Background & Objective : Several studies have introduced different methods to facilitate the fetal expulsion. One of these methods is episiotomy during the second stage of labor followed by instant repair of episiotomy incision. Perineal repair, its different methods and the outcomes have long been a matter of discussion and research. This study was performed in order to compare results of two different methods of perineal repair, namely standard (three stage) and two-stage method (leaving the skin unsutured).

  Methods : This study is a randomized clinical trial in which, 80 mothers were selected continuously and divided randomly into the two stage and three stage repair groups. A scaled pain ruler, a questionnaire and information checklist were used to collect the data. The setting of this study was the labor room, the postpartum unit and subjects’ homes.

  Results : The finding of this study showed no significant difference between the outcomes of the two groups in terms of perineal pain in the first 4-6 hours, the 2nd day, 15th and 21st day, incision recovery on the 15th and 21st day, dyspareunia and the first postpartum pain-free intercourse.

  Conclusions : The findings of this research indicated that the results obtained from the two above-mentioned methods are not significantly different. However, since the two stage method requires spending less time and energy and reduces the time that mothers should stay in labor room, it is suggested to be used as one of the perineal repair methods.

  Background & Objective : Breast cancer is the most common type of cancer among women worldwide and accounts for the majority of their deaths due to the cancer. Hence, diagnosing its risk factors is of great importance. In this study the association between abortion and breast cancer risk was investigated.

  Methods : In this Case- Control study in Mashhad, 105 patients with confirmed breast cancer were compared with 105 healthy women who were living in their neighborhood and were the same age. A questionnaire including demographic information as well as same questions regarding the factors associated with conception and emphasising abortion were used to collect the data, which then were analyzed using SPSS ver 9.

  Results : the findings indicated a relationship between breast cancer and history of abortion, compared to women with no history of abortion (OR=2.09 95% CI=1.18- 3.69). Also there was a significant relationship between the frequency of abortion and breast cancer (P=0.008 ). but odds ratio was not higher among women whose age at first abortion was less than 20 years. Also abortion before first full- term pregnancy increased breast cancer risk (OR= 5.97 95% CI=1.18-19.6). But the age at the time of abortion did not have any effect on the breast cancer risk.

  Conclusions : The findings suggested that the risk of breast cancer has a positive relationship with frequency of abortion and the risk is even higher if the abortion occurs before the first full-term pregnancy. Thus, health interventions seem to be necessary in this regard.

 Background & Objective: Poster is a non-projector, visual, graphic and printed medium that is applied in various cases specially in health education. On the other hand, one of the health education experts task is evaluation of educational methods and media. Since few studies were performed on effectiveness of posters on knowledge of people, this study was designed to determine the percentage of people who looked at the posters in health centers and also to determine the level of knowledge attained from these posters located in different places of health centers.

 Methods: This was a semi-experimental study. The population was people who referred to Shahid Gannadi health center. Samples were selected by simple random method. The data were collected by a questionnaire. The posters were fixed in three places during three different stages and the collected data were analyzed.

 Results: The findings showed that from among these subjects, 18.8% in the first stage, 20.8% in the second stage and 61.2% in third stage observed the fixed posters. The probability of the poster to be seen near the doorway and examination room was equal (Odds Ratio=0.9) whereas the probability of the same posters to be seen in waiting hall was 7 times as much as the previously mentioned locations. The ANOVA indicated no significant difference between demographic variables (age, sex, marital status, ets) of study subjects and their knowledge scores.

 Conclusions: The study showed that People paid very little attention to fixed poster. Therefore, regarding the role of posters in increasing the knowledge level, several strategies should be employed to make people pay more attention to these posters. Following the accepted standards in preparation and fixation of posters and preparation of three dimensional boards for the posters in health care centers are suggested.

  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 & Objective: Postpartum depression is a problematic and important disease and if not recognized and treated on time, it can be aggravated or chronic. Exercise is strongly recommended in this regard to prevent any family disorders and improve the health of mother, child and family. The aim of this study was to determine the effect of exercise on mild postpartum depression among women referring to Ardabil health centers.

  Methods : This study was a double blind clinical trial. About 50 subjects with normal vaginal delivery were selected. The subjects had referred to health canters in the second week after delivery and were diagnosed to have mild depression using Beck depression test. They were randomly divided into two groups (exercise and non-exercise). Then Beck test was done 6 weeks after delivery again and the results were compared in two groups.

  Results : The findings indicated that between mildly depressed mothers, 36% were 26-30 years old, 82% were housekeeper, 44% had under diploma education, 60% had two previous deliveries. 56% of exercise group and 32% of non-exercise group were treated. 8% of experimental subjects and 18% of control ones needed psychological consultation 6 weeks after delivery. T-test showed significant differences between two groups (p<0.05).

  Conclusion : Results showed that exercise had a positive effect on the treatment of mild postpartum depression. As a result it is recommended strongly in postpartum care.

  Background & Objective : Inpatient information is the best source for researches, medical education, process of patient treatment and legal organizations. Moreover, correct, complete and ontime registration of this information can play a crucial role in the production of necessary data for these kinds of researches. Regarding the importance of the issue, in this study we evaluated the quality and quantity of these data in the hospitals under Ardabil University of Medical Sciences.

  Methods : In this research 370 rcords from eight hospitals of Ardabil were studied. In each hospital samples were selected randomly based on the number of patients hospitalized in one year. Then according to admission and discharge sheets a certain check list, was completed. The information under study including demography, admission and discharge, inter-hospital and inter-ward transfer, diagnosis, treatment, surgery, death of the patients and authentications (recorded or not) were identified in the check list. The data were analyzed using descriptive statistics.

  Results : The results showed that sex, marital status, date and place of birth had not been recorded in 5.9%, 15.7%, 2.4%, 51.6% of records respectively. Primary, interim and final diagnosis and treatment measures were not recorded about 28.1%, 41.1%, 39.2% 48% of the patients respectively. Although 13% of these patients were hospitalized due to accidents, impairments and poisoning, only in 8.5% of them the external causes were recorded. At 68.6% of the records, condition on discharge and at 76.3% of them recommendation on discharge had not been recorded. 3.5% of records related to dead patients, but only in 31%, main cause and in 8% underlying couse of death was record. 25% of the studied records were not coded. 13.7% of existing codes did not match the final diagnosis .At 52.4% of these records the correct method of writing diagnosis was not observed by physicians and at 36.5% coding had not been done carefully.

  Conclusions : The results indicated that the process of medical recording by health care services was performed deficiently and this leads to the loss of valuable information about the hospitalized patients. As a result, the authorities, physicians and specialists in medical recording should pay special attention to this problem. Physicians and specialitists of medical record to this problem were necessary.

  Background & Objectives: With respect to the importance of observing principles of documentation of medical records for educational, treatment, research, legal and statistical uses, the correct, complete and timely registration of this information can play a crucial role in the production of necessary data for these kinds of researches. This study was performed to investigate the process of documentation of medical records of the patients in hospitals under Ardabil university of medical sciences.

  Methods: In this research 370 medical records from eight hospitals under Ardabil university of medical sciences were studied. In each hospital samples were selected randomly based on the number of patients hospitalized in one year. Then according to admission and discharge sheets a certain checklist was completed. The information under study included dignosis, treatment, surgery, cause of the accident, patient condition on dircharge, postdischarge advice and cause of death (whether recorded or not) which were identified in the check list. The data were analyzed by SPSS using descriptive statistics.

  Results : The findings showed that primary, interim and final diagnosis and treatment measures were recorded 71.9%, 58.9% ,60.8% and 52% respectively in the records studied. Althougt 12.7% of these patients were hospitalized dueto accidents, damage and poisoning, only in 8.5% of them the external causes were recorded. In 68% of the records, condition on discharge and in 76.3% of them recommendation on discharge had not been recorded. 3.5% of the records were related to dead patients, but only in 31% of them the main cause and in 8% underlying cause of death was recorded. In general, in 5 2.4% of these records the correct methods of medical recording were not observed by physicians.

  Conclusion: The results indicated that the process of documentation of medical record by physicians as the main presenters of health care services was performed incompletely. This can lead to the loss of valuable information about the hospitalized patients. It can also have negative impacts on the course of therapy. As a result, the authorities, physicans and specialists in medical recording should pay special attention to this problem.

  Background & Objective: Depot-medroxyprogesterone acetate (DMPA) is an injectable contraceptive method that is widely used by 68 million women in over 114 countries and was reported Different medical and non medical reasons were reported for discontinuation of DMPA use. Due to little information about continuation rate and reasons for discontinuations of DMPA in this region and because of the different result of the research in other countries this study was designed. to evaluate the use of DMPA�including continuation rate and side effects.

  Methods: In this cross sectional retrospective study 396 DMPA user women referring to health care centers in Ardabil were selected through classified sampling. The data were collected by a questionnaire by interviewing the subjects and data were analyzed by SPSS software using analysis variance (ANOVA) and correlation and T-test.

  Results: The mean age of the study population was 32±7.8 years, 33.8% had primary education and the majority of the users were housewives (%95) and only20 (%5) were employed. 6, 9, 12 and 24 month cumulative continuation rate of DMPA were recorded as %44.5, %26.5, %18.2 and %2.3 respectively. The most common reason for discontinuation among all of groups was amenorrhea. The most common side effects were amenorrhea (%69.7), low back pain (%13.4), and weight gain (%13.4) and headache (%10.4). There was a significant corvelation belween education level and spouse's education level, spouse's job, family income, grariding, number of off spring, type of previous delivery and continuity of DMPA (p<0.05).

  Conclusion: The result of this study could help health authorities and care givers in term of correct counseling and follow up. This factor could result in more satisfaction and improve continuation rate of DMPA.

  Background & Objectives : Due to rapid population growth, many activities performed to find ways to prevent pregnancy around the world. Vasectomy is one of the most effective contraceptive methods but despite the benefits, it's using incidence is very low. It is important to involve men in order to population control. This study was aimed to describe the experiences of a group of men who had vasectomy and their sexual satisfaction after Vasectomy.

  Methods: A combination of qualitative and quantitative study (Triangulation method) was used on forty men who had been vasectomized in the city of Ardabil before 2006. The method the thematic oral history was used. Questionnaire about sexual satisfaction after vasectomy was prepared and completed by sample subjects (101 people). The results were analyzed by SPSS software.

  Results: The following three descriptive categories were developed from the men's experiences: influencing factors for doing vasectomy outcomes of vasectomy vasectomized men as advisers of the procedure for other men.

  Frequency of intercourses in 65.4%, sexual desire in 64.4%, sexual pleasure in 59.4%, duration of sexual intercourse in 66.3% and sexual ability in 68.3% of subjects did not change after sterilization.

  Conclusion: Family planning programmes must consider the clients sociocultural background. During explanations about vasectomy, the dissemination of the experiences of vasectomised men could improve the confidence and interest of the men to the method and may promote men’s involvement in reproductive health.

  Background & Objectives: Diarrhea is one the important causes of mortality among children in developing countries. The effect of zinc supplementation in reduction the rate of diarrhea is controversial. The aim of this study was to evaluate the effect of zinc supplementation on the severity and duration of diarrhea in children less than 5 years old hospitalized in Ali-Asghar hospital in Ardabil, 2005.

  Methods: This study was a double-blind, randomized, placebo-controlled trial including 228 children with acute diarrhea. The subjects randomly assigned into two placebo and experimental groups (114 patients in each group). The placebo group received glucose (5%), while the experimental group received 20 mg/day Zn sulfate. The severity and duration of diarrhea were assessed during the study. Data were analyzed using Chi-square, Pearson correlation coefficient tests and Students t-test by SPSS software.

  Results: Our findings showed that most of the patients in both groups were male (age range 1-12 months, weight range 3-11 kg, weight percentile 3-50). These children had breast feeding and complete vaccination. They were the first baby in their family and the majority of them were from urban area (Ardabil city). The severity of diarrhea in zinc supplemented children (74.6%) was less than placebo group (89.5 % ) (p=0.037). There was no significant difference between two groups in the duration of diarrhea (p=0.737). There also was no relationship between the severity of diarrhea and weight percentile (p= 0.085).

  Conclusion: Our data indicate that zinc supplementation reduces the severity of acute diarrhea and could be advised in children with acute diarrhea.

  Background & Objectives : Bacterial vaginosis is a condition which is determined by changes in microbial ecosystem of vagina and is considered as a preventable risk factor for preterm delivery. This study was conducted to assess the effectiveness of bacterial vaginosis screening program in routine prenatal care and its effect on decreasing preterm labor.

  Methods: This clinical trial study was conducted on 474 pregnant women at gestational stage between 2007 and 2008. The participants were randomly divided into 2 groups: intervention group and control group. Screening was performed in intervention group with Amsel's criteria (3 of 4 needed for diagnosis). Positive cases were given clindamycin cream (2%) for one week. The outcome of the delivery was assessed in both groups afterward. Data were analyzed by SPSS11 software using descriptive statistics.

  Results: There was no significant difference between two groups regarding pregnancy rank, wanted and unwanted pregnancy, insufficient weight gain, mother vaccination and complication of pregnancy. Bacterial vaginosis was observed in 17 out of 216 (8%) in the intervention group and then treated. Prevalence of preterm delivery in the intervention and control groups were 3 (1.4%) and 12 (4.7%), respectively. The relative risk was protective (RR: 0.3, DR: 0.033, NNT: 30).

  Conclusion: Screening and treatment of bacterial vaginosis in pregnant women could significantly decrease the rate of preterm delivery.

Background & objectives: Myocardial infarction (MI) isone of the most commonly heart diseases in all countries with the mortality rate of about 30%. Reperfusion of blocked coronary arteries plays an important role in reducing mortality and enhancing the quality of life of patients after acute MI.