مجله دانشگاه علوم پزشکی بابل
سال چهاردهم شماره 5 (پیاپی 68، شهریور 1391)

Menopause is the cessation of ovarian activity and anxiety is one of its symptoms. Many studies show that anxiety is due to decreased estrogen levels after menopause. Since phytoestrogens are plant sterols that are similar to estrogen in structure and function, so the present study was done to evaluate the effect of vitex agnus castus, which has high levels of phytoestrogen on anxiety in ovariectomized rats and compare its effect with estrogen and tamoxifen.

In this experimental study thirty-five female Wistar rats (150 to 200g) were divided into five groups as following: control group, Vitex agnus castus at the dose of 80 mg/kg, Vitex agnus castus at the dose of 8 mg/kg, Estradiol valerat at the dose of 40µg/kg, and the combination of tamoxifen (100 mg/kg) and herbal extract (80mg/kg). All animals were ovariectomized by cauterizing ovaries through bilateral incisions under anesthesia. After two months, anxiety-related indices (% OAE) and (% OAT) was determined using elevated plus-maze test of anxiety for 5 minutes.

Compared to the control group (21.67%±3.47%), Vitex agnus castus extract at the dose of 8 mg/kg (36%±7.34%) or 80 mg/kg (48.61%±1.25) (p<0.005 and p<0.001, respectively (increased the open arm time (%OAT). The plant also increased open arm entries (%OAE) at the dose of 80 mg/kg (55.17%± 6.91% vs. 24.5%± 2.74% in control) (p<0.005(. Locomotor activities were not significantly different among groups.

Based on our data, Vitex agnus castus showed estrogen-like effects on reducing anxiety-like behaviors in ovariectomized rats.

Breast cancer is the most common malignancy among females and is one of the most common causes of cancer mortality in females aged 40-44 years. There are different methods of surgical treatment for breast cancer. Modified radical mastectomy (MRM) and breast conservative therapy (BCT) and radiotherapy are two methods for treatment of this disease. The present study aimed to survey loco- regional recurrence rate, metastasis, disease free survival and overall survival between modified radical mastectomy (MRM) and breast conservative therapy (BCT).

This historical cohort study was done with using extracting recorded data of 300 patients. One hundred and 200 patients were treated by BCT and MRM, respectively. Patients were followed up by visit in hospital and survival determined by phone call. Local recurrence, metastatic rates and survival were measured and compared.

The mean age (SD) of patients was 46.96±12.03 years and 46.79±11.21 years in BCT and MRM groups, respectively. There was not any significant difference between two groups. After two year follow up, loco regional recurrence was 4% (4 patients) in BCT group and 3% (6 patients) in MRM group, but after five year follow up, it was 8% (8 patients) in BCT group and 6% (12 patients) in MRM group. After two year follow up, mortality rate was 10% (10 patients) in BCT group and 4% (8 patients) in MRM group that there was no significant difference between two groups. Also after five year follow up, it was 16% (16 patients) in BCT group and 24% (48) in MRM group that there was no significant difference between two groups.

we can recommend BCT for patients with breast cancer without any concern about increase of local recurrence and survival rate. The patients are more satisfied with BCT because of keeping their beauty, less psychological problems and better quality of life.

Morbid or extended obesity (class III) is uncommon in pregnancy and associated with higher rates of pregnancy complications compared to women with normal weight. In this report, a successful management of pregnancy in patient with severe morbid obesity with weight 175kg and overt diabetes and chronic hypertension was introduced.CASE: A 31-year-old pregnant woman with history of overt diabetes and hypertension with weight 175kg and a body mass index of 64 kg/m2 was admitted to Ayatollah Roohani hospital of Babol, Iran. Her diabetes and hypertension well controlled. She was scheduled for a cesarean section (C/S) at 37 gestational weeks. Spinal anesthesia and C/S by Pfannenstiel incision was applied for this patient. Delivery outcome was a healthy female neonate with 3300 gr weight and Apgar score of 9-10. The mother was discharged with good condition. There were no complications at 4-month follow-up after surgery and the patient's hypertension was controlled and need for insulin decreased.

Because of high maternal and fetal neonatal complications in morbid obesity, we consider good prenatal care for her medical problems and appropriate timed fetal well being test.

Iran is one of the endemic regions of Crimean Congo hemorrhagic fever (CCHF). The most common route for transmission is contaminated pets in this region. This disease is associated with high mortality rate. This article is a report of an outbreak of this disease in Jahrom (a city in the south of Fars in Iran).CASES: The first and second patients were two young brothers aged 23 and 26, with a history of butchering from Banarouyeh (a village in the south of Fars-Iran). These patients were referred to Peymanieh hospital in Jahrom after the death of a woman who was in their neighborhood. The cause of her death was coagulation disorders. They had history of contact with infected animals in the days before the onset of symptoms. Symptoms in these patients were fever, weakness, lethargy, drowsiness, melena, bloody vomiting, and productive cough. The third patient was a young person who was the nephew of the mentioned patients. He had a history of contact with these patients and eating contaminated meat. He came with flu-like symptoms, without any symptoms of bleeding. The fourth patient was a health care worker, who had contact with these patients. She also came with flu-like symptoms and then developed hemorrhagic disorders and alveolar hemorrhagic pneumonia. Serology and RT-PCR for CCHF was positive in all of these patients. They responded to Ribavirin and supportive therapy.

Iran is an endemic region of CCHF. So outbreak of the disease may happen every time. High mortality rate of this disease shows the importance of the knowledge about this disease. It also is necessary to emphasize for being more careful in contact with patients with CCHF in community and hospitals. In addition we should try to improve public information about this disease to prevent it better.