Effect of fasting on prenatal care in Shahrekord

با توجه به اینکه مطالعات گذشته در باره اثرات روزه داری بر پارامترهایی که به عنوان مراقبت های دوران بارداری که غیر مستقیم سلامت جنین و مادر را بررسی می کند در ماه مبارک رمضان نتایج متفاوتی را نشان می دهند، این مطالعه برای بررسی تغییرات مراقبت های دوران بارداری که شاخصی از سلامت مادر و جنین است در روزه داران باردار انجام شد. طی یک مطالعه کوهورت از بیست مرکز بهداشتی درمانی شهرستان شهرکرد با روش نمونه گیری آسان تعداد 623 نفر خانم حامله وارد مطالعه شدند. از هر نفر در سه نوبت یک هفته قبل از آغاز مطالعه در صبح و روزهای 14 و 28 ماه رمضان یک ساعت قبل از اذان مغرب نمونه گیری ادرار انجام شد و مراقبت های دوران بارداری شامل اندازه گیری فشار خون، قد، وزن، اندازه ارتفاع رحم، سمع قلب جنین و احساس حرکت جنین توسط مادر انجام شد. طول مدت ناشتائی 5/. ±5/11 ساعت در شبانه روز بود. از این تعداد، 466 نفر در نیمه اول ماه رمضان روزه نگرفتند و 152 نفر حداقل 7 روز، روزه گرفته بودند و در آخر ماه رمضان تعداد 130 نفر حداقل 15 روز به روزه گرفتن مبادرت کرده اند و 488 نفر بقیه روزه نگرفته بودند. 55 کل افراد در ترایمستر سوم حاملگی و 26 در ترایمستر دوم و 19 در ترایمستر اول قرار داشتند. گروه روزه بگیر باردار با گروه غیر روزه باردار از نظر پارامترهای تغییرات فشار خون سیستولیک و دیاستولیک، شاخص توده بدنی، افزایش ارتفاع رحم، سمع قلب جنین، احساس حرکت جنین توسط مادر و کتون ادرار با هم مقایسه شده اند. بین میانگین فشار خون سیستولیک و دیاستولیک در افراد روزه گیر و غیر روزه نسبت به فشار خون پایه (قبل از ماه رمضان) در دو نوبت وسط ماه رمضان و آخر ماه رمضان اختلاف معنی دار آماری وجود نداشت. همچنین بین میانگین مقادیر افزایش شاخص توده بدنی در وسط و آخر ماه رمضان افراد روزه گیر و غیر روزه گیر نسبت به شاخص توده بدنی پایه تفاوت معنی داری مشاهده نشد. حس حرکت جنین و سمع قلب جنین همه مادران باردار روزه دار و غیر روزه در قبل از ماه رمضان 5/45 و در آخر ماه رمضان 6/75 بود که افزایش آن به دلیل افزایش سن حاملگی است. موارد کتون مثبت ادرار افراد باردار روزه گیر در وسط و آخر ماه رمضان نسبت به باردار غیر روزه بیشتر بود. بین میانگین افزایش اندازه ارتفاع در وسط ماه و آخر ماه اختلاف آماری معنی داری بین دو گروه وجود نداشت و متوسط افزایش اندازه ارتفاع رحم حامله ها در ترایمستر دوم و سوم حاملگی در آخر ماه رمضان3/0±5/3 سانتی متر بود. نتایج حاصله از این مطالعه نشان می دهد که روزه داری زنان باردار بر روی پارامترهای ارزیابی شده در دو گروه مورد و شاهد تفاوت معنی داری مشاهده نشد، لذا به نظر نمی رسد روزه داری برای مادران باردار مشکل ایجاد کند به شرطی که آنها تحت مراقبت های دوران بارداری قرار بگیرند

Changes of blood sugar and total calcium in hyperbilirubinemic neonates after exchange transfusion

Exchange transfusion is a therapeutic method for immediate treatment of hyperbillirubinemia to prevent kernicterus, but it has some complications including hypoglycemia and hypocalcemia. This study was performed to find the changes of blood sugar and calcium after blood exchange and their possible correlation with weight, blood incompatibility and bilirubin decrease rate. Thirty-six neonates with blood exchange were evaluated over a period of 6 months. Blood samples were collected from umbilical vein catheter, before and 6 hours after the exchange transfusion, and their total calcium, bilirubin and blood sugar were measured. Following every 100 ml of blood exchange, 1 ml of calcium gluconate (10%) was infused slowly. Our results showed that, 6 hours after exchange transfusion, the total calcium level was decreased. There was no significant correlation between calcium decrement and weight. Also, no significant correlation was found between blood incompatibility and bilirubin decrement. There was no significant alteration of blood sugar 6 hours after exchange transfusion. We recommend using of calcium gluconate during exchange transfusion and serial measurement of calcium level until its level is stable

Investigation of cancers incidence relevant to radiation in Chaharmahal and Bakhtiari province during five years (1998-2002

زمینه و هدف: پرتوهای یونیزان با دوزهای پایین (پرتوهای زمینه طبیعی) یکی از عوامل شیوع برخی از سرطان ها می باشد. در کشورهای در حال توسعه مثل ایران، 94 پرتوگیری انسان از منابع طبیعی پرتو می باشد. در نواحی مرتفع همانند استان چهارمحال و بختیاری که دارای سطح اشعه زمینه طبیعی بالا (بالاتر از میانگین جهانی) می باشد، بررسی میزان شیوع سرطان های مرتبط با اشعه حائز اهمیت است که هدف این تحقیق می باشد. مواد و روشها: در این مطالعه تعداد 751 مورد بیمار مبتلاء به سرطان در مدت 5 سال (81-1377) که برابر با معیارهای ICD10 لفظ بدخیم به آنها اطلاق می شد و در این استان به ثبت رسیده بودند، مورد بررسی قرار گرفتند. از این تعداد، 362 بیمار که مبتلاء به سرطان های پوست، پستان، ریه، تیروئید و لوسمی بودند، انتخاب شدند. اطلاعاتی نظیر جنس، سن و دیگر اطلاعات لازم از مرکز بهداشت و بخش های پاتولوژی بیمارستان های استان جمع آوری گردید و داده ها توسط آزمون آماری Chi-square مورد تجزیه و تحلیل قرار گرفت. نتایج: در نتیجه این بررسی، شیوع سرطان های پوست، پستان، تیروئید، ریه و لوسمی نسبت به کل سرطان های ثبت شده به ترتیب 5/20، 5/7، 6/2، 1/1 و 2/16 تعیین گردید. از کل موارد بررسی شده 3/48 موارد مرد و 7/51 موارد زن بودند. ارتباط آماری معنی داری بین جنس و نوع سرطان ها وجود داشت (05/0

A report about a case of Gestational trophoblastic tumor associated with ectopic pregnancy

مقدمه: تومور تروفوبلاستیک حاملگیGTT)) متعاقب حاملگی خارج رحمی یک رویداد بسیار نادر است. در این مقاله یک مورد مول مهاجم که از یک حاملگی خارج رحمی لوله‌ای نشأت گرفته بود معرفی می‌شود. گزارش مورد: بیمار خانم 26 ساله با حاملگی دوم و اولین حاملگی خارج رحمی (G2L1EP1) بود که به خاطر افزایش میزان هورمون گنادوتروپین جفتی((BHCG بعد از عمل حاملگی خارج رحمی (EP) به بیمارستان شهید بهشتی اصفهان ارجاع شد. درمان اولیه EP بیمار با عمل سالپنژکتومی بوده است. پیگیری پاتولوژی سالپنژکتومی مول مهاجم تشخیص داده شد که بیمار تحت دو دوره درمان با متوترکسات قرار گرفت و با توجه به گزارش توده در آدنکس راست در سونوگرافی یک نوبت لاپاراتومی ‌شد که باز هم تشخیص مول مهاجم بود. بنابراین بیمار تحت رژیم درمانی (etoposide methotrexate actinomycin D cyclophosphamide vincristine) EMA/CO قرار گرفت و نهایتاً با BHCG معادل 1 مرخص شد. نتیجه گیری: پیگیری عدد BHCG بعد از عمل جراحی EP هم برای تشخیص EP پا برجا و هم برای رد GTT بسیار مهم است هم چنین پیگیری جواب پاتولوژی اعمال جراحی در صورتی که از تشخیص نیز مطمئن هستیم ضرورت دارد

Age of Menarche and Its Related Factors in School Girls of Shahrekord

Abstract Background: Considering different effective factors in age of menarche in different geographical areas and the necessity of determining a reliable and upto-date reference in this field, the aim of this study was to determine the mean age of menarche in 11-18 years old school-girls of Shahrekord. Methods: This was a descriptive cross-sectional study among 778 school girls aged 11-18 years of Shahrekord which were selected by clustering method among 8163 students. Data was collected using a questionnaire about demographic ..

Can we rely on public data as a source of information for cancer registry in developing countries?

Background/aims: Although a "hospital-based cancer registry" is important in improving patient care, a "population-based cancer registry" with emphasis on epidemiology is important in allocating health care resources and prioritizing public health programs. Because of its reliance on retrieved clinical and para-clinical documents, there is some limitation in registering all cancer incidents in this system, especially in developing countries. In this study we examined the possibility of using public data as a complementary source of information for recording cancers in a population-based cancer registry. Methods: Along with the annual census in rural areas, a survey was performed in Golestan province in March 2004 to identify public awareness about cancer incidents in the community. Individuals were questioned about history of cancer in their close relatives during the last two years. Those who reported cancer in their relatives were also asked to name the main organ of involvement. A similar list was retrieved from the cancer registry at the Ministry of Health in Gorgan, and cases with upper GI (esophagus and gastric) cancer diagnosis from 21 March 2002 through 20 March 2004 were selected for this study. Finally, these two lists were compared for examining accuracy of the collected data. Results: We included 137 cases in our study with rural residence and known addresses. Only 35 (25.5%) cases were reported by the relatives and among them only 20 (57.1%) relatives correctly reported the tumor location. Although we found a difference in accurate reporting of cancer incidents by year of diagnosis (more correct cases reported during the second versus the first year), the difference was not statistically significant between the two years. Conclusion: In this study, we examined the possibility of using public awareness about cancer incidents as a complementary source of information for a population-based cancer registry. We found that this approach is not ideal for reducing limitations. Therefore, we recommend a nationwide cancer registry to record all cancer-related information at the time of diagnosis. This strategy will reduce the need for performing retrospective surveys in collecting cancer-related information

A New Wideband Circularly Polarized Dielectric Resonator Antenna

A wideband and compact circularly polarized (CP) C-shaped dielectric resonator antenna (DRA) is presented. The proposed C-shaped DR is excited by a simple stripe line connected to a coplanar waveguide (CPW) feeding line. The C-shaped DRA is circularly polarized with 19% axial ratio (AR) bandwidth. It is found that the CP bandwidth can be expanded by using a narrow short circuit strip. The final design achieves CP with 50% AR bandwidth. The proposed circularly polarized DRA (CPDRA) with good radiation characteristics offers an impedance bandwidth of 58% between 3.45 and 6.26 GHz for VSWR ≤ 2. The proposed DRA is fabricated and tested. Very good agreement between simulated and measured results is obtained

Hepatitis B/C virus co-infection in Iran: A seroepidemiological study

Background/aims: As hepatitis B and C virus have the same transmission routes, dual infection may occur. The aim of this study was to determine the seroprevalence of HCV in HBsAg-positive subjects. Methods: 139 HBsAg-positive subjects were enrolled in the study. Serum samples were tested using ELISA method for anti-HCV antibodies. Chi-square and Fisher's exact tests were used to compare the proportions. Results: There were 68 (48.9%) males and 71 (51.1%) females. The mean age was 41.89±11.30 years. One case was excluded because of inadequate blood sampling. Anti-HCV antibody was positive in 17 (12.3%) of the 138 remaining subjects. Seropositivity of HCV was similar between female and male patients (p=0.69). Conclusion: The seroprevalence of co-infection with hepatitis B virus and hepatitis C virus in our study was higher than such reports from some countries (Italy), but was in line with worldwide prevalence (>10%)

Long-term interleukin-6 levels and subsequent risk of coronary heart disease: Two new prospective studies and a systematic review

Background The relevance to coronary heart disease (CHD) of cytokines that govern inflammatory cascades, such as interleukin-6 (IL-6), may be underestimated because such mediators are short acting and prone to fluctuations. We evaluated associations of long-term circulating IL-6 levels with CHD risk (defined as nonfatal myocardial infarction [MI] or fatal CHD) in two population-based cohorts, involving serial measurements to enable correction for within-person variability. We updated a systematic review to put the new findings in context. Methods and Findings Measurements were made in samples obtained at baseline from 2,138 patients who had a first-ever nonfatal MI or died of CHD during follow-up, and from 4,267 controls in two cohorts comprising 24,230 participants. Correction for within-person variability was made using data from repeat measurements taken several years apart in several hundred participants. The year-to-year variability of IL-6 values within individuals was relatively high (regression dilution ratios of 0.41, 95% confidence interval [CI] 0.28-0.53, over 4 y, and 0.35, 95% CI 0.23-0.48, over 12 y). Ignoring this variability, we found an odds ratio for CHD, adjusted for several established risk factors, of 1.46 (95% CI 1.29-1.65) per 2 standard deviation (SD) increase of baseline IL-6 values, similar to that for baseline C-reactive protein. After correction for within-person variability, the odds ratio for CHD was 2.14 (95% CI 1.45-3.15) with long-term average ("usual'') IL-6, similar to those for some established risk factors. Increasing IL-6 levels were associated with progressively increasing CHD risk. An updated systematic review of electronic databases and other sources identified 15 relevant previous population-based prospective studies of IL-6 and clinical coronary outcomes (i.e., MI or coronary death). Including the two current studies, the 17 available prospective studies gave a combined odds ratio of 1.61 (95% CI 1.42-1.83) per 2 SD increase in baseline IL-6 (corresponding to an odds ratio of 3.34 [95% CI 2.45-4.56] per 2 SD increase in usual [long-term average] IL-6 levels). Conclusions Long-term IL-6 levels are associated with CHD risk about as strongly as are some major established risk factors, but causality remains uncertain. These findings highlight the potential relevance of IL-6-mediated pathways to CH

Self-burning: A common and tragic way of suicide in fars province, Iran

Self-burning is the most devastating burn injury. It is a common social and medical problem in Iran. In a longitudinal prospective study, from April 2003 to March 2006, all burn patients admitted to Ghotb-eddin burn Hospital were enrolled in this study. Suicide attempts by burning accounted for 283 (21.9%) of all burn patients admitted to the hospital. Most (68.2%) of self-burning patients were female. Self-burn patients had significantly large burned body surface area (64.8±29%). Suicidal burns occurred predominantly in the age group 15-24 years (44.6%). The mortality rate for suicidal burns was (60.4%). Fars is a province composed of many different tribes and cultural minorities whereby major decisions are made by forums of clergymen. It is important to involve those clergymen in burn prevention programs to achieve a meaningful reduction in Self-burning prevalence