Journal of Ardabil University of Medical Sciences
Year:2003 | Volume:3 | Issue:9|Papers Count:12

Background & Objective: Promoting health has always been considered as one of the basic priorities in international, national, regional and local policies. Moreover, retention and promotion of individual health requires a good knowledge of essentials and priorities of the future. Consequently, determining heslth priorities and devising public health programs and policies is just one of the crucial issues to be considered and implemented by the organizations involved. So a fundamental revising of the health care services based on health promotion indices seems to be necessary in order to increase the influence of health interference programs, extend the quality of health care services and improve activities concerning public health. Methods: This project started in 2001 and was defined by precise planning of its organization chart. Its two basic concerns included the current status of health and determining its priorities. The first point, that is the current status of health was performed through investigating the previous researches as well as qualitative and field studies. In this phase of research 1000 urban and 1000 rural families were interviewed about different aspects of health including population characteristics, nutrition, risk factors, treatment habits and so forth. To measure the parameters such as hemoglobin, hematocrite, sugar and lipids, blood samples were taken from members of 200 families who were above 15. Weight, height and blood pressure of all the subjects who were above 15 years of age and weight, height and Mid Arm Circumference (MAC) of the children aged below 6 were measured. The data were collected and scored based on scientific indices and finally the research priorities in the field of health were determined. It should be noted that many people and organizations participated in this research.Results: The findings indicated that mortality of children under 5 years of age, casualties, accidents, etc. were among 34 most essential health priorities. Conclusions: Regarding the great experience of determining health priorities which was conducted through need assessment and wide cooperation of the public and organizations, it seems important to conduct such researches once in some years and transfer their findings to other sectors in order to prevent wastage of costs, time and labor. This will also lead the researches towards the real needs and necessary interference in order to promote public health.

Background & Objective: Palpable thyroid nodules are found in almost 5% of the adults. Regarding the high prevalence of this condition, recognizing and evaluating them are important for physicians. Fine Needle Aspiration (FNA) is the first easy and cost-effective way for recognizing pathologic nature of the nods. The present research was an attempt to investigate the epidemiology and evaluate the pathological findings among patients using FNA. Methods: This is a descriptive study conducted on all 145(113 female and 32 male) patients referring to the endocrinology clinic of Ardabil in the period between October 1999 to October 2002. The data were collected using a questionnaire, the physical examination of the patients, noting down the clinical finding, doing FNA and its report presented by a pathologist. The data were then analyzed with descriptive statistics and frequency tables using SPSS software.Results: Most of the patients (36.5%) were 30-40 years old. FNA of 115 patients (79.4%) was reported as benign and that of 6 patients (4.1%) was malignant, 16 patients (11%) had a doubtful FNA, and in 8 patients (5.5%) the sample was not enough. Among patients with benign FNA, 102 cases (70.6%) had nodular goiter, 8 cases (5.5%) had colloid cyst, 3 cases (2%) had follicular adenoma and 2 cases (1.3%) had thyroiditis. Among patients with malignant FNA 1 case (0.7%) had follicular carcinoma and 5 cases (3.4%) had papillary carcinoma. Conclusions: The results indicated that most of the malignant lesion is papillary carcinoma, which has a lower prevalence compared to similar studies. Regarding the higher prevalence of thyroid carcinoma in middle ages it seems necessary to investigate the thyroid nodules in this age- group.

Background & Objective: Hypertension and diabetes mellitus coexist more commonly than predicted by chance and the synergistic effect of these two diseases is the cause of early disability and high rate of mortality in these patients. Controlling the blood pressure has a critical role in decreasing cardiovascular mortality in diabetic hypertensive cases. The goal of this study is to determine the rate of recognition and treatment of hypertension in type II diabetic subjects referring to diabetes clinic of Bou-ali hospital, Ardabil.Methods: In this cross-sectional study 300 type II diabetic patients were examined in terms of blood pressure control.Results: The patients who participated in this study ranged between 28 to 80 years of age (mean: 55.5 11.4). About 61.6% of diabetic patients had hypertension (BP>140/ 90 mmHg) 76.7% of these patients were aware of their hypertension. Only 8.8% of these patients with hypertension had a well-controlled blood pressure and the rest of them (91.2%) had a poorly- controlled blood pressure (BP>130/80 mmHg). About 21.8% of hypertensive diabetics although aware of their hypertension were not on any anti- hypertensive agents. Conclusions: This study indicates poor control of hypertension in diabetic patients. It seems that reconsidering CME programs for the physicians, emphasizing the control of risk factors especially in high-risk groups and educating the diabetic patients will improve the control of hypertension in these patients.

Temporal arthritis (TA) is a systemic inflammatory vasculitis with unknown etiology, which involves large and medium sized arteries. A wide spectrum of systemic, neurological and ophthalmological complications appears in the course of the disease the most serious of which is visual impairment leading to permanent blindness in 60% of the cases. TA is diagnosed through an elevated ESR (>60 mm/Hg) and pathological findings of arterial biopsy. It is considered as one of the urgent neurological cases in which the patient should be treated with corticostroid immediately after diagnosis. The subject of this research was a 62-year-old male who had had headache associated with fatigue, night sweats and low mood for four month. The diagnosis of TA was made considering an elevated ESR and temporal artery biopsy findings. Treatment with prednisolone was initiated and continued for 19 months resulting in complete recovery.

Background & Objective: World health organization (WHO) has paid a special attention to the reproduction health, which plays a crucial role in women health care and its promotion. The purpose of this study is to determine reproductive factors among Ashayer women in Ardabil province.Methods: Part of the plan entitled Investigating health and disease among Ashayer in Ardabil which was conducted in 2003 aimed at determining the reproduction indices using a structured questionnaire. The present research was a cross-sectional study in which the data regarding the reproductive status of the Ashayer women were extracted, collected and analyzed using SPSS software and descriptive statistics. Results: 268 women at the age of 10-49 completed the questionnaire. Mean age of marriage among women was 18.2, 8.6% of them had a history of stillbirth, 18.1% abortion and 38.19% unwanted pregnancy. 31.4% of the subjects did not have any reproductive health care, and 67.6% of those who did so were taken care less than four times. Conclusion: Improvement of reproductive indices among these women requires proper health care programs in order to enhance family planning services as well as reproductive health. This can prevent future outcomes such as unwanted pregnancy and other related complications.

Background & Objectives: In young females, especially among university students because of the physiological needs, the intake of energy and essential nutrients is very important. Some changes happen in the life style of these students, which can affect their nutritional status. In this study the nutritional status, energy and nutrients intake of young female students living on and off campus were investigated. Methods: In this descriptive-analytical study nutritional status of 82 on-campus female students and 74 off-campus ones (Age range=18-24) were assessed and compared using anthropometrics measurements and three-day dietary records method including one day off. Nutritional values were analyzed using FP2 computer program and statistical analyses were carried out by EPI6.Results: The findings indicated no significant difference between the daily average energy intake of on-campus and off-campus students (2247 24) and (2192 21 kcal respectively). Energy intake of on-campus students from carbohydrates was significantly higher than that of off-campus students, whilst energy intake from protein and fat was significantly lower (p<0.001). 34.2% of on-campus students and 58.1% of off-campus ones received more than 30% of their energy from fat. Besides, 85.4% of on-campus students and 44.6% of off-campus ones received less than 15gr of fiber every day. Results also indicated that mean intake of, calcium, magnesium, vitamins A, C and folacin for on-campus students was significantly lower than off-campus students (p<0.001). Conclusions: The findings indicated that in both groups the intake of some essential micronutrients was lower than recommended levels. However, in general the nutritional status of off-campus students was better than on-campus ones. On the basis of these results the improvement of university food service programs would be beneficial.

Background & Objective: Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status. Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1st, 5th, 10th and 15th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA. Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1st minute Propofol was 7.1 ±2.2 and Thiopental was 74 ±1.8, in the 5th minute Propofol was 9.2 ±0.7 and Thiopental was 9.1 ±0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups. Conclusions: Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.

Background & Objective: Most of the acute poisonings are mild with no complication but in some rare cases they can be life threatening. About 70% of acute poisoning happens in children. More than 90% of these toxic exposures are incidental and easily preventable. The factors leading to acute poisoning are variable based on cultural and socioeconomic differences among the population. The increasing production and distribution of new drugs and chemicals change the etiologic factors. This study was conducted to investigate common acute poisonings and their victims in Tabriz.Methods: In this retrospective study 306 cases of acute poisoning were reviewed from April 1999 to March 2002, in Tabriz Pediatric Medical Center. The factors that were considered included: age, gender, manner (incidental versus intentional), agents route of intoxication, residential area (rural versus urban), duration of admission, clinical presentation, date of first admission and mortality.Results: 306 patients (53.3% male and 46.7% female) were studied in this research. Most of the cases (31%) were 1-2 years old, and the fewest (1.3%) were under 6 months of age. About 95% of the cases were incidental, and 5% intentional suicide attempts among children above 10 years of age. 63% of the subjects were living in Tabriz, 29.5% of them were from rural areas and the rest (7.5%) were dwelling small towns. Poisons in the order of prevalence included: drugs (45.5%), hydrocarbons (26%), organo phosphates (7%), atropinic material and datura intoxication (6%), Rodenticides (3.6%), Opiates (2.9%), Carbon monoxide (2.2%) and alcohol, mushrooms, animal bites, acids & alkalines (6.8%). Average duration of hospitalization was 2 days and the total mortality rate was 3 cases.Conclusions: The most common etiologic factor was drug poisoning followed by hydrocarbons as the second most prevalent factor in this regard. It seems that mass media especially TV programs can play a key role to increase the public knowledge about this issue.