فصلنامه علوم پزشکی دانشگاه آزاد اسلامی
سال چهاردهم شماره 3 (پیاپی 37، پاییز 1383)

Hypoglycemia is an important cause of morbidity in neonates of diabetic mothers. The present study compared the serum glucose level and incidence of hypoglycemia in neonates of diabetic mothers following general and regional(spinal)anesthesia (GA and SA) for cesarean section. The purpose of this study was to show the role and association between anesthesia techniques with incidence of hypoglycemia in these neonates. Subjects of the study were 22 well-controlled diabetic parturient patients that 50% of them received G.A and 50% SA for cesarean section. Serum glucose were measured for all their neonates during 1-3rd and 3-24th hour of life. Post partum neonatal hypoglycemia developed in 2(16.7%) of GA group compared with 7(63.6%)of SA group. There was a significant association (p < 0.05) between the incidence of neonatal hypoglycemia and anesthesia techniques. On the basis of this study we consist on close observation for neonates of diabetic mothers after spinal anesthesia for cesarean section.But we cannot consist on the technique of anesthesia in these patients.

Hepatitis B is a wideworld Disease. There are 2.5%HbsAg positive people in Iran HBV causes chronic hepatitis, fulminant hepatitis, chronic cirrhosis and hepatocelluar carcinoma in adults and children. HBV can be transmitted perinataly and parenteraly but immunization of newborn and health workers with HBV vaccine markedly reduces risk of disease. This research was done for evaluation of immunogenicity and time of immunity of HBVvaccine with HBsAb measurment after vaccination, and also evaluation of correlation between HBV vaccine immunity with age, sex, smoking, chronic disease, immune deficiency, profession, site of work, time of vaccination, numbers of vaccinations, and site of vaccine injection. This is a descriptive cross- sectional study. 304 health workers in Amiralmomenin hospital were evaluated for HbsAb titer.23 were not vaccinated, 281 were vaccinated in the past. 139 (49.5% were women)142(50.5% men)110(39.1%) single,171(60-9%)married, 45 (16% were smoker.) There was no correclation between immunity level and sex,age,chronic disease,but there was correlation between immunity level and job, smoking, time of vaccination,number of vaccinations and site of work. In this study average time of immunity was 6 years, 40 (14.2%)were not responder, 57(20.3%)were poor responder, and 154(65.5%)were good responder. HBV vaccine immunogenicity was 85.5%. Health work is a risk factor for hepatitis B infection, and HBV vaccine has85.5% immunogenicity,Therefore health workers need to be vaccinated for HBV, and every 6-years their HbsAb must be measured, if HbsAb titer is less than 10 mIU/ml, booster dose of HBV vaccine is used.

Pelvic abcess is one of the most dangerous & distressfull gynecologic disorders, that causes controversy among authors for treatment methods. This comparative study was performed in the aim of evaluation af laparoscopy & laparotomy methods in the T.O.A. (tubo- ovarian-abcess) Meterial & This was a prospective controlled new method evaluation study, that porformed on patients who needed surgery for treatment of T.O.A. during 8 years since 1995 till 2002 at Rasoul Akram Hospital. In this study 22 women underwent surgery. Surgical method selected on the basis of patients age, symptoms, signs & findingss during therapy. It was no difference between two groups from the standpoint of antibiotictherapy. In laparoscopy group mean duration of addmission was 2 days shorter than laparatomy group. 80% of genital organs preserved in laparoscopy group. chronic pelvic pain Persisted 2 years after operation in 39% of patients of laparotomy group and only in 27% of patients in laparoscopy group. From prsent & other studies we can conclude that laparoscopy for the treatment of T.O.A. specially in younger patients is a very good choice & perhaps it will be the standard method of surgery for preserving of fertility abilities in these patients at the near future.

Importance of mothers general knowledge on proper nutrition facts to prevent nutritional problems, and the aftermath effects on infant growth, have stimulated us to carryout this study. In fact, the objective of this research was to evaluate the basis of general knowledge of number of mothers on the manner of proper nutrition of infants in Iran. For this purpose, 300 mothers aged 18-40, have been evaluated by the “Simple Random Sampling”, method. They filled the questionnaires and participated in a, , face to face,, interview. After scoring the questionnaire, the results have been statistically analyzed.The measuring variables in this research included, general knowledge of proper nutrition of infants, age, level of education, home address and amount of income of the mothers. After statistical analysis of the data,some meaningful relations have been obtained between the above variables and the level of education of the mothers. It was found that 12% of the mothers had poor, 25% good,and 63% excellent knowledge on the nutrition of infants. Although, it seemed that the general knowledge of the mothers could be more or less accepted, but they ought to be more informed and educated in the related areas.

Measuring of hemoglobin A1c(HbA1c)as the main glycated hemoglobin in circulation, is the most reliable method for evaluation of hyperglycemia control in diabetic patients. Colorimetric measuring method for HbA1c is based on releasing glucose in 100°C as5-hydroxymethylfurfural(5HMF)and then measuring it in a colorimetric reaction with thiobarbituric acid (TBA).This method is affected by different variables. This study shows that TBA solution is stable at 4°c at least for one month. But by reducing the time of boiling from 5 hours to 1 hour, color intensity would decrease as much as 42%. On the other hand, reducing the time and temperature of colorimetric reaction from 40 to 15 minutes and 50 ° C to 25° C would result in 29% and 63% reduction in color intensity, respectively. In addition, developed color is unstable at room temprature and would decerase as much as 53% within 40 minutes. With the colorimetric measurment of HbA1c, it is recommended to use 5 hours boiling, colorimetric reaction in 50 ° C for 40 minutes,and rapid reading of optical density.

Because of the possibility of disturbances in ventilation and oxygenation in patients under tracheostomy and need for anesthesia in most of them, the anesthesiologists are consulted and almost all of tracheostomies are done in operation room. This study compares two anesthesia techniques and their complications and outcomes: general anesthesia and local anesthesia. With a prospective and randomized study, the techniques of anesthesia in tracheostomizeSd patients studied in Rasool hospital during Two years and they were compared acording to age, sex, disease,cause of tracheostomy, anesthesia technique, complication and outcomes. From 126 patients that were tracheostomatized, in 52% it was due to airway obstruction (neoplasm 23%), 40% were operated due to hypoventilation and need to prolonged intubation and 8% due to paranchimal disease. 50% of patients were operated under general anesthesia, 47% under local anesthesia with IV sedation and 3% under local anesthesia alone. There was no difference between two anesthesia technique for tracheostomy in their complication and outcomes and more important factors were: age,underlying disease, emergency situation,anesthesiologist and surgeon experience.

Learning is a continuous process including relatively permanent changes in individual potential behavior and it eclipses a widespread spectrum of individual behaviors and reactions. Studying of influential factors on learning, and enpower learning strategies are, Very important. acording to theoretical studies about influential factors on learning, a researcher devised questionnaire was compiled and carried out on students, then the experimental data were statistically analyzed.This study was descriptive type.and was done on 200 person for the purpose of present study randun sampling was used. Regarding the analysis of the data we found that learning is influenced by different factors such as learning strategies studying habits and motivation. The average number of studying hour among students was 3hour and 15 minute and 6 hours of sleeping per night.Also, 63% of students did non have learning activities, 50% of them meet a regular schedule. 94% of students were interested in their majors. Learning strategies study habits and motivation are, important, among the factors that influence learning and the level of effectiveness of each factor differs regarding sex, average and learnings field. In other word the parameters such as sex,average of grades,course of study are the independent parameters which influence the learning capability which is a dependent parameter.There fore the answerof cases mentioned above are different& the difference is statistically significant with p<0.01 & 0.05.

This study was performed for evaluation of accuracy of fetal weight estimation by clinical & ultrasonographic methods in Iranian population. Meterial & This prospective study was conducted on two hundred preg. nant mothers that reffered to obstetric department during years 1378 & 1379. Our study showed that there was statistically significant difference between clinical estimate of fetal weight and actual birth weight، as well as between ultrasound estimation and actual birth weight. The mean error of clinical estimation was 101g، or 32g/kg، for a 3. 2% error. The error of ultrasound in the same population was 141g، or 45g/kg، for a 4. 5% error. Analysis of these data revealed statistically significant difference between the mean error of clinical estimation and ultrasound estimation of fetal weight. Our study indicates that the mean clinical estimate of fetal weight is more accurate than ultrasound for the estimation of fetal weight in our population. This has important implications for developoing countries where، there is a lack of technologically advanced ultrasound machines capable of performing sophisticated functions like fetal weight estimation.