TEB VA TAZKIEH
Year:2000 | Volume:- | Issue:37|Papers Count:13

An ecological study was conducted to determine an index of life expectancy at birth and its relation to gross national production per capita in different groups of 145 countries of WHO members. The data was obtained from WHO and Unicef report in 1997. In the statistical analysis, the average of indices of life expectancy and GNP in 7 groups of countries using WHO categorization was described and compared. The, using multiple linear regression model, the effect of GNP on the life expectancy after adjusting the effect of infant mortality rate (IMR), total fertility rate (TFR) and the percentage of literacy over 15 years was estimated. The results showed there is a positive correlation (r=0.59) between life expectancy and GNP in the ecological leve, but the middle east and North African Countries with average GNP of 4113 $, the average life expectancy was 67 year while the Latin American countries and Former Soviet Union with the average of life expectancy 70 year, have the lower GNP on the average. The results of multiple regression analysis showed by increasing 1000 $ GNP, the average of life expectancy was increased by 0.2 year after adjusting IMR and TFR and the percentage of literacy over 15 years. Although there is a significant relation between life expectancy at birth and GNP in the ecological Level, life expectancy is a better indicator of health status; it decreases only when the overall health status of population is promoted while GNP increases with accumulation among minority of population.

Providing and distributing the medicine as a strategic production is affected by variouse factors such as import, internal production, distribution, currency affairs, forms of consuming, ... and so on. In general it plays an important role in health economy of society.Parallel to other problems, rational prescribing and uses of medicine is one of the most important difficulties in medical sciences, This problem not only makes the real medication immposible by increasing the side-effects, but also entail the increase of economical loss, inappropriate distribution and shortage of neccessary drugs, Variouse patterns of irrational prescribing have been shown in different studies, in different countries. All of the studies in Iran Proved the irrational pattern of drug prescription, which containes a reasonable percent of the cases.Education plus improvement of the knowledge in this realm leads to changing in attitude and performance. Reviewing the effect of education has a signifcant effect in prescription of the doctors. CME as a component of education is directly involved with medical community and thus has an outstanding influences here. CME is generally involved with improvment of Knowledge, attitude and performance, which effects directly or indirecrly on the rational prescribing of medicine. Paying special attention to the programmes about pharmaceutical education and rational use of drugs from 1374 to 1378 (1991-1999), shows a reasomablly higer trends including: 2 seminars in 1374 increased to 17 in 1378 (%63 pharmaceutical seminars in 1378), - Conferences about rational prescribing of drugs contained in average %7 of pharmaceutical conferences.- Short Periods programmes are %15 of the all programmes.- Pharmaceutical workshops shows %100 increase relative to the years 1370-1377 (1991-1999), which %50 was directly about rational prescribing.- %4 of composed programmes for GPs, and %5 of total composed pharmaceutical programmes were about rational prescribing. Altough education of rational prescribing of medicine from 1374 to 1378 had an increasing improvement, but still, parallele to dept. of CME it demand more attempts for improvement of quality of the actions by scientific groups.

This reasearch is survey study with the aim of determining priorities of treatment and drugs from deputies' view of treatment and drugs affairs of medical sciences and health services universities and faculties around the country have planned. In this survey the method of gathering data, have been questionnaire. From 37 Pariticipants in seminar of deputies of treatment and drugs around the country, 36 persons answered to questionarrie avarage standard deviation and distribution of absolute and relative abundance determined on the basis of great deputies' answers to questions, then by the use of factor analysis method, priorities of treatment and drugs unit gathered between 15 selection subject under study in 3 factors that had the largest special amount of Eigen Value and by the use of factor scree diagram as following: 1- management factors, 2-evaluation factors, 3-acceptance factors.  

Endometrial cancer is the most common cancer in gynecology. Diagnosis of endomertrial cancer is based on histologic abnormality which accheived by endometrial biopsy or curettage. Our aim was to utilize vaginal sonopgaphy for identifying endometrial cancer instead of endometrial curettage in some cases.M & M: In diagnostic clinical trial in 80 postmenopausal women with vaginal bleeding, we used vaginal sonography at first and after that they had dilatation and curettage. Results: We detect 10/.9% endometrial cancer D & C with endometrial thickness equal or more than 5 mm in vaginal sonography. Sensitivity of vaginal sonography is 88.8% for diagnosis of endometrial cancer and its accuracy is 45% with 96.6% negative predictive value.

Attaining of Vascular access is a time - limiting & difficult procedure in the resuscitation of critically ill pediatric patients. A rapid and Effective alternative route for Delivery of fluid & Medications in an Emergency setting is VIA the bone marrow with a few complication in children younger than six years old.During the study period 1374 to 1376 intraosseous lines were attempted in 16 patients. The patients varied in age from 2 months to 5 years. Intraosseous access was placed within 2-5 minutes. Fluids therapy and drugs administration was done by this route for approximately 5 Hours. Complications as leakage & Subcutenous edema was det}n in 2 cases. 6 of these patients expired within 1 to 12 hours because of Diseases. No Complications occured in the Gollow up of the others.

An 8 months old infant who was admitted for adenoidectomy suffered from cardiac arrest following injection of succinylcholine for intubation.Fortunately by rapid resuscitation cardiac function was established in to normal sinus rhythm, and finally the infant left the hospital with a good general condition. The condition is especially conserned for its hyperkalemia are described briefly as: 1) Too much prescribtion of K+ intravenously during therapy.2) In renal failure. 3) A disturbance in equilibration of intra cellular and extra cellular K+ for example in metabolic acidosis and, as in this case, use of succinylcholine. By injection of succinylcholine as acute increase in senlm potassium occurs/This will happen as soon as 1 to 8 minutes and the amount of increase can be 0/5 m mol /Lit in normal adults to 1.8 mmol/Lit in trauma or burned patients.4) During use of K sparing diuretics.5) In patients with adrenal insufficiency.

To evaluation of Avicenna's hygienic views and his attention to principles of clinical epidemiology which are the bases of hygienic thinking; we chose the translation of this book in Farsi which is more than 1.5 millions words and after computerization of it searched the key words related to descriptive aspects of clinical epidemiology as; time (seasonality), place (geographical distribution, climatic situations) person (genetic, ethnic groups, age, occupation) and the results compared with the most novel related articles and analysed them and concluded that Avicenna had been oriented about relationship between these parameters, health and diseases and had written as standard facts about them. He has messaged to all of the physicians: in all of the worlds and all times. "You must know this fact that the seasons in all of the areas on the earth induce any king of diseases or predispose the situations, So the physicians must know geograpyical distribution of diseases" and their seasonalities for prevention and treatment purposes.

Most of the patients that are reached to operative room had degress of anxiety. This condition not only results in systemic problem but also results in psychologic status (eg: effect on vital sign). For example palpitation and hypertension especially in patients with cardiovascular diseases and Raised intracranial pressure that has undesirable and dangerous problem. Thus, reduction of anxiety is very important especially in non drug method eg: relaxation technique but this method is expensive and its effect will remain for 24 hours.Result of this study is evaluation of koran sounds on anxiety and vital sign of patients in preinduction stage and evaluation of koran sounds on control group. The type of this study is clinical trial. This study has done in Al-Zahra and kashani hospitals from 1998 (December) to 1999 (May). Number of patients was 60 and divided to 2 groups. One of the groups had 30 patients. Koran sounds used for study group before induction of Anesthesia that continous to induction. For control group headphone merely used. Then vital signs of patients measured after the patients lied on operation roon bed, checked and recorded and filled the forms by patients. In the forms, symptom of anxiety recorded and patients filled the blanks in the form. After collection of species and evaluation by statistical tests, these results is obtained.1- Koran voices reduced anxiety in preinduction anesthesia. Difference was significant statistically.2 Koran voices reduced palpitation in patients. Difference was significant statistically.3- Koran voices reduced diastolic hypertension in preinduction anesthesia in contrast to control group.4- Koran voices reduced systolic hypertension in contrast to control group that is not meaning of statistically.5- Koran voices reduced respiratory rate in preinduction anesthesia that does not show any significant statistically.