Women with vitamin D deficiency at cutoff 20 ng/ml are more at risk of preeclampsia. This association can be specific up to 90% at 10.60 ng/ml cutoff. Treatment of vitamin D deficiency is necessary before pregnancy.

Anal tuberculosis is an extremely rare extrapulmonary presentation of tuberculosis (TB). Less than 1% of the individuals who contract TB manifests as gastrointestinal TB, and anoperineal TB is much less frequently encountered, 1% of the TB cases of the digestive tract. A rare case of anal tuberculosis is reported in a 37-year-old male patient with a recent anal fistula surgery and relapsing anal lesions. AFB were detected by biopsy and culture. In total, the treatment course lasted 6 months and the patient showed signs of recovery in the early stages of the treatment (after 2 weeks), and complete remission was achieved. In conclusion, it is recommended that in case of encountering Non-healing and recurrent anal lesions, especially in regions endemic for TB, should be evaluated for tuberculosis.

Background & Aim: Since observance of ethical standards is an effective factor for improving the performance of nurses in providing quality care. This study was conducted with the aim of evaluating the ethical sensitivity of nurses working at Shahid Madani Hospital in Khorramabad in the spring of 2017. Materials & Methods: This cross-sectional study was performed on 200 nurses working in Khorramabad city at Shahid Madani Hospital. Samples were selected through simple random sampling. Data were collected using a demographic questionnaire and a nurses' ethical sensitivity questionnaire for decision making. Collected Data was analyzed by SPSS software version 16 and descriptive and inferential statistics. Results: According to the reported results, 19.5% of nurses had a low moral sensitivity, 77% had moderate moral sensitivity and 3.5% had high moral sensitivity. The highest scores were related to knowledge about the relationship with the patient 63.33±15.45 and the lowest score was for professional knowledge of nurses 52.69±13.6. Conclusion: According to the findings of this study, it was found that nurses had moderate moral sensitivity. It is suggested to nursing managers to develop appropriate programs to increase nurses' moral sensitivity in the system of health care in the country.

Introduction: American Diabetes Association updates its guideline every year. However this guideline can be changed for different populations based on their cultural and genetic status. Objectives: We intend to design a regional study in Lur and Lak populations of Iran using receiver operating characteristics (ROC) curve model. Patients and Methods: A total of 133 diabetes mellitus (DM) patients were enrolled in this study. The collected information for each patient were gender, age, body mass index (BMI), DM type, DM duration, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), lipid profile, type of treatments, type of statin and dose, documented neuropathy, documented nephropathy, symptomatic retinopathy, peripheral vessel disease (PVD), documented cardiovascular disease (CVD), food ulcer history, dawn effect, systolic blood pressure (SBP), and diastolic blood pressure (DBP). ROC curve was used and area under curve (AUC) was reported. Results: For neuropathy, age was the most accurate diagnostic index (area under curve [AUC] = 79%). For nephropathy SBP was the most accurate diagnostic index (AUC= 88%). For symptomatic retinopathy DM duration was the most accurate diagnostic index (AUC= 81%). For PVD, HDL-C was the most accurate diagnostic index (reverse AUC= 67%). For CVD age was the most accurate diagnostic index (AUC= 81%). For foot ulcer history age was the most accurate diagnostic index (AUC= 85%). Conclusion: The final suggested guideline is like the international guidelines. However some unique points should be regarded. Blood pressure >165/110 mm Hg is diagnostic of diabetic nephropathy. Additionally serum high-density lipoprotein (HDL-C) >48 mg/dL is strongly suggested.

In nephro-urologic field, extent of approach to causes of lower urinary tract complaints in fourth decade or more of life is challenging matter. Physicians must notice to alarm signs in diagnosis of patients to prevent misdiagnosis of important causes. in practice, combination of hematuria and constipation accompany weight loss are red flags. Bladder neoplasm is a malignant cause of above symptoms that sometime originate from neighboring organ. Bladder metastases are very rare in colorectal cancers (CRC). Symptoms of primary tumor may be precede or coincide with urinary symptoms. The present study describes an unusual case of symptomatic bladder involvement from sigmoid adenocarcinoma. A 68-year-old man with complaints of dysuria, frequency, microscopic-hematuria, nausea, vomiting, and abdominal pain was diagnosed as adenocarcinoma of sigmoid colon metastatic to the bladder. This case underlined the need to prompt and careful attention to patients with hematuria-dysuria in adult age. Bangladesh Journal of Medical Science Vol.18(4) 2019 p.827-829

Introduction: Since observance of ethical consideration is an important factor in improving performance of the nurses in providing appropriate cares, this study aimed to investigate moral sensitivity of nurses in Shahid Madani hospital of Khorramabad in 2017 spring. Methods: The current research was a descriptive-analytic cross-sectional study. The sample consisted of 200 nurses who were selected by simple random sampling method.To collect information, demographic information questionnaire and moral sensitivity questionnaire of nurses were used. The collected information were analyzed using SPSS software version 16, and the data was analyzed using Descriptive and Inferential statistics. Results: Based on the reported results, 19.5% of the nurses had low moral sensitivity, 77% had moderate moral sensitivity, and 3.5% had high moral sensitivity. The highest score was for the awareness of how to communicate with patients' aspect, that is 63.33 ± 15.45, and the lowest score was for the professional knowledge aspect of the nurses, that is 52.69 ± 26.13. Conclusions: Considering the findings of the study, we concluded that the nurses had a moderate moral sensitivity, and we suggest the nurse managers to use some appropriate programs to enhance the moral sensitivity of the nurses in the national health systems.

Introduction: Trauma is considered as one of the major causes of mortality in the World and in Iran. Which, many people die each year. The aim of study we evaluated penetrating traumas as Specific reason of deaths among affected patients.Materials and Methods: In this crosssectional retrospective study, 73patients with penetrating traumas visiting Shahid Rajaee hospital of Tonekabon in 2015-16were evaluated, then, the files were extracted from hospital archive files and information of patients such as age, sex, The type of agent and the cause of the injury, the reasons for the surgery and the type of surgery were recorded from the archived files, then, The data were statistically analyzed by the SPSS software.Results: Based on the findings, over the 60 (80 %) of patients were males, that was a significant relationship between sex and penetrating trauma. Also, the most common were penetrating trauma in the age group of 21-35 years old. There was a significant relationship between age and penetrating traumas (p<0.05), it should be noted that, other variables in this studies were not related significantly withthepenetrating trauma in patients. (p>0.05).Conclusion: The more common causes of penetrating traumas among young are Damage from driving accidents which require better Facilities to manage them. Also, the role of emergency rooms and the provision of equipment to reduce mortality from penetrating trauma can be mentioned.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.484-488

Introduction: Depression is one of the psychiatric disorders and is the most common mood disorder. Stably and sometimes unstable, depression can involve and interfere with different aspects of life. By disrupting tasks, reducing motivation, causing anxiety, fear, and concern, depression impairs a significant part of the intellectual ability. Complications of depression have been proven on presence and absenteeism, accuracy in performing duties and efficiency. This study tends to determine the prevalence of depression among employees of Lorestan University of Medical Sciences and its relationship with demographic variables in 2017.Method: This cross-sectional study was conducted on employees of the Lorestan University of Medical Sciences in 2017. The subjects were 270 people who filled in adult BDI-II (including 21 3-point questions). The inventory is scored from 0 to 63(0- 13 minimal depression (normal)), 14-19 mild depression, 20-28 moderate depression, and 28-63 severe depression). Data were analyzed using SPSS version 23.Results: The mean depression score was 10.7; 48.1% had depression. Prevalence of depression was 12.6% mild depression, 11.1% moderate depression and 6.3% severe depression; 89 (33%) were single and 181 (67%) were married; Prevalence of depression was 29.47% in women and 30.28% in men.Discussion: Men were more likely to develop depression than women (27%), which is contrary to many reports. This study showed a significant relationship between age and prevalence of depression. There was a significant relationship between prevalence of depression and marital status; there was a significant relationship between workplace and the kind of work done by people and depression. There was a significant relationship between parental education and depression. There was no significant relationship between education and depression. However, some studies did not report this significant relationship.International Journal of Human and Health Sciences Vol. 03 No. 01 January’19. Page : 14-18