We report a case of an unusual complication of bilateral humeral head fractures caused by repeated ICD shocks secondary to torsade de pointes electrical storm. A 59-year-old female with osteoporosis and ICD treated with Sotalol for atrial fibrillation presented after receiving multiple ICD shocks due to recurrent torsade de pointes in the setting of severe hypokalemia. The patient complained of severe bilateral shoulder pain. Shoulder X-rays showed osteopenia with bilateral comminuted humeral head fractures. Bilateral shoulder CT scans showed no findings to suggest pathologic fractures. She had no direct shoulder trauma. The comminuted proximal humerus fractures were not amenable to surgical intervention. Sotalol was stopped, electrolytes were corrected with no recurrence of ICD shocks over the next five years of clinical follow-up. This case highlights the need to take the necessary steps to reduce the risk of ICD shocks in patients with osteoporosis to minimize fragility fractures. Catheter ablation, optimizing ICD detection zones and therapies, and antiarrhythmic medications are useful means to reduce ventricular arrhythmia burden and ICD shocks. Mechanical ventilation and the use of paralytic agents could also be considered early during electrical storm treatment when dealing with at-risk patients.

Both aquatic and terrestrial biodiversity information can be detected in riverine water environmental DNA (eDNA). However, whether riverine water eDNA can be used to simultaneously monitor aquatic and terrestrial biodiversity remains unverified. To assess the effectiveness of using riverine water eDNA to simultaneously monitor the riverine and terrestrial biodiversity information, we proposed that the monitoring effectiveness could be approximated by the transportation effectiveness of land-to-river and upstream-to-downstream biodiversity information flows. Subsequently, we conducted a case study in a watershed on the Qinghai-Tibet Plateau. The case demonstrated that there was higher monitoring effectiveness on summer or autumn rainy days than in other seasons and weather conditions. The monitoring of the bacterial biodiversity information was more efficient than the monitoring of the eukaryotic biodiversity information. On summer rainy days, 43-76% of species information in riparian sites could be detected in water eDNA samples, 92-99% of species information in riverine sites could be detected in a 1-km downstream eDNA sample, and half of dead bioinformation (i.e., the bioinformation labeling the biological material that lacked life activity and fertility) could be monitored 4-6 km downstream for eukaryotes and 13-19 km downstream for bacteria. In this case, we tested the eDNA monitoring effectiveness assessment framework, in which the land-to-river monitoring effectiveness was indicated by detection probability, and the upstream-to-downstream monitoring effectiveness was described by the detection probability per kilometer runoff distance and by the half-life distance of dead bioinformation. It provided a new and usable tool for designing monitoring projects and for evaluating monitoring results.

The purple non-sulfur photosynthetic bacteria, Rhodobacter sphaeroides, are capable of growing under a variety of environmental conditions. R. sphaeroides wastewater treatment has received considerable attention, since it can simultaneously realize wastewater purification and biomass recycling. In addition, poly-β-Hydroxybutyrate (PHB), a biopolymer that can be used as a biodegradable thermoplastic material for waste management strategies, and other polyhydroxyalkanoates (PHAs) are accumulated by many bacteria as energy and carbon reserve material. In this study, the used culture media of Escherichia coli and Saccharomyces cerevisiae were reutilized to grow R. sphaeroides to produce PHB and reduce carbon dioxide. Moreover when using used media, photopigments, such as bacteriochlorophyll and carotenoid, was also synthesized. Finally, the co-fermentation of R. sphaeroides and S. cerevisiae showed the potential of enhancing ethanol production with higher yield than the single use of S. cerevisiae. Therefore, this approach provides a low-cost and eco-friendly process that uses waste media to fix carbon dioxide, and produce high-value biomaterials.

Objective: The aim of this study was to describe the clinical manifestation of a specific type of diabetic retinopathy (DR), supra-large range non-perfusion area diabetic retinopathy (SLRNPA DR). Methods: This is a retrospective consecutive case series study. 260 eyes from 236 patients who suffered from diabetic retinopathy and underwent pars plana vitrectomy in the department of ophthalmology, Qingdao Municipal Hospital from February 2016 to June 2019 were enrolled. Fundus fluorescein angiography (FFA) was used after surgery to determine whether it was SLRNPA DR or non-SLRNPA DR. The demographics and relevant clinical data of these patients were carefully collected. Results: In this cohort, 41 eyes from 22 patients were diagnosed as SLRNPA DR, which was 15.77% of all eyes. When compared with non-SLRNPA DR patients, SLRNPA DR patients were more male, younger age and onset, and more likely to have history of smoking, have other comorbidities, have higher HbA1c. As for SLRNPA DR eyes, higher probability of occurrence of neovascular glaucoma (NVG) and diabetic keratopathy (DK) was found. There eyes were more likely to need anti-VEGF therapy before surgery, more likely to need silicon oil or gas tamponade during the surgery, and more likely to be suffered from persistent corneal epithelial erosion (PCEE) and recurrence of NVG. Conclusions: SLRNPA DR is a specific type of DR, which might be more severe than common kinds of DR. We need pay more attention to SLRNPA DR during our clinical process.

ABSTRACT Objective: Aim of this study was to investigate frequency of Demodex infestation and clinical implications in connective tissue disease patients with facial erythema. Methods: Patients who diagnosed with a connective tissue disease and had facial erythema were consecutively enrolled in the study. An age and gender matched control group was formed from healthy volunteers. Presence of Demodex was investigated by standardized skin surface biopsy. Number of Demodex mites over 5 per centimeter square was considered meaningful for infestation. Topical or systemic metronidazole treatment was given to the connective tissue disease patients with Demodex infestation. Facial erythema visual analog scale was questioned in patients at treatment onset and one month after. Results: A total of 31 connective tissue disease patients with facial erythema were enrolled. Control group included 31 healthy volunteers. Demographics and comorbidities were similar between groups. Demodex infestation was present in 58.1% of the connective tissue disease group and in 25.8% of the control group (p=0.01). Pruritus was the most common symptom in patients with infestation. Median (IQR) facial erythema visual analog scale score was 6 (3) at treatment onset and was 2 (2.5) one month after (p <0.001). Conclusion: When evaluating facial cutaneous lesions, Demodex infestation should not be overlooked in a patient group like connective tissue diseases with dysfunctional immune system.

Background and Aims: Oral care is one of the most important treatment programs for patients undergoing mechanical ventilation in ICU that helps prevent nosocomial infections. The aim of this study was to compare two mouthwash solutions: chlorhexidine and ozonated water for prevention of ventilator-associated pneumonia (VAP) in patients connected to mechanical ventilation in ICU. Methods: The present study is a double-blind randomized clinical trial performed on eligible patients in the ICU in two hospitals. The Clinical Pulmonary Infection Score (CPIS) checklists and culture swap to examine the presence of microorganism in the patient’s pulmonary secretions were used to evaluate the effect of chlorhexidine mouthwash and ozonated water on incidence of VAP. Results: The effects of both chlorhexidine mouthwash and ozonated water on prevention of VAP varied over time (the first, the third and the fifth days). There was also a significant difference in the incidence of VAP in the two groups of chlorhexidine mouthwash and ozonated water in terms of the culture of pulmonary secretions in the two groups (P= 0.050). Incidence of VAP in the mouthwash group with chlorhexidine, 45.9% and in the mouthwash group with ozonated water, 25% were positive. Conclusion: Ozonated water mouthwash was more effective than chlorhexidine mouthwash in preventing VAP.

Speciation is a constant theme in evolutionary biology. The continuity of population evolution makes it hard to define species. Here, we revisited three geographical patterns of speciation (sympatric, parapatric and allopatric speciation) and their recent empirical evidence, based on the classical concept of biological species. A survey of the literature reveals the molecular genetics basis of postzygotic barriers and the supporting evidence derived from analyses of population genomic data, including BDMI (Bateson-Dobzhansky-Muller incompatibility), QTL (quantitative trait locus) analysis, Haldane’s rule and the large X-chromosome effects. One prezygotic barrier to speciation, which is often not emphasized, is the pattern of mating system. Given the occurrence of a more common transition to selfing from outcrossing than the reverse direction in plant species, the so-called selfing syndromes for both flower characters and genomic structure could amplify population genetic structure and enhance speciation. It also increases the occurrence of asymmetric or absent gene introgression between incipient species with different mating systems. The role of driving or reinforcing speciation that mating system plays awaits identification with appropriate data collections.

The aims To evaluate the exact role of alpha blocker use for treatment of persistent LUTS after TURP. Methods This is a narrative review of existing manuscripts regarding the alpha blockers use after TURP. The search was done through PubMed in June 2021. The search was conducted using the following key words” alpha blocker” AND “after transurethral prostatectomy”. Results Publications between 2000 and 2020 were reviewed using PubMed database search. 111 studies were found. Seven records were considered for this review. Surgery for BPH is successful in eliminating the need for medical therapy in 75% in patients who use medications before surgery. However, number of patients still have persistent LUTS after TURP. There are no guidelines to direct the management of LUTS after TURP. A little research regarding the outcomes of alpha blockers use for treatment of persistent LUTS after TURP are detected. Based on the studies, theoretical basis exists for using of alpha blockers to treat post TURP urinary symptoms. Conclusion Alpha blockers can be used for treatment of post TURP urinary symptoms whether they are a continuation or de novo. Further large studies are needed.

Abstract Background: The monocyte to high-density lipoprotein cholesterol ratio has emerged as a novel inflammatory marker in the fields of cardiovascular disease. To explore the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR) and the occurrence of coronary microvascular disease(CMVD). Methods: 289 patients with angina symptoms and no obvious obstructive coronary arteries were enrolled in our hospital from September 2019 to June 2021. CMVD was diagnosed by coronary flow reserve (CFR). According to the CFR, 158 patients in CMVD group(CFR≤2), 131 patients in non-CMVD group(CFR>2). The differences in baseline clinical characteristics and MHR between the two groups were compared. And the significative influencing factors of CMVD were analyzed by multivariate Logistic regression. The operating characteristic curve(ROC) was drawn to evaluate the predictive of influencing factors. Results: Compared with NO-CMVD group, triglyceride, monocyte count , MHR, blood platelet was significantly increased in CMVD group(p<0.05), but high-density lipoprotein cholesterol was decreased in CMVD group(p<0.05). From multivariate logistic regression analysis, MHR, monocyte count and high-density lipoprotein cholesterol were all independent factors for patient.(p<0.01). ROC curve showed that the area under ROC curve of MHR in predicting CMVD was 0.738[95%CI为（0.679，0.794）. MHR can be better in predicting the occurrence of CMVD. Conclusion: MHR was shown to be an independent risk factor associated with the occurrence of CMVD. And it also can well predict the occurrence of CMVD.

Oleaginous yeasts are promising candidates as single cell oil (SCO) platforms to meet energy demand due to their high growth rate, easy scaling and the possibility of being cultivated in culture media based on lignocellulosic biomass. The oleaginous yeast Papiliotrema laurentii UFV-1 is able to reach high lipid contents in short periods, besides its composition of fatty acids is suitable in terms of quality standards required for biodiesel production. However, little is known about the regulation of its metabolism. We present here the first genome-scale metabolic reconstruction of P. laurentii, papla-GEM. The reconstruction was based on homology to another oleaginous yeast and the model was subjected to intensive manual curation throughout the reconstruction stages to find out the metabolic specificities of this yeast. The final model includes 764 genes, 2447 reactions and 2112 metabolites, and its biomass equation is based on direct measurements of all major biomass components. The validation step was performed using experimental data obtained in this work, and simulation results evaluated the growth and lipid accumulation physiology of P. laurentii. Therefore, the papla-GEM will lead to a better understanding of the metabolic capabilities of P. laurentii and thus will be useful in systems metabolic engineering approaches.

The biodegradable scaffolds based on biomedical polymeric materials have attracted the wide interest in bone transplantation for clinical treatment to bone defects without the second operation. The composite materials of poly(trimethylene carbonate), poly(L-lactic acid) and hydroxyapatite (PTMC/PLA/HA) were prepared by the modification and blending of poly(trimethylene carbonate) (PTMC) with poly(L-lactic acid) (PLA) and hydroxyapatite nanoparticles (HA). The PTMC/PLA/HA scaffolds were further prepared by additive manufacturing using the biological 3D printing method. The PTMC/PLA/HA composite materials and scaffolds were also characterized by fourier transform infrared spectroscopy (FT-IR), GPC, automatic contact-angle, SEM, XRD, differential scanning calorimetry (DSC) and thermogravimetry (TG). Subsequently, their properties, such as the mechanic, biodegradation, drug controlled release, cell cytotoxicity, cell compatibility in vitro and proliferation/differentiation assay in vivo, were also investigated. Experiment results indicated that PTMC/PLA/HA scaffolds possessed the low toxicity, good biodegradability and good biocompatibility and then improved the cell proliferation of osteoblast cells (MC3T3-E1). Moreover, PTMC/PLA/HA enhanced the adhesion and proliferation of MC3T3-E1 cells, allowing penetration of host cells within the construct boundaries, and then can enable the growing of bone cells and induction of bone tissue regeneration. Therefore, PTMC/PLA/HA composite materials can be used as the potential biodegradable scaffolds for bone regeneration and tissue engineering in vivo.

In this paper, we investigate the characterization for darboux curves in a strictWalker 3-manifold and a classication for ruled surface, which is generated by darboux curve in Walker 3-manifold is obtained. An example was given at the end.

The beginning of a pandemic is a crucial stage for policymakers. Proper management at this stage can reduce overall health and economical damage. However, knowledge about the pandemic is insufficient. Thus, the use of complex and sophisticated models is challenging. In this study, we propose analytical and stochastic heat spread-based boundaries for the pandemic spread. These are compared with the stochastic Susceptible-Infected-Recovered (SIR) model taking place on an interaction graph. The proposed boundaries are not requiring accurate biological knowledge such as the SIR model does.

Castillo Vardaro et al. (2021) explored mechanisms that modulate spatial regularity in social insects without validating the modelled trends using rigorous measures of regularity from empirical data. Here we show that empirical insect data contradict their model generalizations and that their high resource densities cannot explain spatially periodic dryland vegetation.

Background: Endotracheal intubation is a procedure commonly performed in the emergency department. Endotracheal intubation poses a risk of exposure to infectious aerosol droplets. The present study aims to test the effect of using an aerosol box and personal protective equipment on the intubation time while performing on endotracheal intubation manikin. Methods: The study participants (11 emergency specialist, 11 emergency physician and 11 general practitioner) performed endotracheal intubation on a training manikin in three different airway simulations. Simulation 1 had neither PPE nor AB, simulation 2 had PPE, and simulation 3 had both PPE and AB. The intubation times, the number of intubation attempts, and the discomfort caused by the aerosol box were recorded. Results: There was no significant difference in the number of intubation attempts between the physicians according to their position and airway simulations (p>0.05). There was a significant difference at all time points except for the time to endotracheal tube cuff inflation in three different airway simulations using personal protective equipment and an aerosol box (p<0.05). The median intubation times were longer using PPE and an AB. Conclusion: The use of personal protective equipment and an aerosol box significantly increases the total intubation time. Keywords: Endotracheal intubation, Personal protective equipment, Aerosol box, Video-laryngoscope

The Ultrasound Examination of the Optic Nerve Sheath Diameter in the Patients Presenting with Carbon Monoxide Poisoning: A pilot study Introduciton: In carbon monoxide poisoning, hypoxia results in neuronal damage and death of brain cells. It is considered that cerebral edema occurs consequently, with an associated increase in intracranial pressure. The present study evaluates the presence of increased intracranial pressure using the measurement of optic nerve sheath diameter by ultrasonography in the patients presenting with carbon monoxide poisoning. Methods: 28 patients diagnosed with carbon monoxide poisoning after presenting to the emergency department underwent the bilateral measurement of optic nerve sheath diameter by ultrasonography. The patients’ demographic data, laboratory results, stage of the poisoning, and optic nerve sheath diameters were recorded. Results: The median optic nerve sheath diameter in the right and left sides was greater than 5 mm. The optic nerve sheath diameter of the right and the left eye was significantly higher in the patients with severe carbon monoxide poisoning than those with moderate and mild poisoning. Conclusion: The measurement of optic nerve sheath diameter can be used to evaluate the presence of an increased intracranial pressure in the patients with carbon monoxide poisoning. Keywords: Carbon Monoxide poisoning, elevated intracranial pressure, ultrasonography, Optic nerve sheath diameter

Stochastic model for Malaria transmission is introduced, and its behavior under insecticide- treated nets, which is used as a prevention, is considered. A white noise is introduced into the model, representing fluctuations in the environment that manifest them-selves naturally on the transmission coefficient rate. Existence and uniqueness of a global positive solution of the stochastic model is proved, and conditions under which extinction and persistence in mean hold are establish. Numerical simulations are provided which illustrate the theoretical results and conclusions are derived on the impact of the fluctuations which are caused by the environment.

The article has mainly given the exponential distribution race and in the scale parameter race's parameter satisfies the condition which based on the chopped sample maximum likelihood estimator the stochastic order needs, but also certifies that the parameter different two mutual independent normal distribution or the two-parameters exponential distribution, under the complete sample, between the parameter maximum likelihood estimator has the stochastic order relations.At the same time, it is proved that there is also a random order relationship between the maximum likelihood estimators of the parameters under the fixed number truncated sample.

ABSTRACT Numerous bacteria have shown resistance to drugs so the search of new antimicrobials of plant source which have little or no side effects. The aim of the research is to evaluate Cassia occidentalis seeds for antibacterial properties. Proteus vulgaris, Klebseilla pneumoniae and Neisseria meningitis bacteria were selected based on some ethno-botanical uses of Cassia occidentalis. Phytochemical investigations were done. Antibacterial sensitivity test and the minimum inhibition concentration (MIC) were carried out by using agar well diffusion method. Phytochemicals investigation on crude ethanol and methanol seed extracts of C. occidentalis revealed glycosides, steroids, saponins and flavonoids. Each extract concentrations (10ppm-50ppm) used demonstrated growth inhibition of Proteus vulgaris, Klebseilla pneumoniae and Neisseria meningitis. Glycosides, steroids, saponins and flavonoids from both the crude seed extracts could be potential antibacterials against P. vulgaris, K. pneumoniae and N. meningitis if thoroughly investigated. The N. meningitidis was the most susceptible isolate to the ethanol, methanol and the combined extracts of C. occidentalis (MIC= 0.63 ppm). There statistically significant differences between extracts and their effects on used bacteria. (P value, 0.0001, α = 0.05). The methanol extract was more active than the ethanol on the P. vulgaris and K. pneumoniae isolates with MICs of 2.5 and 2.5, 5.0 and 5.0 ppm respectively. The combination of both extracts inhibited S. aureus and S. typhi growth compared to the individual extract that did not. This plant can be a source of antibacterial against bacteria used and justifies the claim that the plant can be used to manage meningitis.

Cold energy storage technology using phase change materials (PCMs) plays an important role in cold chain logistics, air conditioning refrigeration, high temperature operation temperature control clothing and other fields. However, the performance of current phase change cold storage materials is still far from optimum. How to make its shape stable and machinability is still the key problem in its practical application. Herein, we report a novel form-stable hydrogel phase change cold storage materials (HPCCS) with water as PCM and a polyether-based 3D gel as skeleton. These hydrogels exhibited excellent shape-stability i.e. no water leakage, owing to the coaction of capillary forces and hydrogen bonding. HPCCS has similar phase change performance with ice, while HPCCS maintained cold temperature 1.85 times longer than ice. Finally, it was found that HPCCS could prolong the preservation time of Litchi which points towards its excellent potential for use in food cold chain logistics applications.

Objective: Covid-19 may cause thrombosis in both venous and arterial systems. Familiarity with the signs and symptoms of thrombosis and their treatment plays an important role in treating Covid-19 infection and its complications. D-Dimer and Mean platelet volume (MPV) are measurements related to the development of thrombosis. This study investigates whether MPV and D-Dimer values could be used to determine the risk of thrombosis and mortality in Covid-19 early stages. Methods: 424 patients were randomly and retrospectively included in the study, Covid 19 positive according to the World Health Organization (WHO) guidelines. Demographic and clinical characteristics such as age, gender, and length of hospitalization were obtained from the digital records of participants. Participants were divided into living and deceased groups. Results: WBC, neutrophils, and monocytes were significantly different in the two groups (p <0.001), and its values were lower in the living group than in the deceased group. MPV median values do not differ according to prognosis (p = 0.994). Creatinine, Procalcitonin, Ferritin, and the number of hospitalization days in living patients were significantly lower than in patients who died (p <0.001). Median values of D-dimer (mg / L) differ according to prognosis (p <0.001). While the median value was 0.63 in the survivors, it was found as 4.38 in the deceased. Conclusion: Our results did not show any significant relationship between the mortality of Covid-19 patients and their MPV levels. However, a significant association of D-Dimer and mortality in Covid-19 patients was observed. Keywords: COVID-19, MPV, D-Dimer, prognosis, mortality

Objective: To investigate the impacts of demographic, hematological, and biochemical factors on the clinical course and the prognostic outcome in adult COVID-19 patients. Methods: This retrospective study was performed in the internal medicine departments of 2 hospitals and data were extracted from the medical files of 1700 adult COVID-19 patients (836 females, 49.2%; 864 males, 50.8%) with an average age of 48.23 ± 16.68 (range: 18-93). Clinical data included baseline descriptives, prior medical history, admission date, treatment, and hematological and biochemical blood test results. The relationship between the survival, length of hospitalization, hematological, and biochemical parameters was investigated. Results: Advanced age (p<0.001), presence of at least 1 comorbid disease (p=0.045), increased length of hospitalization (p=0.006), elevated white blood cell (p=0.001) and neutrophil (p=0.002) counts, increased serum levels of glucose (p=0.027), blood urea nitrogen (p<0.001), AST (p=0.006), LDH (p<0.001), CRP (p>0.001), and D-dimer (p=0.001). In contrast, diminution of serum levels of albumin (p<0.001), ALT (p=0.028), calcium (p=0.022), and platelet count (p=0.010) were associated with increased mortality. There was a positive and weak relationship between serum D-dimer levels and length of hospitalization. Conclusion: Our data imply that identification and validation of indicators that predict COVID-19 disease progression to improve health outcomes are crucial. Age, comorbidities, immunological response, radiographic abnormalities, laboratory markers, and signs of organ dysfunction may all predict poor outcomes individually or collectively. It is critical to identify characteristics that predict COVID-19 problems to guide clinical management, improve patient outcomes, and allocation of limited resources. Keywords: SARS-Cov-2, COVID-19; severity; prognosis; outcome

Background: Candida score has been developed and used for identifying patients at risk for developing Candida infections. However, its usefulness in predicting outcomes of patients with candidemia has not been evaluated. We aimed to determine the risk factors for mortality in patients with candidemia admitted to an Indian medical intensive care unit (ICU). Methods: We conducted a retrospective cohort analysis of 56 patients with candidemia presented in 18 months duration. Baseline patient characteristics, ICU course, and outcome were noted and Candida score was calculated. We conducted an analysis based on the primary outcome measure of ICU mortality. Results: Out of 3,142 ICU admissions, the incidence of candidemia was 17.8/1,000 admissions. The mean interval between ICU admission and candidemia was 12.9 ± 14.4 days. C. tropicalis was the commonest species isolated from 28.6% isolates, followed by Candida albicans (21.4%) and C. glabrata (12.5%). The mean length of ICU stay was 22.9 ± 28 days and hospital stay was 30.1 ± 30.2 days. Crude ICU mortality was 33.93%. There was no statistically significant difference between mortality of patients with albicans and non-albicans candidemia (p=0.732). On multivariate analysis, only two factors, previous antifungal therapy (p=0.004, OR=101.4, 95% CI=4.52-227.7) and Candida score >3 (p=0.028, OR=13.2, 95% CI=1.3-125) were found to be independently predicting mortality. Conclusion: Candida infection is generally late-onset and is associated with a prolonged ICU and hospital stay, and high mortality. Candida non-albicans infection was more common but there was no difference in mortality among patients with C. albicans and non-albicans infection. Previous antifungal therapy and Candida score were found to be independently predicting mortality.

Objective: Subclinical hypothyroidism may cause complications during the pregnancy. The effect of subclinical hypothyroidism treatment during pregnancy is unknown. The main challenge is to determine an upper limit in which women might experience negative pregnancy outcomes. This study was conducted to assess the subclinical hypothyroidism treatment prognosis in pregnant women in an obstetrical tertiary referral center. Design: A retrospective case-control study Setting: This study was conducted from 2015 to 2019 in a tertiary obstetrical referral center in Iran, Tehran. Population: The patients who were referred to obstetrical clinics for prenatal care entered the study. Methods: A questionnaire was filled for each patient consisting of detailed information about the patients. The patients were followed up until labor and all pregnancy outcomes were noted. The results were compared using SPSS 24 and the P<0.05 was considered the significance level. Result: A total number of 155 patients with the mean age 28.74±5 was referred to the clinic. 80 patients were in the case group while in the control group there were 42 pregnant women. There was a statistical difference between patients positive for Anti-TPO and negative ones (P<0.05). Conclusion: Though there was a significant difference in the TSH level between the two groups, the pregnancy outcomes did not differ among patients. Although the necessity of treatment in this clinical condition is still controversial, it might reduce some neurological damages in neonates and pregnancy complications in mothers.