Tehran University Medical Journal

---

World health organization has introduced concentration of vitamin A in breast milk as a proper indicator for characterization of vitamin A deficiency in lactating mothers and their infants (<6 mo). A normal phase high performance liquid chromatography with spectrofluorometric detection as a specific and sensitive detector was used for characterization of all-trans retional from 13-Cis retinal. The method was sensitive (0.009 ppm) and accurate (1±0.054 µ mol/l) and had a good recovery percentage (99.36%). This method was more better than before methods and was compatible with the other useful methods. Effect of freezing and defreezing on all-trans retinol content of milk sample was investigated. The result was interesting, whatever all-trans retinol content was bigger, it’s destroying was bigger too. Because of that reseon, day today reproducibility wasn’t good. Standard of retinol was 95% all-trans and pure so we should use this method because two retinol isomers wasn’t separated from each other by reversed phase chromatography and UV detection.

---

Low back pain is among the most frequent medical complaints and a major public health problem. 1.7 percent of cases are caused by herniated disc, 20 percent of which require interventional treatment. Percutaneous laser disc decompression (P.L.DD) can be considered as an effective therapeutic alternative in certain cases.

Materials and Methods: To determine the efficacy of this method in Iran in patient's with low back pain due to disc herniation, 40 patients according to medical history, physical examination and MRI findings were selected for this study. Patients who had canal stenosis, marginal, osteophyte, advanced disc dehydration, ruptured posterior ligament and other contraindication were excluded. CT scan was used only for needle navigation. After proper positioning of needle, nucleous pulposus was evapourated with Nd-YAG laser. Total energy was 1200-1600j. The procedure was done out patient and follow up has been done at 1 day, 1 week, 1,3, 6 and 12 months.

Results: There was no serious complication. 80 percent of patients in one-year follow up showed significant clinical improvement.

Conclusion: Our findings suggests that percutaneous laser disc decompression can be considered as an effective alternative method of treatment for disc herniation and patient selection is the critical factor which determines success rate.

---

"Arterial Thromboembolism" is the most common cause of "Acute Arterial Ischemia" of extremities. In this study, It is attempted to collect retrospectively some documentary information of all "acute arterial thromboembolic occlusions of the limbs".
Materials and Methods: In descriptive retrograde study in Sina General hospital, all related records in this regard were collected from March 1991 to March 1997. To reveal the statistical outcomes and analysis the associations between them as well, the statistical tests like nonparametric ones were employed.
Results: Total number of the cases was 24 with " Acute Thromboembolic Arterial limb Ischemia" (3 in upper and 21 in lower limbs). The results were as follows: Female to male ratio =1/2, "Range of Age": 34-91, "Mode"=8th decade of life, "Mean"-64.48, "Etiology" Cardiac Origin in majority of cases ("A.F" in 57 percent) and Unknown Origin in 1/4 of cases. "Pain" was find in 95 percent, Grade HI ischemia in only 38 percent of patients on presentation and the others in Grade n. The most common "site of embolic occlusion" was "Femoral Ar." (76 percent). "Simultaneous Embolic Events" were fined in 29 percent. "Embolectomy" was performed in 79 percent (84 percent success rate) and "Primary Amputation" in 12.5 percent. "In hospital Mortality Rate" was fined in 24 percent and "Limb Salvage rate" in 68 percent. In conclusion, there were some logic relationship only between "Limb Salvage rate" and "Ischemic Grading" and also "Delayed diagnosis". There was also some significant direct relationship between "Mortality rate" and "Concomitant Embolic events".
Conclusion: This study was an explorative one that paves the way for further complementary investigations. Although there are many recommendations due to upgrading knowledge, attitude and practice of physicians as well as lay people Besides, the upgrading of educational and curative facilities should not be neglected.

---

Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000.

Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing.

Results: From the cases, 64 patients (32 percent) referred without delay and 136 patients (68 percent) referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004), lower education level (P=0.002), and lower economic status (P=0.001). The frequency rate of single were lower among them (P=0.001), fewer percent were residual of big cities (P=0.01) and they had less rate of available physician (P=0.004). 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001). 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E) (P=0.002) and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01). 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference.

Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.

---

Introduction: It is suggested that quadriceps muscle has an important role in stability & mobility of Knee joint in athletics and normal individuals therefore, the purpose of this study was evaluation of the strength in Power Athletics (PA) and Normal Un-trained Individuals (NUI) groups.

Methods and Materials: 31 Females (20 NUI & 11 PA) participated in this study. For measuring the strength, each individual performed 5 continuous concentric-eccentric maximal contraction at angular velocities of 90°/s, 135°/s. Twenty five percent of each individual (Maximum Voluntary Isometric Contraction) MVIC was determined and used as Pre-load force.

Results: Averages concentric & eccentric torques were greater in PA group in comparison with NUI group. The significant difference (P<0.02) existed between PA and NUI groups. Average concentric torques of quadriceps muscle decreased (with increasing of speed from 90°/s to 135°/s) and average eccentric torques increased. Average eccentric torques were greater (P<0.01) in PA & NUI groups in comparison with average concentric torques.

Conclusion: PA group strength was greater in comparison with NUI group. This is possibly due to the type of muscle fibers in this group have (greater type II fibers). Accordingly, it is critical to consider the role of eccentric exercise in PA group for preventing sport injury.

---

Introduction: Reciprocal changes are ST depression ≥1 mm in electrocardiogram of the patients with acute myocardial infarction in the reciprocal leads. This question that these changes are merely secondary to ST elevation in infarction area or that they are truly subendocardial ischemia secondary to involvement of coronary artery that perfuse that area is not clearly defined.

Methods and Materials: In this study, 33 patients with acute myocardial infarction and reciprocal changes in ECG at the time of admission, were selected and coronary angiography was performed in them in a week of infarction.

Results: Correlation between reciprocal changes in ECG and involvement of reciprocal coronary artery the coronary artery that perfuse area of myocardium related to reciprocal changes in ECG were studied. 32-63 percent of patients (1/3-2/3) with reciprocal changes had significant stenosis of reciprocal coronary artery in coronary angiography (CI=95 percent). The incidence of multivessel disease was about 60.6 percent. After coronary angiography 33.3 percent of patients referred for coronary arteries bypass graft surgery (CABGS) and 27.3 percent for percutaneous transluminal coronary artery angioplasty (PTCA). In the other words, 60.6 percent of our patients refered for revascularization, PTCA or CABGS.

Conclusion: We concluded that because of the need for intervention in about 60 percent of our patients, coronary angiography could be recommended in all patients with acute myocardial infarction and reciprocal changes in ECG.

---

Introduction: The bone mass density (BMD) may vary in different countries due to different genetic and environmental factors. This study was performed to determine the BMD of the normal population in Iran.

Methods and Materials: Subjects were selected randomly from different works and social classes in Tehran (from the lowest to the highest). For each decade and sexes, 20 normal subjects were selected (140 men and 140 women). BMD was measured with a Hologic 1000 plus machine by dual energy x-ray absorptiometry (DEXA) method for the lumber spine (L1, L2, L3, L4, L1-L4) and the femoral neck (neck, trochanter, intertrochanter, ward, total). Data were treated by polynomial approximation (3 rd degree). The obtained curves were compared with the standard Hologic curves for Caucasians.

Results: In female the peak bone mass (PBM) was 1.019 g/cm² for the lumbar spine and 0.832 for the femoral neck. In male the peak bone mass (PBM) was 0.987 g/cm² for the lumbar spine and 0.907 for the femoral neck. The BMD of both lumbar spine and femoral neck were lower than the Hologic standards. For the lumbar spine the mean difference was 6.5 percent (2 to 21 percent, CI=1) for women and 13.8 percent (2 to 36 percent, CI=1.45) for men. In femoral neck the mean difference was 5.4 percent (2 to 16 percent, CI=0.96) for women and 4.6 percent (1 to 14 percent, CI=0.96) for men.

Conclusion: The BMD of the lumbar spine and the femoral neck was lower in Iranian compared to the Hologic standards for Caucasians. This was seen in all age groups and in both sexes. It was less pronounced for the PBM in spine was lower in men than woman. The lower BMD of the spine in men was also seen in a cohort of patients with different diseases (inflammatory and non-inflammatory).

---

Background: Cuffed pharyngeal tube is a device designed for ventilation of anesthetized patients. CPT has advantages over face mask including: maintaining of face mask can be difficult and boring after several minutes and mobility of the practitioner is reduced due to involvement of hands. Mask pressure can cause soft tissue and nerve damage around the nose. Anesthetic gas leakage from the mask adds to the operation room pollution. In difficult intubation CPT can be life-saving.

Materials and Methods: In our study CPT was compared with endotracheal tube (ET) in anesthetized patients. A scoring system for evaluating ventilation of patients was designed using symmetric chest wall motion during ventilation with anesthesia bag and sensing lung compliance through it, auscultation of breathing sounds, oscilation of bag with breathing and peripheral oxygen saturation by pulse oxymetry. Respiratory complications (pulmonary aspiration, Iaryngospasm and bronchospasm, nausea and vomiting) were looked for during anesthesia.

Results: The results showed that CPT was successful as ET in ventilation of spontaneously breathing patients and incidence of respiratory complications with CPT was no more than ET. Airway resistance was significantly greater with CPT than ET (P<0.05). Patients with ET had significantly greater incidence of sore throat than with CPT (P<0.05).

Conclusion: Thus we concluded that CPT can be used for ventilation of anesthetized patients not predisposed to pulmonary aspiration and whose peak airway pressure does not exceed 20-25 CmH2O.

---

Background: The role prophylactic antibiotics in otologic surgery continues to be debated and perhaps misused. Prior studies have provided conflicting evidence with benefits obtained from the use of prophylactic antibiotics in surgery for chronic otitis media.

Materials and Methods: The current study was designed to evaluate the role of prophylactic antibiotics in the wound infection and outcome of surgery for chronic ear disease. It was the authors' impression that there was no difference between topical and systemic antibiotics in such surgery. Patients who met the inclusion criteria (n=193) were randomly assigned to a topical treatment group or a control group receiving only intravenous antibiotics for 1 dose intra operatively and 3 dose there after. Patients were followed post-operatively and observed for clinical evidence of infection, graft failur and hearing status.

Results: There was no statistically significant difference between the two groups with regard to the incidence of postoperative infection or graft survival.

Conclusion: The use of prophylactic antibiotics in surgery for chronic otitis media can be recommended as an alternative method.

---

Background: The purpose of our study was to assess the potential of color Doppler (CD) and Power Doppler Imaging (PDI) to differentiate benign from malignant solid breast masses.

Materials and Methods: Seventy-one biopsy proven solid breast masses were evaluated with CD and PDI using 7.5 MHZ Transducer. Vascularity, Resistive Index (RI) and patterns of vascular distribution of masses were assigned before biopsy.

Results: There were 22 cancers and 49 benign lesions. All malignant masses had vascularity in some degrees, except 3 cancers which were less than 10 mm in diameter. Most of cancers were hypervascular (15 cancers) and had penetrating or diffuse vessels (14 cancers). Most of benign lesions and fibro adenomas were avascular (35 masses). 12 cancers, 2 fibro adenomas and all vascular benign lesions had RI>0.6. 7 cancers and 6 fibro adenomas had RI<0.6. By using hypervascularity to indicate malignancy sensitivity for CD and PDI was 68 percent and specificity was 90 percent and by using penetrating and diffuse vessels sensitivity was 64 percent and specificity was 82 percent. By using RI<0.6 sensitivity was 32 percent and specificity was 88 percent and by using these three criteria together sensitivity was 73 percent and specificity was 82 percent (P<0.00001).

Conclusion: The vascularity and pattern of distribution and morphology of blood vessels in solid breast masses seen at PDI and CD is a potentially important feature to predict the likelihood of malignancy. But RI appears to be of limited value.

---

Background: The preeclampsia/eclampsia is one of the most serious condition peculiar to pregnancy, which defined as occurrence of hypertension, proteinuria in pregnancy and convulsion in eclamptic women. There are major risk for eclamptic and pre eclamptic women due to maternal and fetal complications.

Materials and Methods: In a prospective study, preeclamptic and eclamptic patients who were visited at Shariati hospital were divided into two groups due to having proper prenatal care or not. Maternal and fetal complication were studied in that two group. Maternal variables were included: incidence of preterm labor, eclampsia, mode of delivery, long term hospitalization, need for ICU, need to antihypertensive drugs over postportum, insistence of hypertension up to 6 weeks, postpartum trombocytosis, incidence of cesarean section due to abruptio placenta and IUGR, elevation of serum creatinine, incidence of HELLP syndrome and death of mother fetal variables were included incidence of IUGR and IUFD, pre term delivery and for need NICU. Relationship of demographic characteristics such as maternal age, parity, educational level, mode of delivery, presence of underlying disease, and educational level of person who referred the patient were studied.

Results: These variables except of educational level, and referral level were there was statistically significant difference between incidence of all of variables, in exception of mode of delivery. That means incidence of complications is lower in group with adequate prenatal care. Conclusion: It seems that adequate pernatal care can reduce or obligate maternal and fetal complication in hypertensive disorders in pregnancy.

---

Myocardial infarction sequel of coronary artery diseases, can be sometimes asymptomatic, called silent myocardial infarction. Some risk factors predispose the patients to this condition. In this study, we intend to determine the predisposing factors in such patients.
Methods and Materials: We included those patients with electrocardiogram changes, consistent with myocardial infarction, who had not any symptoms of ischemia or a previous history of coronary artery disease, consulted for preoperative work up of eye surgery during the year 2000.
Results: We analyzed 100 patients with the diagnosis of silent myocardial infarction. (59 males and 41 females). Among our patients. 99 percent were above age 50 years of age. Their mean age at the time of study was 69.7 years. 78 percent of patients were illiterate. In 41 of them body mass index was above the normal limits (overweight and obese). Their past medical history revealed that 46 patients had hypertension, 38 patients had hyper-lipidemia. and 26 patients had diabetes mellitus. Also, a positive family history of coronary artery disease was seen in 52 percent of the patients. The rate of cigarette smokers and opium addicts, among our patients, was 33 and 13 percents. respectively. Analysis of electrocardiogram changes, showed that 43 patients had inferior myocardial infarction, 24 had antero-septal. and 17 of them suffered from anterior myocardial infarction.
Conclusion: Almost all of our patients with silent myocardial infarction were in old age group. Diabetes mellitus, hypertension, overweight, hyper-lipidemia, and a positive family history of coronary artery disease were the most important predisposing factors, found in such patients, thus taking into account these predisposing factors and control of them would dramatically reduce the prevalence of morbidity and mortality of silent myocardial infarction.

---

Defining the patient outcome and decision making about allocation of our limited fund and technology for comatose patients depends on our knowledge about frequency and outcome of various coma etiologies. We determined the various coma causes frequency and one-month outcome of non traumatic coma. . In addition the co existence of the primary neurologic signs with the one-month outcome of non traumatic coma was defined.
Methods and Materials: Our study is based on 130 comatose patients in a one-year study in Sina Hospital that consisted of 80 non traumatic and 50 traumatic patients.
Results: 74% of the cases were men and 26% were women. The most common etiology of coma was trauma (38.5%). The other common etiologies were cerebro‌vascular diseases (25.4%), cancer (10%) and hypoxia-ischemia (8.5%). The most common cause of coma in men was trauma (46.9%) while the vascular diseases were the most common etiology of coma in women (41.2%).In under 40 year patients trauma was the cause of coma in 57.5% of cases in respect to 28% in above 40 cases. On the other hand, vascular diseases and malignancies were the etiology of coma in 15% of under 40 year patients and 46.5% of above 40 year patients. Among traumatic etiologies of coma, subdural hematoma was the most frequent (40%). In our research none of patients who did not have one of pupillary, oculocephalic or motor reflexes in the 3rd and 7th day of the onset of coma had acceptable outcome after one month. With consideration of pupillary, corneal, oculocephalic and motor reflexes in combination, loss of at least two of them in the 3rd and 7th day accompanied with no acceptable outcome. On the other hand the presence of three or more reflexes in the 3rd and 7th day of coma was a good prognostic factor, with 80% and 88.9% chance of acceptable recovery respectively.
Conclusion: According of the study, the best time for prediction of outcome in a comatose patient, is the third or seventh the day after the onset of coma. Also relay on combination of brain stem reflexes, gives us more acceptable result.

---

Introduction: Occupational exposure to carbon, silica, and quartz, particles are known predisposing factors for bronchial anthracosis. In some cases bronchoscopy may reveal anthracosis infection to be associated with mycobacterium tuberculosis.

Materials and Methods: In a prospective study, from 1999 and 2001, 919 patients underwent diagnostic bronchoscopy for pulmonary diseases.

Results: Of these, 96 patients had some evidence of anthracosis infection. Twenty-six (27%) of these patients had positive smears or cultures for mycobacterium tuberculosis and only eight (8.3%) patients with positive history of occupational exposure. In the other 70 patients 29 had previous occupational exposure, and 41 stated no previous exposure.

Conclusion: Our findings show a significant association of tuberculosis with anthracosis however further studies are needed to document an etiologic relationship.

---

Introduction: Coronary artery disease (CAD) and its complications are the most prevalent etiology of mortality all over the world and diabetes mellitus (DM) is one of its risk factors. In this study prevalence of MI and unstable angina have been compared with different kinds of retinopathy and their severity.

Materials and methods: This study is a descriptive, cross sectional one that performed on 100 patients admitted in Imam, Farabi and Amir Alam Hospitals.

Results: Most important findings are as below: 1) Non-proliferative diabetic retinopathy (NPDR) are more prevalent than proliferative diabetic retinopathy (PDR), 41 Vs 17 cases, and 24 person were normal in MI population. And 12 persons had NPDR and 2 PDR and 5 normal in unstable angina. 2) Different diabetic retinopathy lesion were: 23 Venous dilation, 22 aneurysme, 18 hemorrhagic, 11 neovascularization, 10 macula edema, 6 retroretinal detachment, 2 gliosis. 3) on the point of presence or absence of diabetic retinopathy (DR), 72 percent had some kind of DR and 28 percent had nothing. Finally, in MI population 58 patients (70 percent) had DR and 24 patients (30 percent) didn't have any. In unstable angina 14 patients (77 percent) had diabetic retinopathy and 4 didn't have (23 percent).

Conclusion: Regarding the lack of facilities and shortcoming of necessary data, it was not possible to conduct a prospective investigation in this item, so the design and implementation of a prospective study based on enough cases and controls is strongly recommended.

---

Introduction: Thyroid diseases are one of the most common endocrine diseases. Incidence of thyroid diseases in women is ten times more than men. Menstrual irregularities and fertility is occasionally the first sign of thyroid diseases.

Materials and methods: In a prospective study, 325 thyroid patients were evaluated in Emam hospital. Incidence and type of menstrual irregularities were evaluated in these patients.

Results: 55.8 percent of hypothyroid patients had normal pattern ob bleeding. 44.2 hyper thyroid patients had menstrual irregularities which were in the form of oligomenorrhea and 41.7 percents of hypo-thyroid patients were irregular in the form of polymenorrhea, oligomenorrhea and menorrhagia.

Conclusion: In these patients, menstrual irregularities cured by treatment of thyroid diseases and reduced surgical interventions.

---

Introduction: Clinical manifestations of primary hyper-para-thyroidism (pHPT) had been dramatically changed during last 25 years. Evaluation of changes in clinical findings was the aim of this study.

Materials and methods: In a retrospective, descriptive case series, patients' records of all 47 pHPT (44 females, 3 males) from 1988 till 1998 were studied. Patients’ clinical presentations, signs and symptoms, laboratory and radiologic findings were reviewed and the results were compared with 34 patients' studied during 1978-1987. Serum Ca>10.5 mg/dl with increased or high normal PTH were the diagnostic criteria of pHPT.

Results: Patients’ age range was 11-70 and mean ±SD was 38±16 years, with a female to male ratio of 14:1. 57 percent of the patients had bone pain and muscle weakness, 12 percent were asymptomatic, 10 percent had pathologic fractures, 8 percent had renal stones, 8 percent had symptoms of hypercalcemia, and 2 percent had giant cell lesion. The mean±SD of serum calcium was 11.48±1.16 mg/dl, phosphorus was 2.4±0.6 mg/dl and 24-h urinary Ca was 294±197 mg. Serum PTH was increased from 1.5 to 500 folds. The frequency of single adenoma in right inferior, left inferior, and left superior gland were 43 percent, 30 percent, and 13 percent respectively.

Conclusion: In the study 12 percent of patients were asymptomatic whereas there was no asymptomatic case in the previous study. Prevalence of severe bone disease and the interval between onset of symptoms and diagnosis was also reduced. According to this study detection of pHPT in asymptomatic phase remarkably increased.

---

Wide variations in the prevalence of asthma, allergic rhinitis and eczema have been reported in the world, between regions and countries. The international study of asthma and allergies in childhood (ISAAC) was developed to provide standardized method to ascertain the prevalence of asthma and allergies in different regions. Comparisons of prevalence rates across geographic regions may help to identify factors that influence the development of these conditions in individuals.
Methods and Materials: For doing this descriptive study the ISAAC written questionnaire was completed by the parents of 3000 school children aged 6-7 years in Kashan, the central area of Iran, with different geographic and cultural characteristics, during the fall of 1998.
Results: The overall cumulative and 12 month prevalence of wheezing were 10.2 percent, 6.9 percent in the girls and 18.2 percent, 13.1 percent in the boys respectively. The prevalence of doctor diagnosed asthma were 1.3 percent and 2.2 percent in the girls and boys. Rhinitis symptoms were reported by 14,7 percent, 16.9 percent and chronic pruritic rashes by 5.1 percent and 8.3 percent of the girls and boys respectively.
Conclusion: Allergic disorders are common in this area and prevalence is comparable to other parts of Iran and many other countries. Prevalence of asthma by medical diagnosis is relatively low with respect to other studies performed with the same methodology.

---

Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients.
Materials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years), neutropenic (PMN<1000) patients with fever (Temperature, oral >38.5c) in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A) and Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B). Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever) were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result).
Results: During a twelve months period of study, a total of 57 patients (17female, 40male) were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent), the treatment was effective, compared to 15 of 29 (51.7 percent) in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B).
Conclusion: Cefriaxon monotherapy is at least equally effective in low risk neutropenic patients with fever compared to combination of ceftazidim plus amikacin at a decreased cost and probably (expected) less adverse side effects in our patients.

 

---

This study was carried out to examine the comorbidity of depression and anxiety disorders.
Materials and Methods: 261 depressed (n=153) and anxious (n=108) patients were psychiatrically interviewed, and then tested by two scales, BAI and BD1 261 healthy subjects (matched with depressed and anxious patients) completed BAT and BDl as well.
Results: The results showed that %55.6 of depressed and %58.3 of anxious patients had respectively a comorbid anxiety and depression disorders.
Conclusion: The detection of symptoms overlap revealed that depressed patients experienced most of the anxiety symptoms, and anxious patients reported most of the depression symptoms. The prevalence of depression and anxiety symptoms among healthy subjects will be discussed.