Effect of a participatory intervention to reduce the number of unnecessary cesarean sections performed in Shahrekord, Iran

چکیده: زمینه و هدف: در سال های اخیر در کل جهان و از جمله ایران روند رو به رشد سزارین به چشم می خورد. در شهرکرد در سال 1380 سزارین 49 زایمان ها را به خود اختصاص داده است. در دنیا رویکرد جدیدی جهت کمک گرفتن از نیروهای مردمی در حل مشکلات سلامتی بوجود آمده است. در این تحقیق نقش مشارکت گروههای مردمی در کاهش میزان سزارین مورد بررسی قرار گرفته است. روش بررسی: در یک مطالعه میدانی (فیلد تریال) 171 زن باردار که سابقه قبلی سزارین نداشتند و کمتر از 3 بار زایمان داشته اند از زنان باردار به صورت تصادفی انتخاب شدند. ساختار یک گروه مردمی متشکل از پزشکان، ماماها، پرستاران علاقمند، زنان خانه دار، معلمین، رابطین بهداشتی، پرسنل بهداشت خانواده، خانم های فروشنده و نمایندگانی از سازمان های غیر دولتی فعال شهر شکل گرفت. این گروه، زنان باردار انتخاب شده را از طریق آموزش ترغیب به انجام زایمان طبیعی نمود. رضایت زنان باردار از آموزش ها و فراوانی سزارین قبل و بعد از مداخلات جمع آوری و با استفاده از آزمون های آماری t زوجی و مک نمار تجزیه و تحلیل گردید. یافته ها: در این مطالعه 70 زنان باردار از آموزش های ارائه شده راضی بودندو فراوانی سزارین از63 قبل از اجرای طرح به 52 بعد از انجام مداخلات کاهش داشت (05/0

Comparing the Combined Effect of Garlic and Mint Extract with Metronidazole in Helicobacter Pylori Treatment: Garlic and Mint in Helicobacter Pylori Treatment

Helicobacter pylori infection is one of the most common human infections which have been associated with many upper gasterointestinal complications. Different treatment regimens for Helicobacter pylori eradication have been used. One of these regimes is the quadruple therapy regimen which metronidazole is one of the medications. In recent years several reports on H. pylori resistance to this antibiotic has been presented. This study was performed to compare the effects of garlic and peppermint extract combination with metronidazole in the treatment of Helicobacter pylori infection. In this randomized double blind clinical trial, 142 patients who were eligible for inclusion in study after completing the questionnaire and consent form were randomly divided into two groups, receiving garlic and peppermint extract or metronidazole. Moreover, for both groups the drugs; amoxicillin, omeprazole and bismuth were also administrated. Two weeks after drug administration completion, urease breath test (UBT) was performed and based on the obtained data, the recovery rate in the two groups were compare using SPSS 16 software T-test and Ki squire. The patients mean age was 43.89± 13.37 years. Evaluating the age and sex factors, we found no significant difference between two groups. Results suggest that although the combination of amoxicillin, omeprazole, bismuth plus garlic and peppermint was not successful in the eradication of Helicobacter pylori such as the quadruple therapy, but less than half of cases lead to eradication of Helicobacter pylori infection

Diagnosis of Pulmonary Tuberculosis by measurement of ADA, CEA and PCR in Bronchoalveolar lavage and compare with smear and culture of BK in the patient with pulmonary infiltration

Background: Pulmonary tuberculosis ( TB) is one of the problems in diagnosis and management of patients with pneumonia and pleural effusion. Bronchoscopy and bronchoalveolar lavage (BAL) can help us in the differential diagnosis. Tumor markers are substances that are produced by cancer or other cells of the body in response to diseases. These substances can be found in the blood, urine, or body fluids, for example in bronchoalveolar lavage of some patients with pulmonary diseases. CEA is a tumor marker that can help us for diagnosis and monitoring of peripheral lung cancer. ADA has been shown to rise in the BAL of patients with TB. Because the sputum smear negative TB patients have been a diagnostic challenge for health professionals this study was designed to determine the diagnostic value of ADA & CEA & PCR in BAL fluid and then compare the relationship of these markers with sputum and clinical finding in diagnosis of pulmonary tuberculosis. Material and Method: A cross sectional study conducted in Shahrekord Hajar hospital where 100 patients were enrolled in our study (62 females, 38 males). These patients were admitted to hospital and bronchoscopy with BAL was performed, then fluid was analysed for ADA, CEA, PCR and sputum smear for TB. Result: From 100 patients who were evaluated in this study 9 patients had TB, 39 patients had pneumonia, 11 patients had primary lung malignancy, 9 patients had metastases to lung and 8 patients had bronchitis. In Patients with TB the level of ADA was not significantly elevated in BAL. ADA increased significantly in patients with pneumonia (P: 0/95). In patients with metastases to lung and primary lung cancer and a combination of both groups compared to other patients without malignancy there was no relationship between CEA. PCR was positive in TB and other patients, but significantly increased in TB. (p=0/021) Discussion: Although it was thought that CEA may be elevated in BAL of patients with malignancy and ADA in tuberculosis we did not find a correlation in these patients. This study showed that ADA and CEA levels in BAL fluid does not help us in diagnosis of TB or cancer. It may have afalse positive in pneumonia, COPD and other diseases, but PCR for TB may assist in TB diagnosis but not alone