Journal of Ardabil University of Medical Sciences
Year:2009 | Volume:8 | Issue:4 (30)|Papers Count:17

Background & Objectives: Delivery is a process with pain so one of the midwives duties is to decrease the severity of pain during delivery so decrease in labor period has been much of a concern. Atropine and Hyosine are two common drugs in decreasing time of labor and decreasing the need for labor stimulation with oxytosine. The aim of this study was to investigate the effects of hyoscine and atropine in the progress and time of labor.Methods: This study was double blind clinical trial on 200 primiparous women who had labor pain and were admitted in labor in Alavi hospital in 2008. Who were randomly divided into two groups the case group infused 20 mg Hyoscine with Atropine in the onset of active phase of labor (4cm dilation, Ruptured membrane) and in the control group 2cc, Dextrose water was infused 0.05. Then, progression in dilatation and effacement, time of active labor, time of 2nd and 3rd stage of labor, fetal heart rate monitoring, infant APGAR score of the 1st and 5th minute were registered. The data were analyzed by SPSS software using descriptive and analytical statistics as chi- square.Results: The findings indicated that there was a significant difference in dilatation & effacement between two groups (5/2cm/h, 1/5cm/h) (p<0.05). Duration of active phase of labor was 105 min in case group and 251 min in control group (p<0.05), duration of stage 2 was 17 min in case group and 33 min in the control group (p<0.05). Total time of labor and deliver (121 min in case group, 274 min in control group), incidence of Tachycardia and bradycardia in FHR in 30 min after infusion 25%(15% Tachycardia and 10% bradycardia in case group) 20% (12% Tachycardia and 8% bradycardia in control group) and no difference in two group was seen.Conclusion: according to the findings of this study hyoscine and atropine are effective in the progressing of labor and delivery.

Background & Objectives: Pregnancy is one of the most sensitive periods of lifetime and married life and sexuality may bring about numerous physical and psychological changes. Lack of attention to sexual matters during pregnancy may cause sexual dysfunction in each of couples. The aim of this study was identifying male sexual behavior and its relevant factors during the partner’s pregnancy.Methods: This was a descriptive-analytical study in which 350 men, whose wives were pregnant, were selected in two stratified stages. The instrument for data collection was Arizona Sexual Experiences Scale- male questionnaire. All data were analyzed by SPSS11.5. Descriptive information was used for describing the frequencies and also the x2 test was used for determining relation ship among variables. Results: The findings revealed that 21.3% of men in the first trimester, 19.3 in the second and 28.3 in the third trimester had sexual dysfunction. In each trimester, inability to reach orgasm was the most common sexual dysfunction in men. Frequency of vaginal coitus decreased in 64.9% of men and in 46.6 % of them fear from risk for fetus health during vaginal coitus was the essential reason for this reduction. There were significant differences between sexual dysfunction and fear from risk for fetus health and guilt feeling of sexual activity. Therefore decreased vaginal coitus caused sexual dysfunction. Conclusion: As men’s knowledge and attitudes about sexuality affect their sexual behavior during pregnancy it is crucial to provide proper consultation regarding sexual relations in prenatal care services.

Background & Objectives: One of the major concerns for parturient omen and midwives is the healing of episiotomy and prevention of its subsequent complications. In order to achieve perineal healing in the past, cold and warmth therapy, traditional medicine and povidone iodine were used. But today episiotomy care includes ice pack and warm. One of non pharmacologic methods is aromatherapy and one of aromatherapy products is chamomile essence used in midwifery care and can extensively be applied to perineal healing and prevention of episiotomy infection. This clinical trial was conducted to assess the effects of chamomile essence on episiotomy healing on primiparous women referring to Talesh Hospital of Shaheed Norani in 2007.Methods: In this double blind clinical trial, 44 women on intervention group of chamomile essence and 44 women on control group of placebo used sitz bath together with routine care twice a day, for two weeks. Then episiotomy healing process was assessed on the first 12 hours, 7th and 14thdays of postpartum. Results: Healing process was considered as basic information on the first 12 hours. Findings showed that Mean pain on the 7th & 14th day decreased in the intervention group but it did not indicate a significant difference. Mean score (±standard deviation) perineal healing on the 7th day was on intervention group 1.61±1.08 and placebo group 1.34 ±0.9.Perineal healing mean on 14th day in intervention group 0.58 ±0.54 and placebo group 0.57±0.36. Mann Whitney, statistic tests showed no significant difference between these two groups. Conclusion: Results revealed that episiotomy healing was the same for both groups. It seems that more studies on this field with various doses and types of chamomile medical plant are necessary.

Background and objectives: Voice problem is the most common problem in singers and the prevention of this problem and clearance of voice is the cause of voice quality improvement in these people. So this study was carried out to" determine the traditional methods for prevention of voice problem in religions singers at Ardabil city". Methods: This survey was a descriptive (cross-sectional) study. In this study 43 religious signers were selected. Then singers completed a questionnaire that consisted of data about age, sex, duration of singing, history of Voice problem and the prevention methods that they used. Data were analyzed with SPSS software and descriptive statistics. Results: The findings showed all of samples were male. Most of them were 24-44 years old. All of them used their voice in Moharram and 15 persons (34.4%) in Ramadan and 8 cases (18.6%) sang in other months. Clearance of voice was often seen in summer (79%) and Voice problem often was seen in winter (67.4%). 36 singers (83.7%) experienced Voice problem that in most of them (32.6%) its duration is 2 days. Resting and well nutrition were the common methods for prevention of voice problem. Most of singers used corticosteroids and changed singing method to a treble voice. Conclusions: The rate of voice problem in religious singers was higher than that of the general population, and it was often seen in special months. Duration of voice problem was low in most of them. Change of singing method and corticosteroid therapy was the common way of its treatment.

Background & Objectives: Cardiovascular disease is the most important cause of death in the world. Statistics shows that mortality and morbidity from cardiovascular disease in Iran is going up, so quality of management and treatment of these patients need to be better. For these reasons, determination of survival rates and factors affecting it is important and is also the aim of this study. Methods: This is a survival analytic prospective study, done on 800 patients, admitted in Ardabil Bouali Hospital CCU. All of the patients were followed up one year and a questionnaire about them was obtained. Statistical analysis was done with SPSS. For survival analysis Kaplan Maier, life table, logReng test and Cox regressions model were used. Results: Mean age of patients was 60.6±12.4 years. Total number of mortality in one year was 84 persons (10.5%). 582 patients were men and 218 were women. 47.4% were smokers, 33.4% had hypertension, 18.1% had diabetes mellitus, 15.3% had hyperlipidemia and 30% had arrhythmia. Survival rate in the first 10 days, 28 days and one year were 94%, 93% and 90% respectively. Conclusion: Factors that affected survival in Cox regress ional model were: diabetes mellitus, age, use of streptokinase, left ventricular ejection fraction, heart rate and heart block. Knowledge from survival rates and relative risks can help health managers in better health service preparation.

Background and objectives: The most common cause of death in the people (1-44 years old) is trauma and it ranks third as the cause of death in all ages. Road and city accidents with motor vehicles and its effects consist 50% of trauma cases. The mortality rate in traffic accident shows the depth of traffic event, but in any way most of the victims can be saved and we can prevent many of these accidents. The accident is of greater importance in especially developing countries like our country, because in addition to losing a great number of active economic and social power, it causes damage in the corpus of the community, in a way that these accidents cost more than 3% of country in gross productions. Methods: This investigation which is considered as a descriptive study is in order to do an epidemiologic investigation of accidents that have led to death in Ardabil Province from Farvardin 2002 to Farvardin 2003 through collected data from Ardabil’s legal medicine center and was analyzed through SPSS. Results: The analysis of collected data consisted of 272 cases of events, shows that most of them are male (82%) and they are 21-30 years old. The existence of inverse relationship with educational level and mortality rate was one of the other findings. Also it became clear that most of the vehicles were small vehicles (70.6%) and most of the victims were pedestrians (34%). Accidents rate in road was 63.6% and accidents in the cities 36.4%, and most of them have happened in summer (38.2%). Most of the mortalities took place in the first minutes and at the same place of accident (50%) and mortality cause of most people was multiple traumas (48.5%) and Brain injuries (46.6%.( Conclusion: Factors influencing the rate of death in accidents are as followings: male, age (21-30), low education level, summer, and small vehicles. The main causes of death in accidents are multiple trauma and head injuries.

Background & Objectives: With regards to the importance of health and Quality of Life improvement in the elderly in relation with physical activity and self esteem, the aim of this study was to determine the effect of programmed exercise on the self esteem of elderly residents in the nursing home of Rasht city in 2008.Methods: This study included a pretest and post test on 32 qualified samples. The Rosenberg self esteem scale were filled by them. Then, they attended a programmed exercise for one month. The scale was filled again by participants. The collected pre-test and pot-test data were analyzed using a-t-test SPSS software.Results: The average age of the participants was 73.53 (± 8.31). Most of them were widowed, 43.8% had no children, 87.5% were uneducated and the rest (12.5%) had a primary level of education. 37.2 of them had resided in the nursing home for less than one year and their average of residence was 1357±17.11 days. The source of income for 59.4% of participants was through children and relations. 27 persons (84.4%) had frequent visits with relations. 34.4% of them had a disease in history. There were significant correlations between number of children, marriage, education and job and number of previous jobs, gender; job and education and number of previous job, visit frequency and education and time of the last visit. The correlation between sums of self esteem scores before and after the exercise was positive and significant and 22.81±4.84 Average of self esteem score before and after programmed exercise was 26.84±4.35.Conclusion: Regular exercise is effective in improving the self-esteem among the elderly and it can recommend to the elderly as a safe and cheap method.

Background & Objectives: The prevalence of diabetes and its different methods of treatment have significantly been increased in the last two decades. The actual effect of these treatments is a common topic in the patients’ health and quality of life among these patients has a considerable importance in the community medicine. This study was designed to indicate the quality of life in the diabetic type II patients. Methods: This was a cross-sectional, descriptive analytic study in 2004 on 110 type 2 diabetic patients who had referred to Bu Ali Hospital in Ardabil. The patients were randomly selected and took the SF-36 Questionnaire and in the end the data were analyzed by SPSS. Results: The average age of the patients was 52.5 with the standard deviation of 11.3 years. 73 of the patients were female (66.4%) and rest of them were male. The average period of sickness among diabetics was 8 years from the time of diagnosis with a standard deviation of 6.2 years. The average of duration of therapy was 7.7 years with 6.1 years standard deviation. 51 patients (46.36%) had the history of hospitalization. Vitality indicator was low in 39.1% of patients. Social functioning was low in 50% of patients. In general, by adding up the quality of life’s various indexes scores based on SF-36 questionnaires standard coefficients, 77% of patients had intermediate and low quality of life. Conclusion: According to this study most of the patients in this study had a low quality of life.

Background & Objectives: With respect to the importance of diabetes mellitus prevalence and contradictory role of treatment with metformin on vitamin B12 and folic acid serum levels and this study was done in order to determine of Vitamin B12 and folic acid serum level in patients with diabetes mellitus under treatment with metformin. This research was performed in diabetes center of Kashan in 2004.Methods: Information about research method, target and conclusions were given to patients. Those who were under treatment with anti acids, and chemotherapy drugs and also those who were alcoholic and had gastrointestinal diseases and hepatic diseases were excluded among all samples of this research, then patients were divided in to 2 groups: The first group were under treatment with metformin, second group were with other drugs for diabetes treatment. All of people were under treatment for at least 6 months folic acid, vitamin B12 serum level of them were checked after 14 hours fasting and the findings were studied with SPSS software and X2 tests, T test fisher exact test.Results: there were 145 (84.31%) female and 27 male (15.69%) between 172 patients. Average age of patients was 52.1±12.7 years. Duration of disease was 5.42±9.1 and average Body Mass Index was 27.7±4.7 kg/m2. Folic acid average was 9.2±5.1 (ng/dl) in patients who consumed metformin and was 8.7±4.6 (ng/dl) in patients without consuming of metformin that did not show significant difference (p=0.557). B12 vitamin average was 5.43±342.54 (pg/dl) in patients under treatment with metformin and was 516±32.16 (pg/dl) in patients without consuming metformin in statistical findings between these 2 groups was not significant. (p=0.639). Significant correlation was observed between age of patients whom were studied and serum folic acid level of them. (p=0.07), But did not show significant correlation between age with serum B12 level (p=0.095). There was no significant correlation between age, length of disease, body mass index and level of B12 and folic acid.Conclusion:Correlation between reduction serum level of B12 and folic acid with consuming of metformin was not found. Difference between results of this study with other studies is likely because of more use of routine vitamin supplement that is consumed by patients without physician’s recommending, genetic differences or drugs composition.

Background & Objectives: Toxoplasmosis is an important zoonosis parasitical disease. Infection with Toxoplasma gondii in transmission of parasite to fetus or its reactivation among immune-compromised persons can lead to server clinical symptoms. The aim of study was to determine immune level of Toxoplasmosis among women who were to get married and have referred to Health Center of Ardabil.Methods: In this study 272 blood samples of women who had referred to health center of Ardabil in 2007 were collected. Samples were tested with ELISA method to detect Anti- Toxoplasma IgM and IgG Antibodies. Results: The tests showed that 42.3% of women were IgG Positive, 57.2% were IgG negative and 2.6% women were IgM positive and also IgG positive. They have ( IgG positive women) 11.3% family history of abortion, 96.5% eating raw vegetables, 92.2% eating half cooked meat, 89.6% not washing the vegetables with disinfectants, 29.6% animal contact, 57.4% contact with raw meat and 94.8% used piped wate. Conclusion: Since 57.7% of women who were to marry in Ardabil city were negative from the view point of Toxoplasmosis, health education for elimination of risk factors especially within pregnancy period seems mandatory.

Background & Objectives: Preeclampsia is a major cause of prenatal and maternal morbidity and mortality. The early diagnosis of pre-eclampsia remains one of the most important functions of antenatal care .By predicting pre-eclampsia maternal and infantile prenatal mortality rates are expected to be lowered.Methods: This was a prospective study with randomly sample that was performed on 400 primiparous women between the 28 and 32 weeks of gestation. At first weight, height, blood pressure on left position and supine position were measured then these women were followed until delivery.Results: Of total 400 women, 23 women developed pre-eclampsia. Mean difference of diastolic blood pressure in left position and supine position and BMI were significantly different in the two groups (P<0.05). Using the ROC, BMI higher than 28/88 showed a sensitivity of 61%, specificity of 92%, positive predictive value of 33% and negative predictive value of 97%. Roll-over test higher than 20 mmHg showed a sensitivity of 52%, specificity of 95%, PPV= 39% and NPV= 97%. When the two tests were positive they showed a sensitivity 30%, specificity 99%, PPV= 58% and NPV= 96%.Conclusion: The combination of Roll-over test and BMI with low sensitivity has high specificity for rulengout pre-eclampsia.

Background & Objectives: Intensive care unit (ICU) is one of the most critical parts of the hospital. In other words the intensive care means taking care of patients suffering fram acute and life-threaning diseases by the most expert personnel, using modern equipment and facilities. The purpose of this study was to evaluate the mortality rate of the patients admitted to ICU and the effective factors in at Ardabil Fatemi Hospital.Methods: This is descriptive-cross sectional study carried out on the patients admitted to surgical and neurosurgical ICU in Ardabil Fatemi Hosbital from June 2005 to June 2006. Among all the patients admitted to ICU (903 patients) who were under investigation, only those who died were included in the study. The effective factors were age, gender, previous sickne type of illness, complications, ventilator connection requirment. The information collected using the questionnaire and the data were analyzed with spss and chi square statistical programs.Results: From the total namber of 903 patients admitted to ICU 140 (15.5%) of them died. According to the information collected 72.8% of the cases were male and 27.2% were female. The age range of pateints was 10-80 years old. The mortality rate was high among the patients over 60 years old. The second one was 21-30 years old. The highest mortality rate was observed in the first five days of admission to the ICU 92.8% of these patients were being ventilated, 48.5% had a history of underlying diseases and 33.5% were afflicted with CNS trauma.Conclusion: Accordig to the findings, there was a significant relationship between traumatic patients and the mortality rate. The CNS trauma was the most prevalent factor of death in ICU. It is also noticeable that the mortality rate was higher in males and the old age group.

Background & Objectives: Neonatal mortality rate is a main indicator of hygienic development and recognition of the mortality causes is the first step for reduction of the mortality rate and promotion of this indicator. Therefore, in this study, the causes of neonatal mortality have been investigated in Ardabil medical university related hospitals.Methods: This study is a retrospective, cross-sectional and descriptive-analytical one that has been done on the bases of admission's units and filling the medical record form for all neonates who have been admitted to Alavi and Imam Khomeini hospitals in Ardabil from September 2006 to September 2007. The questions of forms consisted of infant’s sex, birth weight, gestational age, cause and age of death. The data were analyzed by SPSS software with utilizing T- test and Chi-Squares.Results: During this study, there were 1881 admissions of which there were 148 deaths (7.86%). The causes of mortality were hyaline membrane disease (HMD) (52.02%), sepsis (14.86%), pneumonia (9.45%), congenital anomaly (12.83%), asphyxia (7.43%) and meconium aspiration (3.37%). Among the dead neonates, 54.72% were male and others were female. There were 550 LBW neonates and 111 deaths in this group; result of our study showed that mortality rate in LBW neonates was 20.18%. There were 578 preterm neonates and 122 deaths in this group; prevalence of mortality rate in preterm neonates was 21.10%.Conclusion: Prematurity and low birth weight are the most important and fixed cases of infant mortality. The most common causes of mortality were hyaline membrane disease and sepsis. Therefore, the prevention of preterm labor for reduction of prematurity and its related complication recommended which may lead to decreased rate of neonatal mortality.