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.

  Background & Objectives : Smoking is one of the major problems in the world today. It threatens people ’ s health. Pregnant women are no exception in this regard. Today, it is found that smoker women bear low birth weight babies, but the studies don ’ t offer clear findings about passive smoking in pregnancy and its effect on weight and height of newborns. This study is an attempt to determine the effects of passive smoking on the weight and height of the newborn babies.

  M ethods : This was a retrospective cohort study. We studied 100 pregnant mothers who were exposed to cigarette smoke and 100 others who were not. A checklist was completed in order to select those who could enter the study. A questionnaire was then filled out for both groups including the information related to the newborns ’ physical specifications.

  Results: This study showed that the average age of the mothers, their education, their husband ’ s education, number of pregnancies and the sex of babies born weren ’ t meaningfully different between the two groups. In the case group the mothers were exposed to cigarette smoke for 2.36 ± 2.28 hours on average and most of them (72%) were exposed to their husbands ’ cigarette smoke. The findings also indicated that difference in weight, height and head circumference among two groups ’ newborns were 11 grams, 0.15 cm and 0.02 cm respectively. The T-test indicated no significant difference between the two groups.

  Conclusion: The study showed that the newborns ’ of mothers exposed to the smoke had lower weigh, height and head circumference than the babies ’ of the control group subjects although the difference was not statistically significant.

 Background & Objectives: Demographic and environmental factors are effective in the pathogenesis and prevention of Parkinson Disease (PD). Sex, family history of PD, farming, literacy, history of head trauma, smoking, well water consumption, overusing oil seeds and contact with herbicides and pesticides are apparently effective in this regard. This study set out to investigate the risk factors of PD.

 Methods: 100 patients with PD and 200 age matched controls refering to Neurology clinic of Birjand UMS were investigated in this case-control study during 2002-2003. PD was diagnosed by a neurologist and the demographic and environmental factors were recorded in a questionnaire. Student T and Chi-Squire tests were used for statistical analysis.

 Results: 68% of the cases and 53% of the controls were male. Family history of PD, farming, literacy, stress and well-water consumption were significantly more frequent in PD group(p<0.05). Smoking and overusing oil seeds were more frequent in control group (p=0.007, p=0.001 respectively). Frequency rate of contact with herbicides, pesticides and history of head trauma were not significantly different in case and control groups. Conclusion: Family history of PD, farming, literacy, stress and well-water consumption are risk factors of PD, while smoking and using oil seeds could be protective factors against PD.

 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.

 Background & Objectives: Unintended pregnancy is a worldwide problem. Despite abundant efforts by lranian family planning authorities during the last decade, unintended pregnancy and its consequences such as infected abortions is still a common problem. The aim of this descriptive study was to examine the causes of unintended pregnancy in Kosar Hospital, Urmia.

  M e thods : In this descriptive-analytical study the data were collected from 330 unintendedly pregnant women (out of 1830 pegnant women) visiting gynecology unit at Koshar Hospital in Urmia in 1999. These subjects were interviewed to fill out a questionnaire. Statistical analyses were performed with SPSS using t-test and Chi-square.

 Results: 83.6% of the cases were illiterate and 96.36% were housewives. 59.69% of the cases were above 30 79.09% had 3 or more children. The subjects used the following prophylaxy.

 Methods: thads. Pills (40%), withdrawal (25.5%), IUD (10%), injection (6.4%), minipills (4.5%), condom (3.6%) breast feeding (2.7%), rhythmic (0.9%) and tubectomy (0.6%). The remaining 5.8% had not used any prevention methods. We found a significant correlation between aging and number of unwanted pregnancies (P<0.0001 r = 0.44) and a negative meaningful correlation between literacy and rate of pregnancy (P<0.0001 r = 0.39). Reasons for failure were irregular use of pills, minipills or condom (90% each), unfamiliarity with prevention affter forgetting to take the pill (0.77%), IUD extraction, interrupted use of DMPA method and incorrect use of breast feeding method.

 Conclusion: This study reveals that desptie available prevention methods, due to lack of knowledge irregular use and misconceptions about complications of prevention methods, the subjects used unreliable methods which are more likely to lead to failure. Therefore, new measures should be taken in family planning centers to increase awareness among women concerning risk of unitended pregnancy.

 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.