The prevalence of CVD risk factors within our population is high compared to Western countries, indicating the necessity for interventional risk modifications.

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tized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.

Background Accurate information about disability rate after stroke remains largely unclear in many countries. Population-based studies are necessary to estimate the rate and determinants of disability after stroke. Methods Patients were recruited from the Mashhad Stroke Incidence Study and followed for five years after their index event. Disability was measured using the modified Rankin scale and functional dependency was measured using the Barthel index. Results Among 684 patients registered in this study, 624 were first-ever strokes. In total, 69.0% (n = 409) of patients either died or remained disabled at five-year follow-up. Among the first-ever stroke survivors, 18.5% (n = 69) at one year and 15.9% (n = 31) at five years required major assistance in their daily activities. Patients with a history of stroke (before the study period) compared with first-ever strokes were more likely to be disabled at one year (modified Rankin scale>2 in 40.0% vs. 19.1%; P < 0.001). Advanced age, severity of stroke at the time of admission, diabetes mellitus, and educational level (<12 years) were independently associated with greater disability and functional dependency. Conclusion We found that significant disability and functional dependency after stroke in Northeast Iran were largely attributable to the effects of stroke severity and prior dependency.

Introduction:Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years. Objective:This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy. Materials and Methods:In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire.Results:Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus). Conclusion:With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.

Our study suggested that there was no considerable difference between GCS and APACHE II scores for predicting mortality in head injury patients. Both scales showed acceptable PPV, while APACHE II showed better results. However, the utilization of GCS in the initial assessment is recommended over APACHE II as the former provides higher time- and cost-efficiency.

Background: Breast cancer is the second most common malignancy in women, worldwide. Several etiologic factors may cause anemia in a patient with breast cancer. Anemia is a prevalent complication in patients with breast cancer who undergo chemotherapy which affects the health status and quality of life in these patients. The aim of this study was to evaluate the prevalence of anemia in patients with non-metastatic breast cancer who underwent adjuvant chemotherapy. Methods: In this cross-sectional study, 144 women with non-metastatic breast cancer who referred to radiotherapy and oncology department of Imam Reza hospital and met inclusion criteria were included. Data were obtained from patients' archived documents and were analyzed by SPSS software (version16). Results: In this study, 41% of patients were anemic before the chemotherapy and 43.1% of patients became anemic during and after treatment. The prevalence of post-chemotherapy anemia was significantly higher in advanced stages of cancer (P = 0.01). The chance of developing anemia were more in patients who underwent 8 cycles and AC + paclitaxel regimen, compared to the ones with 6 cycles and other regimens. There was no significant relationship between the prevalence of anemia and type of chemotherapy regimen, number of chemotherapy cycles, positive lymph nodes, co-morbidities, menstrual status, and body mass index (BMI). Conclusions: Due to the high prevalence of chemotherapy-induced anemia and its effects on quality of life, even mild degrees of anemia should be detected and evaluated before treatment. Considering early interventions is of cardinal importance, especially in the elderly.

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