It is believed that vaginal delivery is associated with less maternal mortality than cesarean section. On the other hand, repeated cesarean sections are said to be associated with more risks threatening both the mother and the infant. Besides, it is believed that during the next pregnancies, there are many risks involved, such as Placenta Previa, Placenta acreta and even hysterectomy. This article is about a woman who experienced successful vaginal deliveries giving BIRTH to healthy newborns in spite of her numerous cesarean sections she had already experienced.

The aim of the present study was the histological evaluation of Enamel Matrix Derivative (EMD) effectiveness for regeneration of periodontal DEFECTs. EMD activates cementum synthesis, PDL and bone during the maturation stage of follicole. In this research, EMD was used in surgical DEFECTs of premolar teeth in four adult sheep. Muccoperiosteal flap was reflected in buccal site of teeth. The buccal bone plate was removed from mesial to distal in 4 mm depth. After eliminating the cementum by bur and its etching, EMD was applied on exposed dentine and flap was sutured. In opposite sites of those teeth (control sites) the same process was performed without etching. After 100 days, sheep were sacrificed and histological study through light microscopic was performed on black sections of operation sites. The results showed that in test sites, regeneration of cementum and bone was 62/5% and 42/5-50% respectively. But in control sites regeneration of cementum and bone was 37.5% and 32/5-42/5% respectively. Also the migration of junctional epithelium in control sites was 8-10% more than test sites. The important point is that in test sites, cementum was completely attached to undermining dentine. But, in control sites, the gap between cementum and dentine was visible. As a result, this study suggests that EMD promotes periodontal regeneration, and EMD application is a successful achievement in regenerative periodontal therapy.

Statement of Problem: The goal of bone regenerative therapy is to reconstruct the damaged tissues to initial condition, which seems so important in periodontology and implantology. In such therapies, different biomaterials, with some advantages and disadvantages, may by use.Purpose: The aim of this research was to evaluate the quality, bone trabecular density and thickness of newly forming bone as well as foreign body reaction against Biostite®, in comparison with the control group.Material and Methods: In this experimental study the total number of 5 sheep was operated with general anesthesia. At first 10 standard DEFECTs were created in 5x5x5 mm on the left and right edentulous mandibular ridge. Five DEFECTs were randomly treated by Biostite®, the remaining five were considered as controls. After six months, the sheep were sacrificed and the separated DEFECT areas with intact margin were placed in 10% formalin and prepared for histologic and histomorphometric study. To analyze the data, Mann- Whitney U test was used.Results: The mean percentage of new bone formation in Biostite®group was statistically more han the control group (P<0.05). Newly formed bone was vital in both groups which was a combination of lamellar and woven types, however, the thickness and density of new bone in biostite® group was more than the controls. Foreign body reaction was observed in Biostite® group. Conclusion: It is suggested that Biostite® synthetic material can be useful in bone regenerative therapies.

Background: Congenital anomalies play a significant role in perinatal and infantile morbidity and mortality. There is a variation in the frequency of congenital anomalies in different populations. Determination of the prevalence of different types of congenital anomalies may help plan primary prevention measures for these anomalies. The objective of this study was to determine the prevalence at BIRTH of overt congenital anomalies in Urmia, in the northwest of Iran. Methods: In a cross-sectional hospital-based study, charts of 14,121 deliveries including liveBIRTHs and stillBIRTHs during the period from January 2001 through June 2005 were studied. Results: A total of 264 (187 per 10,000 BIRTHs) anomalies were detected. The anomaly categories with the highest prevalence were nervous system DEFECTs (52.65%) followed by musculoskeletal DEFECTs (23.86%). The total prevalence at BIRTH of overt congenital anomalies was 1.87%. The rates for live- and stillBIRTHs were 1.17% and 40.7%, respectively. Conclusion: Considering the high frequency of central nervous system anomalies recorded in our study, it seems to be reasonable to pay more attention to the role of periconception vitamin supplementation for the primary prevention of congenital anomalies, particularly neural tube DEFECTs.

Background and Objective: Neonatal mortality rate is one of the most important health criteria, worldwide. Understanding the major neonatal mortality causes will help to plan for better pregnancy, prenatal and neonatal care systems. This study was conducted to determine the neonatal mortality risk factors in Maraveh Tapeh County in Golestan province, north of Iran.Methods: In this case-control study, according to either death or live in 28th day after BIRTH, 52 neonates were considered as case group and 201 neonates were considered as control group. Data collection questionnair were adjusted and completed for each neonate.Results: Neonatal mortality rate was 11.76, 13.36 and 6.46 per 1000 live BIRTH in 2011, 2012 and 2013, respectively. Five main causes of death were prematurity, events, BIRTH DEFECT, respiratory distress syndrome and sepsis, respectively. There was a significant relation between death and prematurity, BIRTH weight and gender (P<0.05). There was relationship between BIRTH weight and neonatal mortality (Odds Ratio=29.6).Conclusion: Prematurity and low BIRTH weight were the most important causes of neonatal mortality in Maraveh Tapeh county in Golestan province, north of Iran.

Dear Editor-in-Chief The prevalence of Down Syndrome (DS) has in-creased in association with increasing maternal age (1). The prevalence of multiple BIRTHs, particularly dizygotic BIRTHs has also increased in association with increasing maternal age (2). Surprisingly, the risk of DS in twins is significantly lower than in singletons due to early fetal loss of DS in multiple pregnancies, particularly in pregnancies concordant for DS (2).

Background: Congenital limb DEFECTs (CLDs) are the leading cause of disability across the world. CLDsvary depending on the anatomical location, type, and cause of anomaly. The present study aimed to evaluate the prevalence and patterns of CLDs in the North of Iran. Methods: This descriptive-analytical, hospital-based study was conducted in three hospitals in Gorgan, the capital of Golestan Province in the north of Iran. Samples included 32, 895 newborns with CLDs, and stillborn neonates were excluded from the study. Data analysis was performed in SPSS version 16 using Chi-square at the significance level of ≤ 0. 05. Results: Overall prevalence ofCLDs was three cases per 1, 000 live BIRTHs, and the rate was estimated at 3. 17 and 2. 82 cases per 1, 000 live BIRTHs in male and female infants, respectively. In addition, the prevalence of upper-and lower-limb anomalies was 1. 03 and 1. 91 cases per 1, 000 live BIRTHs, respectively. In terms ofethnicity, the prevalence of CLDs among the native Fars, Turkmen, and Sistani populations was 3. 86, 2. 02, and 3. 85 cases per 1, 000 live BIRTHs, respectively. Clubfoot was the most common type of CLDs, and the most prevalent type of the associated malformationswas gastrointestinal anomalies. Conclusion: According to the results, the prevalence of CLDs in the north of Iran was similar to European countries (2. 11-3. 18 cases per 1, 000 live BIRTHs), while it was lower compared to the other regions in Iran (5. 8 cases per 1, 000 live BIRTHs).

Aim: Congenital anomalies are one of the leading causes of disabilities and mortality in children worldwide. We aimed to set up a system for scientific registration to reduce perinatal mortality and improve the quality of health services. Methods: As an applied developmental research in 2020, we launched a web-based hospital registration and surveillance system for major congenital anomalies by C# programming language hosted at "mis. hums. ac. ir". Data management was comprised of a) registration of anomalies b) training how to use ICD10 c) imaging specific cases d) assessing the accuracy of the data e) sending information to definite centers. All the live BIRTHs, fetal deaths and pregnancy termination along with physical examination, reviewing hospital records and parental interviews were recorded. The present system is of two compartments including 43 maternal and 20 neonatal elements. Results: Initially, the system was set up based on hospital data in two main referral hospitals in Bandar Abbas. Next, all the hospitals in the province, were gradually covered by the system in an active and passive combination. Major congenital anomalies are registered using ICD-10. During the first four months after starting the project, one thousand BIRTHs were registered and 18 cases of congenital malformations were observed and confirmed. Conclusion: This study provides the minimum data set required to record congenital anomalies for the first time in southern Iran. This event can be useful in designing electronic patient records. This, itself, will improve perinatal health indicators, particularly, prevention and management of congenital BIRTH DEFECTs.

Statement of problem: Low BIRTH weight (LBW) infants are subjected to a variety of metabolic stresses and exhibit a higher prevalence of oral-dental disturbances than normal infants. Factors such as metabolic disorders, hypoxia, prolonged neonatal jaundice, nutritional deficiencies and low serum calcium have been implicated as causes of enamel DEFECTs in LBW infants. These enamel DEFECTs lead to the alteration of primary teeth with subsequent problems such as esthetic concerns, dental caries and dentofacial problems.Purpose: The aim of this study was to compare the developmental enamel DEFECTs in the children with lower than normal weight at BIRTH (less than 2500 gr) and children with normal BIRTH weight Materials and method: In this retrospective (expose–fact) study, 181 children (95 girls and 86 boys) aged 3 to 5 years were examined. The data were collected using infant’s BIRTH files and questionnaires based on the general information, BIRTH time and weight as well as medical examination. Dental examination was performed by two examiners. Developmental Enamel DEFECT Index was used to classify the enamel DEFECTs. Data were statistically analyzed by SPSS13. Kappa test was used for evaluating validity between examiners (Kappa≥0.8) and two-sampling proportional test by means of Mini Tab software was used for data analysis.Results: Enamel DEFECTs were more in children with low BIRTH weight compared to the normal children (p<0.05). There was no statistically significant difference in hypocalcification and hypoplasia between girls and boys with LBW and also between girls and boys with normal BIRTH weight (p>0.05). Enamel DEFECTs were most common in both groups on the canine teeth (% 51.3) followed by incisors, first molar and second molar teeth.Conclusion: Based on the results of the present study, without considering etiologic factors, hypocalcification and hypoplasia was noticed more in children with low BIRTH weight. Further studies are needed to evaluate the relationship of enamel DEFECTs and various causative factors in these children.