[Therapeutic effect of cryotherapy in facial lentigo and junctional nevus]

Superficial pigmented lesions are the most common complaint in dermatology. This study was done to assess the therapeutic effect of cryotherapy in facial lentigo and junctional nevus. In this descriptive study, 100 cases of flat-pigmented lesions with diameters up to 2 mm and after taking a photograph with USB microscope M2 [Scalar] treated with one freeze thaw cycle with liquid nitrogen through an applicator for 2 second in Imam Reza hospital, Mashhad, Iran during 2004-05. The patients were visited 3 times again through 3 successive months. According to the decrease in color of the lesion, patients were divided into 4 groups: sever pigmentation, no response, partial [>50% color loss] and complete response [<50% color loss]. Data were analyzed using SPSS-11.5 and Wilcoxon test. 96% of our patients were female and 4% were male. Mean age was 30 +/- 11.7 years. Based on Fitzpatrick criteria fifteen patients had type 2, fifty had type 3 and 35 had type 4 skin color. After the period of 3 months follow up, 6% of the patients completely healed, 58% had partial response, 31%with no response and 5% develop hyperpigmentation. Response in patients with type 2 Fitzpatrick skin color was clinically better than type 3 and 4 but this difference was not significant. Cryotherapy is considered as a simple, cost effective and safe therapeutic regiment in treating of 64% facial pigmental lesions

[Learning improvement in organizations through transformational leadership at Isfahan university of medical sciences in 2012-2013]

Introduction: studies show that organizations using transformational leadership, achieve high levels of growth and development. For this reason, in recent decades, transformational leadership has become an unavoidable necessity, because through transformational leadership organizations can improve their competitive advantage such as organizational learning. Therefore, the main purpose of this paper is to investigate the relationship between transformational leadership and organizational learning at Isfahan University of Medical Sciences

Methods: Research method was descriptive-correlative. To collect data, 117 employees at Isfahan University of Medical Sciences were surveyed. Research instruments were to questionnaires: 1] Bass and Avalio's transformational leadership, and 2] Neif's organizational learning. Reliability coefficients were.87 and .88 respectively, using Chronbach's formula. The collected data were analyzed using one- sample t-test, and Pearson correlation

Results: Findings showed that there are a positive and significant relationship between transformational leadership and its components [Idealized Influence, Inspirational Motivation, Intellectual Stimulation, and Individualized Consideration] with organizational learning. The collected data were analyzed using one variable t-test, and Pearson correlation

Conclusion: according to the findings, it can be suggested that the existence of transformational leadership can result in the improvement of organizational learning

Alveolar echinococcosis infection in a monkey [ateles geoffroyi] in Mashhad, Iran

Alveolar echinococcosis [AE], which is caused by ingestion of eggs of the fox tapeworm Echinococcus multilocularis, is the most potentially lethal parasitic infection because of its tendency to invade and proliferate in the liver and the difficulty in treatment. This article describes a case of alveolar echinococcosis found in Ateles geoffroyi in Mashhad, Iran. The cysts were characterized as an alveolar structure, composed of numerous small vesicles in liver, abdominal cavity, retroperitoneum and lungs. A characteristic feature of these vesicles was its exogenous tumor-like proliferation. These cysts were filled with numerous protoscoleces suggesting a potential role of this monkey in cycle of transmission. Up to now, this is probably the first report of alveolar echinococcosis in A. geoffroyi in the world

[Factors associated with quality of life in people with lower limb amputations]

Amputation of a body part is a "life-changing event". Amputation affects almost all aspects of an individual's life. Many issues arise following the loss of all or part of a person's limb[s]. Disability as a consequence of amputation has a devastating effect on the quality of life of the disabled people. The aim of this study was to investigate the factors associated with quality of life in people with lower limb amputations. It was a descriptive, cross-sectional study. The study population consisited of all above 18 years refferd to the rehabilitation center of Tehran during 2008 who had lost part or all of their lower limb due to disease or accident. Data was collected by the Short Form 36 Item Health Survey Questionner [SF36], and a researcher made tool, and analyzed using SPSS-PC [v.12]. The score of the quality of life of most study sample [%59/2] was 34-46. The mean and standard deviation of total quality of life was 55.02 +/- 17.226. there were a significant relationship between the quality of life and the samol's age, marital status, number of children, education, job status [before and after amputation], financial status, residence, the status of residence, type of insurance, type of home, the amputated limb, the level of amputation, the time after amputation, using prosthesis, use of assistive devices, and the reson for amputation [P<0/05]. The regression analysis revealed that the factors associated with quality of life in order of importance were using prosthesis, financial status, the reson for amputation, and the number of children. Identification of these factors for consultation, planning and implementing appropriate health policies to improve quality of life of these individuals is recommended

[Study of variety of toxicity in the poisoned cases rescued by emergency medical sciences center in Guilan]

Today, toxicity has become one of the major social problems due to the increased number and variety of chemical materials entering the human cycle. Also, it would get more importance considering the increasing development of different kinds of poisons and lethal medicines. Determining the prevalence of various toxicity can serve as a suitable pattern for public education, available to respective authorities. Prevalence Study of variety of toxicity in the poisoned cases rescued by EMS of Guilan in 2010 This is a descriptive study conducted on 1310 poisoned cases rescued by Emergency 115 in 1389, in terms of age, gender and kind of toxicity. The obtained research data were statistically analyzed in SPSS software. Findings show that 73.7% of poisoning happened in men, 25.4% in women and 0.9% in cases with unclear gender. Age range of 20-40 years was with 56.1%, the highest rate of poisoning, and the most frequent toxicities were with drugs [37.9%] and medicines [26.7%]. Considering the fact that young people account for the most poisoned cases and the most common kind of toxicity is by drugs and improper use of medicines, providing proper education to families specially youth about the dangerous complications of drugs and proper keeping and using medicines in the house seems to be necessary

[Viscoelastic properties of acid-induced casein gel in a model system]

Nowadays, acid-induced milk protein gels are used extensively in the dairy industry and are the base of many food products. Therefore, a deeper fundamental understanding of the effects of process parameters and system components on the mechanisms of gel formation and final gel properties in real and model systems is important for researchers and industries. The present study was designed to investigate the effects of casein-to-whey protein ratio, incubation temperature, and heating temperature on viscoelasic properties of the final gel in a model system. Samples of solutions with different casein-to-whey protein ratios [2.1:0.9, 2.4:0.6 and 2.7:0.3] were prepared and refrigerated overnight. This was followed by heating the samples at different temperatures [70, 80, or 90°C] for 15 minutes using a water bath and cooling to incubation temperatures [25, 35 or 45 °C]. In the next step lucono-sigma-lactone was added and the samples were transferred to a rheometer. The gelation process was monitored by the time sweep oscillatory test. A second-order polynomial model was fitted to the experimental data and the optimum response was determined using the Minitab15 software. Incubation and heating temperatures influenced significantly [P<0.001 and P<0.01, respectively] the G'200 value [storage modulus value of the final gel measured 200 minutes after addition of GDL]. The casein-to-whey protein ratio had no significant influence on the G'200 value. Increasing the incubation temperature led to a decrease, whereas increasing the heating temperature led to an increase, in the G'200 value. The maximum value of G'200, 268/93 Pa, was obtained at the presence of 2.6152% [w/w] casein and at incubation and heating temperatures of 25 °C and 90 °C, respectively. Smaller quantities of casein and higher incubation and heating temperatures shortened the length of time required for gel formation. Finally, increased incubation temperatures and decreased heating temperatures led to increased the damping factor [tan sigma]. The effects of different process parameters on the viscoelastic properties of dairy gels can be determined and characterized by oscillatory rheometry. The findings of this study show that incubation temperature is the most effective factor, whereas casein-to-whey protein ratio has no significant effect on the final gel strength

Accessory mitral valve tissue in mirror-image dextrocardia

A 20-year-old man was referred to us for further evaluation due to infective endocarditis. He had mirror-image dextrocardia with visceral situs inversus. He had a history of dyspnea on exertion [NYHA class II] of several years' duration with no new onset symptoms. On physical examination, he had no peripheral stigmata of infective endocarditis. Laboratory examination showed a normal erythrocyte sedimentation rate with normal hemoglobin. Three separate sets of blood cultures obtained over a 24-hour period and cultures were negative in aerobic and anaerobic media. Transthoracic and transesophageal echocardiographic studies showed mirror-image dextrocardia with total situs inversus as well as accessory mitral valve tissue with chordal attachment to the posteromedial papillary muscle with no significant LVOT obstruction [Figs. 1,2] but resulting in mild to moderate aortic insufficiency [Fig.3]. There was also aneurysmal dilation of the membranous part of the interventricular septum with a residual pouch and no residual ventricular septal defect according to computational fluid dynamics and contrast studies [Fig 4]. There was no other concomitant abnormality. The patient was discharged in good physical condition

[Clinical and pathological study of long-term bath of zinc sulfate on cutaneous healing in common carp [Cyprinus carpio]]

Cutaneous lesions in fishes due to viral, bacterial, parasitic, mechanical and chemical agents are very common, leading to severe infection and high mortality. The aim of this research was to investigate the effect of long term bath of zinc sulfate [15 and 23 ppm], healing of cutaneous lesions caused by surgical incision in carps. In this study, 210 carps were disinfected by 3% salt solution for 15 minutes. In each fish, an incision of 1.5 cm long and 2 mm deep was made on the left dorsal side. The fishes were then randomly divided into 3 groups, 70 fishes in each group. One group served as the control, and the other two groups were considered as the test groups which treated with 15 and 23 ppm of zinc sulfate respectively. During the study, at days 1, 2, 3, 5, 7, 10, 14 and 21, 7 fishes were randomly selected and tissue samples were prepared from incision site. Histopathological examination revealed that regeneration process of epithelial tissue was started at day 2 and was completely at day 7 in all fishes. However the healing process in group 2, particularly the formation granulation tissue, was started and completed earlier than group 1 and the control group. According to the results of clinical assessment and histopathology, it is concluded that long term bath of zinc sulfate has positive effects on fibroplasias during the healing process of cutaneous lesions

[Self assessment with Baldrige model in health organizations]

Self-assessment is a framework for the evaluation of organizations in all fields. This tool moves the organization toward excellence. So, Continuous improvement obviously is shown in organizations that have used the self-assessment. This research is a literature review article, based on library studies. This article shows the benefits of self-assessment, implementation process and its techniques. Also this paper will express Baldrige model. Considering Baldrige criteria presented in health care different countries, and continuous improvement possibility of model. It seems that this model is useful for health care organizations, particularly in hospitals

study on gastrointestinal helminths of camels in Mashhad abattoir, Iran

Abattoir survey was carried out to determine the prevalence of gastrointestinal helminths and the seasonal fluctuations in intestinal worm burdens and faecal worm egg counts of camel in Khorasan Razavi province in the northeast of Iran. A total of 306 dromedaries [Camelus dromedarius] in the Mashhad abattoir, in the northeast of Iran and the capital of Khorasan province were examined between October 2007 and September 2008. By coproscopy examinations, 75.1% of dromedaries were found to be harboring different types of nematod eggs. Faecal flotation revealed the presence of Nematodirus, Strongyloides, Trishuris, Marshallagia, stongyle type nematode eggs. In addition, gastrointestinal tracts of 50 camels slaughtered in the Mashhad abattoir were used for identification and count of helminths. Postmortem examinations revealed that the prevalence of helminths were Trichostrongylus probolurus [64%], Trichuris globulosa [40%], Camelostrongylus mentulatus [38%], T. colubriformis [34%], Stilesia globipunctata [30%], Nematodirella dromedarii [22%], Haemonchus longistipes [18%], Nematodirus oiratianus [16%], Cooperia oncophora [16%], Trichuris barbetonensis [10%], Parabronema skrjabini [10%], Nematodirella cameli [10%], Marshallagia marshalli [4%], Teladorsagia circumcincta [4%], Moniezia benedeni [3%], Moniezia expansa [3%] and Trichostrongylus vitrinus [2%]. Nematodirella dromedarii, Trichostrongylus probolurus, Trichostrongylus colubriformis, Cooperia oncophora, and Nematodirus oiratianus, were identified from dromedary in Iran for the first time. The pathological lesions in the affected abomasums, as well as small and large intestines, were hyperaemic and thickened mucosa with haemorrhagic foci. Histopathological examination revealed inflammatory reaction in the abomasa, flattened mucosa and villous atrophy with inflammatory reactions composed of eosinophils and lymphocytes in the intestines, respectively. The prevalence observed in the present study indicates the necessity of using an anthelmintic drug for increasing the health and productivity of camels

Evaluation of regional myocardial systolic function in the early stage of acute myocardial infarction by strain rate imaging

We sought to evaluate the impact of different therapeutic strategies on longitudinal regional myocardial systolic function in the early phase of acute myocardial infarction using strain rate imaging. A total of 38 patients [34 males], with first acute myocardial infarction [AMI] were evaluated. Our patients were divided into 3 groups according to the kind of therapy. The mean age of the patients was 55 +/- 9.4 years [range: 39- 75 years]. Mean left ventricular ejection fraction [LVEF] in the patients was 41 +/- 10.7%. Primary percutaneous coronary intervention [PCI] was performed in 10 patients. Sixteen patients were treated by thrombolytic therapy using streptokinase [SK] and 12 were followed-up conservatively. All patients underwent a comprehensive echocardiography study including SR imaging within 3- 5 days after AMI. The parameters measured included peak systolic strain [peak epsilon] and strain rate [SRs], end-systolic strain [epsilon es], post systolic shortening [PSS], time to peak systolic strain rate [tSRs], time to end of shortening [teSRs], post systolic strain [PS epsilon], post-systolic strain index [PSI], PSS ratio [PSS/ epsilon [Max]] and peak postsystolic strain rate [SRPSS]. There was not any association either between WMSI and ta [P=0.4], or MI location and PSS ratio [P=0.13]. But there was an inverse relationship between WMSI and mean SRS, especially when WMSI was more pronounced. A significant relationship was found between t epsilon epsilon and teSRs with the kind of therapy [shorter in PCI group [P= 0.04]. Using a simple linear regression model, no association was found between PSS ratio and SRs [a=0.056, P =0.70], PSI and teSRs [beta= -0.772, P=0.12]. Simple linear regression model showed a weak but significant relationship between PSI and Median t epsilon [beta = -0.851, P =0.04; r =0.33]. Our study showed that PCI resulted in early recovery of regional systolic function of infarcted myocardium during the early stage of acute myocardial infarction

[ effect of using The organizational culture improvement model of patient education on anxiety and satisfaction of patients with coronary artery disease]

Cardiovascular diseases and their related complications, disability and mortality are proliferating in Iran. Developing and applying native models can be an important strategy to control such complications, more effectively. Organizational Culture Improvement Model of patient education was developed through a native qualitative research study which was tested in this study. The study aimed at investigating the effect of Organizational Culture Improvement Model of patient education on anxiety and satisfaction of patient with coronary artery disease. Using quasi- experimental method, 70 patients with coronary artery diseases purposely and five nurses through randomized sampling were selected. Data were collected using "The Eshpel Burgers' anxiety questionnaire" and "patients' satisfaction questionnaire". Findings demonstrated significant statistically reduced level of anxiety [before 58.81 and after 30.15 in intervention group and / before 58.74 and after 54.36 in control group] and increased patients' satisfaction [before 23.86 and after 52.57 in intervention group and / before 24.88 and after 26.7 in control group] in intervention group, compared to control group, after the intervention. Organizational Culture Improvement Model of patient education can have impacts on anxiety and satisfaction in patient with coronary artery disease

[Performance evaluation of Ayatollah Kashani hospital based on baldrige organizational excellence model]

Aimed to systematic self-assessment, with main performance criteria, Organizational Excellence Models make it possible to evaluate performance of Health Care Sector within a fundamental and systematic framework, leading to development of management skills in the field of performance evaluation. Performance of the concerned hospital was evaluated based on Baldrige Scoring System with process and results criteria. For process criteria, the hospital was evaluated in specific areas with 13 process sub criteria, based on four factors of "Approach", "Deployment", "Learning", and "Integration". For result criteria, the hospital was evaluated in specified areas with six results sub criteria based on four factors of "Performance level", "Rate and breadth of performance improvement", "Appropriate Comparisons and/or benchmarks", and "Linkage of evaluation results measures". The hospital obtained 231.35 scores out of total 550 scores fir process criteria in the model and 111 scores out of 450 scores for results criteria, as its performance results in 2006. In sum, the hospital obtained 347.35 scores out of 1000 scores for both criteria as its performance in 2006. Using Baldrige Model in evaluation of performance of country's hospitals can provide a continuous and systematic self-assessment, facilitating organizational learning and improvement and continuously providing hospitals with inputs, outputs, system components, process and feedbacks

Prevalence of left ventricular diastolic asynchrony in patient with systolic heart failure

To study the occurence of left ventricular [LV] diastolic asynchrony in patients with systolic heart failure [HP] and its relationship to diastolic function regardless of QRS duration. Recent work has demonstrated that intraventricular asynchrony is a common finding in patients with systolic heart failure. Little attention has been paid to diastolic asynchrony in patients with systolic heart failure. We have therefore decided to determine the extent to whuch patients with systolic heart failure have evidence of diastolic asynchrony and wheather or not diastolic asynchrony is correlated with diastolic dycfunction. Tissue Doppler echocardiography was performed in 50 HF patients [LV EF=23 +/- 8%]. Diastolic and systolic asynchrony was determined by tissue synchronization imaging using a 6 basal, 6 mid-segmental model. Systolic and diastolic asynchrony were assessed by the maximal difference in time to peak systolic and early diastolic velocities between any two of 12 LV segments, and the standard deviation of time to peak systolic and early diastolic velocities of the 12 LV segments. The mean +/- SD maximal difference in time to peak systolic velocity [controls: 17.2 +/- 9.6 ms versus narrow QRS: 66.7 +/- 38.0 ms versus wide QRS: 76.5 +/- 34.6 ms, both P<0.05 versus controls] and in standard deviation of time to peak systolic velocity of 12 LV segments [controls: 15 +/- 6.1 ms versus narrow QRS: 25.9 +/- 15.3 ms versus wide QRS: 28.6 +/- 14.4ms, both P<0.05 versus controls] was prolonged in both the narrow and wide QRS groups compared with normal controls. Similarly, the maximal difference in time to peak diastolic velocity [controls: 39 +/- 16.8 ms versus narrow QRS: 73.1 +/- 58ms versus wide QRS: 108.5 +/- 168 ms, both P<0.05 versus controls] and in standard deviation of time to peak early diastolic velocity of 12 LV segments [controls: 15.3 +/- 5.8ms versus narrow QRS: 25.1 +/- .13.8ms versus wide QRS: 25.5 +/- 14.9ms, both P<0.05 versus controls] was prolonged in both the narrow and wide QRS groups. The respective prevalence of systolic and diastolic asynchrony was 31.4% and 20%, in the narrow QRS group, and 40% and 28.6%, in the wide QRS group respectively.Stepwise multiple regression analysis showed that low ejection fraction and low mitral annular early diastolic velocity were independent predictors of both systolic and diastolic asynchrony. QRS complex duration was found to correlate only with diastolic asynchrony. LV systolic and diastolic mechanical asynchrony is common in patients with HF regardless of QRS duration. Selection for cardiac resynchronization treatment should also be based on information about systolic and diastolic synchronicity

[Economic appraisal of two methods of using governmental versus private transportation in Shahrood medical university]

Resource limitation and indications on lowering governmental incumbency and private sector contribution necessitate comparison studies. This study considers economical issues using these two methods in Shahrood medical university. This study is a descriptive, cross sectional one. Cencus method was used for data gathering. 97.6% of cars were in service and 33% of drivers were official employee while 40% had contract private sector. Average payment in governmental section [for car and personnel] was 2567974 Rials [R] per month. 25% of this [expense] was for car and 75% for personnel payment. The cost of governmental transportation was 1956R per Km. and 386R per Km. in private sector. Comparison between two methods reveals that the average costs in governmental is 2.66 times more than private sector for [the] same cars. Thus according to this study the payment for private sector was lower than governmental. Transportation state should be revised because of limitation of resources, costs of car working and legal obligations for private sector contribution. Managers should plan to increase the efficacy and effectiveness of services

Comparison of transesophageal echocardiographic assessment of right and left atrial appendage functions

To define right atrial appendage functional parameters and comparing them with those of left atrial appendage. A consecutive series of 154 patients [76 males and 78 females] with mean age of 42 years were referred for transesophageal echocardiography. Ejection and filling velocities of right and left atrial appendages were measured at 120 and 70 degrees respectively. The left and right ventricles size and function, right atrial size, tricuspid regurgitation severity, and pulmonary artery systolic pressure were prospectively measured and calculated during transthoracic echocardiography. Mean right and left atrial appendages velocities were 42 +/- 18 cm/s and 50 +/- 26 cm/s respectively [PV<0.001]. Statistically significant positive association [PV<0.001] was found between right atrial appendage velocity and right ventricle ejection fraction and statistically negative relationship was observed between right atrial appendage velocity and smoke pattern [PV<0.001]. Also, the results suggested marginally significant associations between right atrial appendage velocity and right atrium size [PV = 0.05] and pulmonary artery systolic pressure [PV = 0.07]. It was also found that right atrial appendage measures were relatively independent on right ventricle size and tricuspid regurgitation severity. Our study showed right atrial appendage measures were relatively dependent on right ventricle function, right atrium size and pulmonary artery systolic pressure and relatively independent on right ventricle size and tricuspid regurgitation severity. In patients with right atrium smoky pattern right atrial appendage velocity was significantly reduced

Correlation of right ventricular DP/DT with functional capacity and RV function in patients with mitral stenosis

Evaluation of right ventricular [RV] contractility and systolic function in patients with right sided heart disease is an essential component of clinical management. The aim of this study was to assess RV systolic function by qualitative and quantitative methods and compare it to rate of ventricular pressure change during the isovolumic contraction period [dP/dt] as RV contractility index in patients with rheumatic mitral stenosis. In 56 consecutive patients with moderate to severe mitral stenosis, RV systolic function, RV dP/dt and dP/dt/Pmax, were calculated and compared. There was significant correlation between RV dP/dt and RV function [P < 0.001] and between RV dP/dt and New York Heart Association [NYHA] functional capacity [P < .001]. The mean of dP/dt was decreased with increasing severity of RV dysfunction [mean dP/dt was 648 +/- 159 for normal RV function, 592 +/- 126 for mild RV dysfunction, 319 +/- 146 for moderate RV dysfunction and 166 +/- 150 for severe RV dysfunction] Severity of tricuspid regurgitation and pulmonary hypertension had no significant effect on RV dP/dt and RV function. RV dP/dt/Pmax had also significant relationship with RV function and functional capacity [P < 0.001]. Measurements of dP/dt and dP/dt/Pmax, are practical methods for estimating RV contractility and results have a good correlation with RV systolic function and functional capacity

Markel cell carcinoma on mustard Gas scar: a case report

Merkel cell carcinoma [MCC] is a rare primary neuroendocrine carcinoma of the skin in elderly individuals, on sun exposed areas of the body, with the head and neck being the most common sites. Excessive ultraviolet exposure may play an etiologic role in the development of it. Exposure to mustard gas can cause skin reactions and increase risk of skin neoplasms and probably MCC. The Aim of this study was to report this interesting case and review the published literature on MCC. In this article a 60 year old man with a history of exposure to chemical warfare sulphur Mustard gas in Iraq-Iran conflict and development of a hemorrhagic nodular mass with a duration of 3 months on his scalp, that based on histology, immunohistochemical staining and was diagnosed as MCC is presented. This was the first reported case of Merkel cell carcinoma in Iran exposed to sulphur Mustard gas. Sulphur Mustard gas can be an etiologic factor for this tumour

Multiple cardiac malformation and congenital nephrotic syndrome in two sibbling from Iran

Congenital nephrotic syndrome is a rare disease in Iran but co morbidity with cardiac malformation in two consecutive male siblings with pulmonic stenosis, closed VSD, severe PS with small ASD and sever Right ventricular hypertrophy and tricuspid regurgitation is reported

[Comparison of durability of cardiac bioprosthetic valves between pregnant and non pregnant patients]

Since anticoagulant therapy during pregnancy has high fetal and maternal risks, using bioprostheses valve is recommended for young women with cardiac valve disease who hope to have Children. Evaluation of the effect of pregnancy on the rate of deterioration of bioprosthetic valve is the aim of this study. This case - control study was done on 53 women in the reproductive age who underwent cardiac valve replacement using bioprostheses during 1977- 2001. Twenty seven patients [mean age 22. +/- 7.73 yr] at the time of valve replacement had pregnancy [Group A], and 26 patients [mean age 26.8 +/- 10.9] had no pregnancy after valve replacement [group B]. Mean time of structural valve deterioration, and need for redo valve surgery compared between the two groups. In group A 81.48% of patients underwent mitral valve replacement [MVR], 14.81 aortic valve replacement [AVR], and 3.71% tricuspid valve replacement [TVR]. In group B 84.6% underwent MVR, 11.6% AV R, and 3.81% both MVR and AVR. Fifty six pregnancy occurred in group A which 19.6% of them ended with abortion, 76.8% had normal infant birth 94.64% of pregnancies had no complications and 5.3% had valve degeneration during or 2-4 months after delivery. Average time of freedom from structural valve deterioration in the patients who had pregnancy was 16.60 years and it was 16.74 years in patients who had no pregnancy [P=0.91]. 55.5% of patients in group A underwent redo valve replacement [14.46. +/- 5.4yr] after first operation and 50% in group B after [10.61 +/- 5.63 yr] underwent redo valve replacement. Our finding didn't show any differences in structural valve deterioration time or need for redo valve operation between pregnant and non pregnant patients