Vision impairment is an important general health issue that imposes many costs on governments and the health system every year. Despite the decline in infectious eye diseases, which has reduced the vision impairment and blindness over the past two decades, vision impairment is still a major health problem in some parts of the world. In traditional medicine books, visual weakness is referred to as "any disturbance in the act of seeing ". Many medicinal herbs have been mentioned in books of Traditional Iranian medicine (TIM) for the management of vision impairment. The aim of this study is to review the medicinal plants mentioned in TIM, which are considered effective for the treatment of vision impairment or its enhancement. In this library-based study, medicinal plants effective in the treatment of vision impairment were searched using 6 valid sources of traditional medicine, including Makhzan ol-Adawiya, The Canon of Medicine, Tuhfat al-Momenin, Al-Abniyah An Haqaiq al-adwiya, Al-Shamil Fi al-Sana'at al-tebiyah, and Ekhtiarate Badiee. This was done in 10 steps (finding keywords, searching for resources, preparing a single list, finding synonyms, classifying, reviewing, extracting plants from compositions, summarizing, scoring and sorting based on the obtained score). A total of 89 medicinal plants were extracted, most of which had a hot and dry temperament. Based on the obtained score, 12 plants got the highest scores (10 and above). The extracted plants can be the basis for further clinical studies to make new effective drugs for the prevention and treatment of vision impairment.

Daily Consumption of Caper Fruit Along With Atorvastatin Has Synergistic Effects in Hyperlipidemic Patients: Randomized Clinical Trial.

BACKGROUND: Dyslipidemia leads to micro- and macro-vascular complications. Atorvastatin is the main therapeutic drug used for dyslipidemia, but it causes side effects such as new type 2 diabetes mellitus onset and elevation of liver enzymes. Herbs may be useful in reducing atorvastatin doses. Caper fruit, an herbal drug in Persian Medicine, has hypolipidemic effects. Hence, the effect of atorvastatin therapy with and without daily caper fruit pickle (CFP) consumption was assessed on hyperlipidemia. MATERIALS AND METHODS: In this single-blinded, randomized, controlled trial, 60 hyperlipidemic patients were allocated in two groups and treated with 10 mg atorvastatin plus 40-50 g CFP (A10+CFP) or atorvastatin alone (A10) for eight weeks. Biochemical parameters were measured at baseline, 4, and eight weeks of the intervention. One-way repeated measure ANOVA and mixed ANOVA were used to measure the effect of the two treatments and the interaction between the type of treatment and time on lipid profile. RESULTS: Serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the A10+CFP group compared with the A10 group (P<0.001 and P<0.001, respectively) from baseline up to the week 8. At week 4, mean changes of LDL-C was significantly higher in the A10+CFP compared with the A10 (P=0.01). Adjusting for the baseline variables, the mean difference of alanine aminotransferase (P<0.01) and triglyceride (P=0.003) were significantly higher in the A10+CFP group at the end. CONCLUSION: This study reports that the intake of CFP along with atorvastatin daily may have synergistic effects which improve the lipid profile in hyperlipidemic patients.

Effect of Phototherapy on Serum Level of Calcium, Magnesium and Vitamin D in Infants With Hyperbilirubinemia.

BACKGROUND AND OBJECTIVE: Phototherapy is one of the therapy methods for jaundice caused by hyperbilirubinemia. Vitamin D and bilirubin have two distinct routes of metabolism yet part of their syntheses is common in the liver and thus they may influence each other's synthesis. One of the consequences of phototherapy not previously studied in detail is hypocalcaemia and hypomagnesaemia. The current study aimed at investigating the effect of phototherapy on serum level of calcium, magnesium, and vitamin D. METHODS: The current semi-experimental investigation was conducted on 50 term infants with jaundice that had phototherapy indication. Bilirubin, calcium, magnesium, and vitamin D were measured in their blood samples at admission and then 48 hours after beginning the phototherapy. Data were analyzed with SPSS version 16 using paired-samples t test. RESULTS AND DISCUSSION: The serum calcium was 9.85 mg/dL before phototherapy and significantly decreased after it (9.51 mg/dL) (P <0.001). Also, the mean serum magnesium was 2.21 mg/dL before phototherapy and significantly decreased after it (2.06 mg/dL) (P=0.047). The mean of serum vitamin D significantly increased after phototherapy (before 17.44 mg/dL and after 21.77 mg/dL) (P <0.0001). The current study showed that phototherapy could decrease the level of calcium and magnesium and increase the level of vitamin D.

Expression of estrogen and progesterone receptors in papillary thyroid carcinoma.

BACKGROUND: Papillary thyroid carcinoma (PTC), occurs mostly in women and sex hormones may play a role in the pathogenesis and clinical course. The objective of this study was to determine the status and prevalence of estrogen and progesterone receptors in PTC with regard to age, gender, tumor size and lymph node involvement. METHODS: Immunohistochemical stains were performed on 92 tissue blocks of PTC for estrogen receptor (ER) and progesterone receptor (PR) expression in tumor cells. Chi-square test and Mann-Whitney U test were used to determine statistical difference using statistical software SPSS. RESULTS: The mean age of patients was 39.32±1.7 years (range 13-80) with 79(85.9%) women and 13 (14.1%) men. Lymph node involvement was seen in 76.1% of patients. The average tumor size was 3.6±2.21 cm. The rate of ER and PR expression were 46.75% and 5.6%, respectively. ER expression for females was higher than males (P=0.014), but no relation was found between males and females in PR expression (P=0.7). Also there was no statistical difference between ER and PR expression with respect to age, lymph node involvement and tumor size. CONCLUSION: Our study showed higher ER expression in females than males with PTC. No relation was found between the expression of these receptors and age of presentation, lymph node involvement and tumor size. Further investigation is required to determine the prognostic importance of ER and PR in PTC.

Expression of Vascular Endothelial Growth Factor in Nasal Polyp and Chronic Rhinosinusitis.

BACKGROUND: Nasal inflammatory disorders such as chronic rhinosinusitis and nasal polyp are among the most prevalent complications with high socioeconomic costs. Vascular Endothelial Growth Factor (VEGF) plays a key role in angiogenesis and cell proliferation. In the present study the effect of VEGF on the development and prognosis of chronic rhinosinusitis and nasal polyp was investigated. METHODS: This cross sectional study was performed on the nasal histological specimens of two groups of patients suffering from nasal polyp or chronic rhinosinusitis, and the expression of VEGF in the two groups was compared immunohistochemically. Based on the percentage of VEGF-positive cells the specimens were classified into four scores. Furthermore, the relations between the VEGF expression and some demographic characteristics were evaluated. RESULTS: The VEGF immunohistochemistry findings indicated a significantly higher expression of VEGF in nasal polyp group compared to chronic rhinosinusitis without nasal polyp group. In terms of VEGF-expression scoring, in both groups most of the specimens were classified as score-2, namely indicating 10-50% of VEGF-positive epithelial cells. In both groups no significant relation between VEGF expression and age or sex of the patients could be seen. CONCLUSION: Local modulation of VEGF expression might be taken as a putative therapeutic strategy in management of sinunasal inflammatory disorders, especially nasal polyps.

Cytokeratin7 expression in gastric and colorectal adenocarcinoma: Correlation with prognostic factors.

BACKGROUND: Gastric and colorectal adenocarcinoma are the second and the fifth most common cancers in Iran, respectively. Expression of cytokeratin 7 (CK7) is established in most malignancies including gastric and colorectal adenocarcinoma. Demonstration of Ck7 could be related to prognostic factors and help to the better management of the patients. The objective of our study was to evaluate the CK7 expression in gastric and colorectal adenocarcinoma and its correlation with other prognostic factors. METHODS: This cross-sectional study was performed on 99 tissue blocks from patients with gastric or colorectal adenocarcinoma undergoing surgery. Tumor grade, tumor size, depth of invasion and metastasis to lymph nodes were determined. Then, the expression of CK7 was studied using immunohistochemistry staining. RESULTS: Expression of CK7 was 50% and 33.8% in gastric and colorectal adenocarcinoma, respectively. There was not only a significant correlation between CK7 expression and tumor size (r=0.267, P=0.009) but also histologic grade (r=0.222, P=0.028). CONCLUSION: CK7 could be more expressed with the increase in tumor size and was associated with poorly differentiated gastric and colorectal adenocarcinoma. However, with these results gathered, it is highly recommended that further studies will be conducted to reveal the exact prognostic role of this factor.

Frequency of Group B Streptococcal Colonization in Pregnant Women Aged 35- 37 Weeks in Clinical Centers of Shahed University, Tehran, Iran.

BACKGROUND & OBJECTIVES: One of the important infectious factors in pregnant mothers and newborns is Group B Streptococcus (GBS). There is no perfect report about prevalence of GBS in Iran and in the case of preterm rupture of amniotic membrane or preterm labor all patients are treated by antibiotics without culture so this has led to adverse taking antibiotics and drug resistance. The present study is intended to determine the frequency of colonization of GBS in the pregnant mother (35-37 weeks), referred to medical centers of Shahed University. METHODS: Overall, 210 pregnant women (35-37 weeks), referred to medical center of Shahed University, Tehran, Iran were selected as sample group and after filling out the questionnaires about demographic data and midwifery status and the related information of post- partum, the rectovaginal culture was done for them. RESULTS: Among 210 samples, 7 (3.3%) included positive culture in terms of GBS colonization while all these cases were sensitive to penicillin, ampicillin, cephalothin, nitrofurantoin, and all of the samples were resistant against tetracycline and contrimoxazole. There was no relationship among age, job, education, number of pregnancy, blood pressure background, diabetes and preterm childbirth with positive culture. Similarly, because of limited number of positive cases it was not possible to examine the relationship among GBS colonization and infection in mother and newborn. CONCLUSION: There was a low frequency in GBS colonization in the studied hospitals and the study inside the country also confirms this finding.

Evaluation of the effects of resting in appearance of post lumbar puncture headache.

Lumbar puncture (LP) is a procedure for obtaining spinal fluid from spinal meningeal spaces this can be done as a diagnostic or therapeutic procedure which can result in to a typical positional headache named as post lumbar puncture headache .This can cause a lot of discomforts for patients and makes fear from the procedure. This study designed to evaluate the effect of resting position after LP on post lumbar puncture headache (PLPH). Patients who had a diagnostic lumbar puncture were divided randomly in two groups .Group A patients had one hour rest in the supine position while group B patients had one hour rest in the prone position. Both groups followed for appearance of symptoms of PLPH for 5 days. 119 patients completed the study, 57 (48%) male patients and 62 (52%) female .PLPH totally appeared in 38 (31.9%) patients .In the group A PLPH was present in 20 patients whereas in group B it was present in 18 patients. Statistical analysis showed no significant differences between two groups (P>0.07). Position of rest after LP has no significant effect on reducing post lumbar puncture headache and there is no need to emphasize on position of rest after LP.

Skin protective behavior amongst girl students; based on health belief model.

Skin cancer is the most prevalent type of cancer in most of the countries and more than 90% of cancer cases are related to ultra violet rays of the sun. Therefore protective behaviors against sunlight are considered the most essential measures for skin cancer prevention. This study has been conducted to determine the frequency of protective behavior against sunlight among female students of Tehran city high schools. The Health Belief Model has been used for this cross-sectional study to analyze the factors related to protective behaviors. A multi-phase sampling method was used. 941 female student of Tehran city high schools were studied using a probed question form. The data were then analyzed using SPSS software. During the study of protective behaviors against the sunlight, 24.7% of participants mentioned that they always use sunscreen. The behavior of using sunscreen is related to perceived sensitivity, severity and benefit amongst the students (P<0.05). Also 3.8% of the students who participated in our study were always using gloves in summer to protect against sunlight. The behavior of using gloves in summer was also related to perceived sensitivity, severity and benefit (P<0.05). Physicians were the most effective influencing people with 84.9% influence on the appropriate decision making by these students. There is a low frequency of protective behavior against sunlight among the female students of Tehran city high schools. These findings show the necessity of training the students in this regard and promote the protective behaviors amongst them.

Clinical Evaluation of Commiphora Mukul, a Botanical resin, in the Management of Hemorrhoids: A randomized controlled trial.

BACKGROUND: Hemorrhoids complaint is one of the most common problems in most society, especially in Asian countries. Current drug treatment protocols cannot cure the disease, and they are palliative. According to Persian traditional medicine, Commiphora Mukul (CM) resin is a medication choice. AIM: This randomized study was undertaken to evaluate the efficacy and safety of crude CM resin compared to a combination of lactolose and anti-hemorrhoid (LandA) in patients with uncomplicated hemorrhoids grade 1 and 2. MATERIALS AND METHODS: This trial was carried out on 99 patients with hemorrhoids, in Ghaem and Imam Reaza Hospitals of the Mashhad University of Medical Sciences, Iran. They randomly received CM 3 g/d for 4 weeks (as study group) or LandA (Lactolose syrup in laxative dose for 1 month and anti-hemorrhoid suppository daily for 10 days) as control group. Subjective and objectives variables including painful defecation, flatulence, constipation, gastro-esophageal reflux (GER), dyspepsia, proctorrhagia, anal protrusion, and colonoscopic grading were assessed before, immediately after, and 4 weeks after the treatment period. An intent-to-treat analysis was used. Safety was assessed with evaluation of clinical adverse effects by common toxicity criteria version 4.0. Forty-nine patients were assigned randomly to receive LandA and 50 to receive CM. After 4 weeks, flatulence, dyspepsia, GER, and colonoscopic grading scores significantly decreased in study group, whereas in control group constipation, painful defecation, and proctorrhagia showed better but not significant improvement. After 4-weak follow-up, the rate of constipation, and proctorrhagia also showed significantly improvement in study group. Constipation and proctorrhagia in control group recurred significantly in 4-week follow-up than after the treatment, whereas this recurrence in test group was not seen. CONCLUSION: CM was more effective than LandA in 4-week treatment of patients with uncomplicated hemorrhoids grade 1 and 2.

Evaluation of patency of arteriovenous fistula and its relative complications in diabetic patients.

PURPOSE: To study the arteriovenous fistula patency, duration of its maintenance, and its relative complications. MATERIALS AND METHODS: One hundred and thirty patients who had undergone hemodialysis during five years (1996 to 2001) were included in this study. The patency rate and complications, including paresthesia, pain induced by ischemia, venous hypertension, infection, erythema, and edema, were assessed. Data were recorded in the pre-designed questionnaire and statistically analyzed using t test. RESULTS: Mean ± standard deviation age of the patients was 58.08 ± 11.73 years (range, 18 to 80 years). Most of the fistulas were created at the left bracheocephalic (58 subjects). Side-to-side technique was the mostly applied technique (99.2%). The fistula patency was 100%, 92.64%, 89.48%, 84.38%, and 83.61% at year 1 to 5, respectively. There was a significant negative correlation between the subjects' age and maintained patency (P = .02). However, no significant difference was observed between the maintained patency and other variables, including gender, location of the fistula, and the type of the technique applied for creation of the fistula (P > .05). CONCLUSION: Diabetes does not have a negative impact on the rate of patency and its duration in arteriovenous fistula. However, further investigations on a larger population are recommended.

Monitoring of intraocular pressure and its correlation with systemic parameters before and after hemodialysis.

INTRODUCTION: End-stage renal disease and hemodialysis affect intraocular pressure (IOP). This study aimed to evaluate the effects of a one session of hemodialysis on IOP. MATERIALS AND METHODS: In this study, the IOP of 130 eyes of 65 hemodialysis patients (38 men and 27 women) was measured before and every 1 hour after the initiation of hemodialysis therapy. Patients with any glaucomatous conditions were excluded. Demographic information including age, gender, underling systemic or ocular diseases, hemodialysis duration and frequency, KT/V, and levels of blood pressure, body weight, blood urea, serum sodium, serum potassium, blood glucose before and after hemodialysis were recorded. RESULTS: The mean age of the patients was 60.3 +/- 16.7 years. The mean predialysis and postdialysis IOPs were 13.50 +/- 4.09 mm Hg and 12.73 +/- 4.07 mm Hg, respectively (P = .02). The mean IOP at the first and second hours (12.32 mm Hg and 11.83 mm Hg, respectively) of hemodialysis were significantly lower than the mean predialysis IOP (P < .001 for each). In nondiabetics, the mean IOP significantly decreased after hemodialysis. The mean predialysis and postdialysis blood glucose levels were significantly different between diabetics and nondiabetics, but were not significant in each group of diabetics and nondiabetics. There was a significant inverse relationship between IOP and blood glucose changes after hemodialysis (r = -0.180, P = .040). CONCLUSIONS: Increased blood glucose levels significantly decreases IOP in hemodialysis patients without glaucomatous features. Changes in other metabolic parameters do not affect IOP during hemodialysis.

Impact of hemodialysis on visual parameters in patients with end-stage renal disease.

INTRODUCTION: Patients with end-stage renal disease who receive hemodialysis are prone to visual disturbances. The aim of this study was to evaluate the effects of metabolic changes on visual parameters during hemodialysis sessions. MATERIALS AND METHODS: Demographic information including history of underlying diseases, wearing eyeglasses, any ocular diseases or surgeries, and hemodialysis duration and frequency were recorded in 65 hemodialysis patients. The best corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution and spherical equivalent (SE) per diopter were measured before and after hemodialysis. Other systemic and metabolic parameters including systolic blood pressure, body weight, KT/V, and blood levels of glucose, urea, and sodium were recorded. RESULTS: A total of 130 eyes of 38 men and 27 women with ages ranged from 24 to 90 years (mean, 60.3 ± 16.7 years) were enrolled. The mean BCVA changed significantly after hemodialysis (0.29 ± 0.48 increased to 0.31 ± 0.49; P < .001). The mean SE changes were significant as well (-0.33 ± 0.31 D decreased to -0.40 ± 0.12 D; P < .001). There was a weakly positive correlation between the BCVA and blood glucose changes (P = .05, r = 0.166). There were significant associations between diabetic retinopathy and wearing of eyeglasses with BCVA and SE (P < .001 for both). CONCLUSIONS: Hemodialysis could influence on visual parameters such as BCVA and refractive status by means of changes in blood glucose or possibly other systemic parameters.

The effects of sleep quality and duration in late pregnancy on labor and fetal outcome.

BACKGROUND: Sleep disturbance is common during pregnancy. The aim of this study was to assess the effects of sleep duration and its quality on labor and fetal outcome. METHOD: In a cross sectional study, primigravida women with singleton pregnancy (gestational age > 37 weeks) were recruited. Women with hypertension, diabetes mellitus, or those who needed emergency cesarean section were excluded. Data regarding the type and length of delivery, the quality of sleep as well as the neonates' weight and Apgar scores were recorded. RESULTS: Totally, 457 participants were recruited. There was a significant correlation between the sleep duration and length of delivery stages. In most participants with more than 8 hours sleep, the first stage of delivery lasted between 6 and 10 hours. They had normal vaginal delivery with induction, and their neonates' Apgar score was > 9 (p = 0.029, p = 0.018, and p = 0.001, respectively). Most mothers with refreshing sleep had normal vaginal delivery with induction, their neonates weighted ≥ 2500 g and with Apgar score > 9 (p = 0.010, p < 0.001, and p = 0.005 respectively). CONCLUSION: Sleep duration and quality of sleep can affect the type of delivery, length of labor stages, as well as neonates' Apgar score and birth weight. Such predictors of labor and fetal outcome should be assessed during prenatal evaluations.

The Study of Anti-Inflammatory Activity of Oil-Based Dill (Anethum graveolens L.) Extract Used Topically in Formalin-Induced Inflammation Male Rat Paw.

Inflammation is one of the symptoms of many common and harmful diseases. As it is incurable through chemical drugs, the study on this ailment using new methods and drugs seems necessary. In addition, the adverse effects of the present anti-inflammatory drugs like NSAIDS and Glucocorticoid appeared in the long time use make such study more demanded. Accordingly, in this study we examined the effects of aerial organs' extract and seed of a plant commonly used in Iranian traditional medicine named Dill on the inflammation caused by plantar injection of formalin in rats and compared them with Diclofenac-gel. One of the methods used for the inflammation assessment is injecting formalin in the rat paw and then measuring the paw volume by the new plethysmometer (weighing method). The assessment is done at a specific time on day for 8 days and then recorded. This study includes 3 groups of 6 male rats: Formalin, Dill-Oil and Diclofenac-gel groups. The Dill-Oil group received 2 g of Dill-Oil, containing 100 mg Dill-extract and the Diclofenac group received 2 g gel containing, 20 mg Diclofenac Na. Data were analyzed with SPSS 17 using ANOVA, Kruskal-Wallis, and Repeated-Measures. The average paw volumes changes in these groups after Formalin-induced inflammation on 1st day, were 0.31 (standard error (SEM) = 0.02), 0.30 (SEM = 0.01) and 0.32 (SEM = 0.05) respectively, with no significant difference. Regarding the peak of inflammation on the 2nd day, it was indicated that the average inflammations in Formalin, Dill-Oil and Diclofenac-gel groups were 0.44 (SEM = 0.03), 0.15 (SEM = 0.04) and 0.36 (SEM = 0.08), respectively. The paw volume changes in groups receiving Dill-oil and Diclofenac-gel, after the daily formalin injection in 8 days compared to the blank group, had a significant decrease (p < 0.001). The Dill group showed even more decrease in the paw volume compared to the Diclofenac one. The results of paw volume measurement analyzed by the Plethysmometer manifest that the Dill-Oil is able to decrease the paw volume significantly.

Frequency and Perception of Sexual Activity during Pregnancy in Iranian Couples.

BACKGROUND: Pregnancy stimulates partners to search for ways to preserve their mutual emotional relations and satisfy their sexual needs, with some limitations. This study evaluates the frequency and perception of sexual intercourse during pregnancy in a group of Iranian couples. MATERIALS AND METHODS: In this cross-sectional study, 155 pregnant women were recruited from two academic clinics in Tehran. The exclusion criteria were: any underlying disease, history of pelvic surgery or gynecologic and obstetric complications, abortion or sterility, and previous preterm labor. A checklist was administrated in the labor room, that included: demographic data, partus and their viewpoints about sexuality. Frequency of sexual activity in each trimester, vaginal intercourse, coitus position, orgasm, breast stimulation, condom usage, and pregnancy outcome were recorded. Data were analyzed with t- and chi-square tests. RESULTS: Women and their husbands with sexual behaviors during pregnancy had a lower mean age; the majority were nulipara (p<0.05). The biggest reason for decreased intercourse in the first trimester was fear of abortion (39.45%). No significant relationship between sexual activity in pregnancy and preterm labor, gestational age, membrane rupture, and fetal outcome was shown. There was a significant negative relationship between intercourse in the 2nd and 3rd trimesters and need to induction. CONCLUSION: Although our results showed that sexual intercourse had no adverse effect on the fetus and was a proper stimulus for the induction of delivery, its frequency was reduced during the gestational stage due to parents' fear of adverse effects.

Evaluation of pre lumbar puncture position on post lumbar puncture headache.

BACKGROUND: The most common complication of lumbar puncture (LP) occurring in over thirty percent of patients is headache. The position after lumbar puncture, needle type and size, and volume of the extracted cerebrospinal fluid (CSF) have been evaluated as contributory factors in occurrence of post lumbar puncture headache (PLPH), but the position before lumbar puncture has not been evaluated. METHODS: The occurrence of post lumbar puncture headache was evaluated in 125 patients undergoing lumbar puncture, divided randomly into sitting and lateral decubitus groups in the following five days. Chi-square test was used for statistical analysis. RESULTS: Thirty eight patients (30.4%) reported headache after lumbar puncture in the two groups, and post lumbar puncture headache was significantly lower in the lateral decubitus position (p = 0.001). There was no significant difference between genders in the post lumbar puncture headache occurrence (p = 0.767). CONCLUSIONS: Lumbar puncture in sitting position could produce more post lumbar puncture headache in comparison with lateral decubitus position.

The effects of body mass index on the treatment of the patients with migraine headaches.

BACKGROUND: Migraine is a prevalent disease which is classified into two groups of migraine with aura and without aura. Eighteen percent of women and 6.5 percent of men in United States have migraine headache. Migraine headache is prevalent in all age groups but it usually subsides in adults above fifty. Migraine has many risk factors such as stress, light, tiredness, special foods and beverages. The aim of this study was the evaluation of the effects of body mass index (BMI) on the treatment of migraine headaches. METHODS: All patients assigned to four groups according to their BMI. Patients with more than three attacks per month received nortriptyline and propranolol for eight weeks. The frequency, duration and severity of pain were measured by visual analogue scale (VAS) and behavioral rating scale (BRS-6) in regular intervals. RESULTS: 203 patients completed the study. 153(75%) subjects were women and 50(25%) were men. Mean age of patients was 30.5 ± 7.1 years. Mean weight was 80.4 ± 14.1 kg and mean height was 1.67 ± 0.07 m. Pain frequency and duration showed statistically significant differences among four groups with better response in patients with lower BMI (P < 0.0001). VAS and BRS-6 scales showed statistically significant differences among four groups in favor of patients with lower BMI (P < 0.0001). CONCLUSION: This study showed that obesity has a direct influence on the treatment of migraine headaches. It could be recommended to patients to reduce their weight for better response to treatment. In addition, care should be taken about migraine drugs which make a tendency for increased appetite.