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Afshar Tamook, Nayereh Aminisani , Joubin Mogadam Yeganeh , Afrooz Mardi,
Volume 3, Issue 2 (Summer 2003)
Background & Objective : When a cesarean is necessary, it can be a life-saving technique for both mother and infant. In recent twenty years, the cesarean childbirth rate has increased dramatically. Moreover a cesarean costs nearly twice as much as a vaginal birth. The world Health organization states that a cesarean rate greater than 10-15% cannot be justified. The aim of this study was to determine the cesarean rates and its indications in social security hospital of Ardabil.
Methods: In this cross-sectional study was conducted all of the deliveries (both cesarean and normal delivery) in Ardabil social security hospital were investigated using a questionnaire including the characteristics of indication. The data were analyzed using SPSS software.
Results : 45.4% of the deliveries were done using cesarean and 54.6% of them with a normal procedure. 55.8% of all the cesareans had an accepted indication. 44.2% of cesareans were controversial or elective, 22.7% were repeated cesarean, 8.4% were breech presentation and 2.3% were golden baby and 10.8% of the cesareans did not have a clear indication.
Conclusions: The cesarean section rates in this study were higher than world rates. As a result the rising cesarean birth rate must be stopped and reversed with health interventions.
Afshar Tamook, Farhad Salehzadeh, Naiere Aminisani , Goubin Moghaddam Yeganeh,
Volume 5, Issue 4 (Winter 2005)
Background & Objectives: The incidence of neonatal hyperbilirubinemia disease is noticeable. Studying neonatal hyperbilirubinemia and its related factors is a step to reduce its incidence and remarkable treatment expenses. On the other hand, due to lack of on time recognition and suitable treatments, this disease can cause irreversible neuro-cerebral complications. This study was conducted to examine the etiology of neonatal hyperbilirubinemia and its associated signs, in order to provide on time and suitable treatment measures.
Methods: This cross-sectional study was performed in 2003 on neonates affected by neonatal hyperbilirubinemia in Ardabil Sabalan hospital. The data obtained from their conditions, clinical examination, and measurment of total and direct bilirubine was used to fill out a questionnaire. The data were analyzed by SPSS software (release 10).
Results: From among 132 neonates affected by neonatal hyperbilirubinemia, 50% were male and others were female. 85.6% of these subjects were fullterm births and the rest were premature. 56% of these neonates were born by C/S. 6.8% of hyperbilirubinemia cases, which were considered as “pathologic”, occurred during 24 hours after birth. 72% were related to the second to seventh days of birth, 17.2% to second week of birth, and the rest (4%) had prolonged Icter. 65% of these neonates were the first children of the family. The average time of hospitalization was 4.8 days. 34.8% of these neonates had pathologic signs beside hyperbilirubinemia and had a clinically serious condition. About 23% of these neonates were born by C/S and only 11.8% of them were vaginal births. 46 cases (34.8%) had accompaynig pathologic problems in addition to Icter, among whom 33 children (25%) had evident infection. The causes of hyperbilirubinemia were Crigler-Najjar syndrome in one case, ABO in 11 cases (8.33%) and RH discord in 4 cases (2.8%). Generally speaking the precise cause of 36.89% of Hyperbilirubinemia was determined.
Conclusion: Some factors such as children by C/S, neonatal infection, prematurity, ABO discords and RH discords play an important role in hyperbilirubinemia incidence and severity.
Afshar Tamook , Fereidoon Ashenaie, Joobin Yeganeh Moghadam , Mahdi Chiniforush , Nayereh Amini Sani, Shahram Habibzadeh ,
Volume 7, Issue 1 (spring 2007)
Background & Objective: Visceral leishmaniasis is a reticulo endothelia system and it is known as 'black fever' by Indians. According to WHO every year there are 500 thousand new cases of it in the world. The province of Ardabil, with 25-40% from all the country's leishmaniasis has a major part in the country and is considered as one of the main focuses in Iran. Due to its importance, this study was done to identify clinical signs and demographic characteristics of the patients.
Methods: This was a descriptive cross-sectional study which was done retrospectively 110 children who were hospitalized in three different active hospitals between 1375-1382 entered in this study. Disease definition include parasite detection in bone marrow aspivation or special clinical signs (fever, spleenomegal, pansytopenia and weight loss) in addition direct agglutination test was positive. The samples were investigated in terms of demographic information. Place of living, clinical signs and the length of time between the symptoms of the disease and its diagnosis. To get to the results, simple descriptive statistics was used. 37.8% of the patients were diagnosed from the beginning of symptoms with in a month.
Results: There were 56.4% boys and 43.6% girls of all the 110 children. DAT test was done in 97 patients which was positive in 91 cases (minimum positive titer 1/400). In 42 patients biopsy and bone marrow aspiration was done which was positive in 26 cases (lishman body detection). The age of the patients was 4 months -14 years. The most common findings were fever 97.3% and anorexia 97.1%. There was anemia in 90% thrombocytopenia in 60.8% and leukopenia in 24.8%. There was death in 6 patients (5.5%) and unresponsiveness to the treatment in 3 cases (2.7%).
Conclusion: The results of the present study nearly corresponds to those of other studies. The main vulnerable community of visceral lieshmaniasis are mainly children. In order to decrease the mortality and morbidity its early diagnosis is essential. It is necessary that the physicians working in endemic regions be familiar enough with the disease.