Background & Objective: Hepatitis C Virus is the most common cause of post-transfusion hepatitis. This study was conducted to evaluate the prevalence of hepatitis C in multiply transfused patients.

 Methods: 45 patients with B- thalassemia major, 4 patients with hemophilia and 1 patient with aplastic anemia were studied prospectively during 2000. An initial questionnaire was used to collect the data regarding age, sex, duration and interval of at blood translation family history and the type of blood product received and the date of first infusion and then a blood sample was taken for detection of antibody against HCV.

 Results: 62% of the subjects were male and 38% of them were female with the age range of 6 months- 29 years old. 92% of the patients used packed red blood cells. 27 patients had a positive family history of thalassemia and two seropositive patients (4%) had thalassemia. Duration and mean amount of blood transfused were significantly higher in patients with HCV infection. Data analysis showed now significant relationship among variables of the study and hepatitis C cases.

 Conclusions: It is concluded that multiply transfused thalassemic patients are at high risk for HCV infection. Thus, routine screening of blood and anti- HCV test in these patients is necessary.

  Background & Objective : Diabetes is one of the most important world health problems and a chronic disease that needs continuous care. Therefore, these kinds of patients should take self- care education. This study is an attempt to investigate the effect of nutritional education on blood sugar level and macronutrients intake in IDDM patients.

  Methods : 24 IDDM patients under 20 were selected for educational program on nutrition. The data were collected two times using food questionnaire (24- hour recall) and blood sugar level before and after education was estimated. The data were analyzed by paired t-test, using SPSS and Food Processor.

  Results : There was not statistically significant relationship between blood sugar level before and after education. Also the results showed that there was statistically significant relationship between macronutrients intake before and after education (P=0.35). After education, macronutrients were similar to WHO recommendations. HbA₁C level in most of the patients was 9-12% which refers to the moderate control of this diseases and hypoglycemia decreased from 4.2% to 3%.

  Conclusions : There were no remarkable changes in blood sugar but the amount of HbA₁C and Macro Nutrients showed that education had a positive effect on patients.

  Background & Objective : The fast population growth is one of the basic problems in Iran and using family planning devices has a remarkable role in decreasing it. The findings of researches carried out nationwide indicate the effectiveness of instruction in the application of family planning methods and devices. The objective of this study is determining the level of knowledge of 15-49 year-old women under Ardabil health and treatment center services.

  Methods : 138 qualified mothers were chosen randomly from among 15-49 year-old women under Ardabil health and treatment centers services. These subjects were selected from among 14 centers (10 mother from each center) and had secondary school level of education. This descriptive cross-sectional and prospective research was conducted by filling out the pre-planned questionnaire and preparing educational booklets and giving them to the mothers under the study as pretest and post-test procedures during the time span of December 2000 to May 2001.

  Results : No meaningful relationship was found between employment and utilizing family-planning devices. The results of Mc-Nemar test and t-test showed that statistically the instruction given with regard to the method of beginning to take anti-gestation pills, method of the intervals of taking the anti-gestation pills, taking measures at the time of forgetting to take anti-gestation pills, the preference of vasectomy to tobectomy, the interval between the injection of anti-gestation ampoules and the duration of IUD effectiveness before and after studying the manuals demonstrated a significant difference.

  Conclusions : Education plays an important role in increasing the knowledge level of the population under study and hence it improves their performance about family planning. So this instruction is recommended to be followed seriously.

  Background & Objective : Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status.

  Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1^st, 5^th, 10^th and 15^th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA.

 Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1^st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5^th minute Propofol was 9.2 ± 0.7 and Thiopental was 9.1 ± 0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups.

  Conclusions : Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.

  Background & Objective : Failure To Thrive (FTT) refers to the insufficient physical growth or inability in keeping the desired growth rate in a period to time.

  It is a problem in Iran as far as hygienic nutrition is concerned. FTT is a multifactor problem which is caused by various organic and nonorganic agents. This study was conducted to pinpoint the major risk factors involved in the growth of children under 2 years of age who are the most vulnerable age-group in terms of growth disorders.

  Methods: This case-control study was conducted in 2002-2003 on 120 infants (60 cases with FTT and 60 controls) in Namin health centers. The case group was under the third percentage of their growth chart or they had -2SD in growth chart at least in three months. The control group was composed of infants with normal growth chart.

  The demographic characteristics of parents, and the nutritional and antropometric (height/weight, head circumference) characteristics of the subjects were measured. The collected data were analyzed by SPSS software, using chi-square and ANOVA.

  Results: The findings indicated higher frequency of respiratory infections, diarrhea and vomiting in case group (p<0.05). The control group, on the other hand, outnumbered the case group in terms of the number of infants under 6 months who were exclusively breast-fed (p<0.05). Most of the infants with FTT had a lower birth weight than control group (p<0.05). The number of mothers with lower level of education and those who were housewives and also the number of family members were significantly higher in case group than control group (p< 0.05). However, no significant difference was observed between two groups in terms of frequency of breast feeding and birth rank.

  Conclusions : The results indicated that some risk factors such as respiratory infections, birth weight, education, mother ُ s knowledge, exclusive breast feeding and the frequency of diarrhea and vomiting have far more important role in growth disturbances in children compared to factors such as frequency of breasr feeding and birth rank.

 Background & Objective: Each year thousands of children under five years old die due to acute respiratory infection and diarrheal diseases. A huge number of infants and children are hospitalized and visited by the physicians whereas most of these diseases can be prevented with timely treatment. Child health maintenance and improvement is one of the most important considerations in each society. Moreover, identifying child morbidity patterns should be a matter of concern in order to improve the health services. This study provides an overview of the leading causes of hospitalization among children with the aim of determining the most important causes of hospitalization and offering appropriate strategies to decrease them.

 Methods: This cross-sectional study was conducted in 2001 in Ardabil Ali-Asghar hospital. The subjects were randomly selected from the admission list on a daily basis. A questionnaire including demographic characteristics such as age, sex, time of admission and primary diagnosis was completed for each subject. The data were analyzed by SPSS software using descriptive statistics.

 Results: A total of 1945 patients were admitted almost half of which were studied. Febrile convulsion was found to be the most common cause of hospitalization (26%) while gastroenteritis (22.1%) and pneumonia (20%) were in the second and third order. Other causes included epilepsy, drug poisoning, meningitis, mumps, drug encephalitis, asthma, etc.

 Conclusion: According to the findings of this study, standard case management is necessary especially about febrile convulsion which is the most common cause of hospitalization. Since the present pattern is different from similar studies, further investigations are required to identify its causes.

 Background & Objectives: Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance of variable severity with onset or first recognition during the pregnancy. Diagnosis of this disorder can prevent complications in mother and her fetus during pregnancy. This study was an attempt to determine GDM prevalence in pregnant women referring to Ardabil health centers.

 Methods: In this cross-sectional study 601 pregnant women with 24-28 weeks of gestational age were screened by glucose challenge test (GCT) using 50 gr of oral glucose. GCT was considered positive if the serum level of glucose was larger than or equal to 140 mg/dl. Oral Glucose Tolerance Test (OGTT) was done on GCT⁺ subjects with 100 gr oral glucose. The diagnostic criteria were these of National Diabetes Data Group.

 Also a questionnaire was used to record history, age, height, blood pressure, weight before pregnancy and other characteristics. The data were analyzed using SPSS software.

 Results: From 601 pregnant women, 64 cases (10.6%) were GCT⁺. OGTT indicated that from these 64 cases, 8 cases had GDM (GCT ⁺, OGTT⁺). GDM prevalence was estimated 1.3%. There was a statistically significant relationship between BMI, mean age and mean diastolic blood pressure on the one hand and GCT and GDM positivity on the other (p<0.05). There was a significant relationship between increasing of BMI and the prevalence of GDM positivity GCT (p<0.05), but the relation was not significant between increasing of systolic blood pressure and gravidity with prevalence of GDM and positive GCT.

 Conclusion: It seems that the prevalence of GDM in Ardabil is low and general screening is not necessary for all pregnant women. The prevalence of GDM showed an increase with the age of pregnant women, BMI and obesity.

 Background & Objectives: Neglecting children can have irremediable and harmful effects on them concerning their growth, evolution, acquisition, and health both at present and in the future. Since lack of nutrition knowledge and failing to observe the principles of infant nutrition is one of the important causes of malnutrition and its unpleasant consequences, we decided to carry out an assessment concerning mothers’ level of awareness about infant nutrition and the factors affecting this knowledge, as well as the effect of this knowledge on growth and development of children.

 Methods: This descriptive-analytical research was conducted to evaluate mothers’ knowledge of infant and neonatal nutrition and its effect on infant growth in Hir health center. The data were collected using a questionnaire, including 20 questions, which was filled out in the health center. Moreover weight, height and head circumference of 100 infants were measured. The data were analyzed using SPSS software.

 Results: All mothers’ age ranged between15-36 and were housewives.15% were unlettered, 18% had high school education and others primary or secondary school education. 55% of children were female and 45% male. 67% of mothers had knowledge about proper neonatal and infant nutrition. 97% of them had little knowledge about when to start introducing different nutrients for infants, 3% had moderate knowledge in this regard.

 Conclusion: Regarding the findings of this study and the lower knowledge level of mothers about when to start giving different food to infants as well as the importance of proper nutrition in their growth, it is necessary to improve mothers’ knowledge and promote children’s health.

 Background & Objectives: Hysterectomy is the most common surgery among nonpregnant women. A review of indications of hysterectomy can provide the specialists with new insights about these patients’ treatments. The aim of this study is to investigate the indications and methods of hysterectomy in patients referring to Alavi hospital.

 Methods: This cross-sectional study was done in Alavi hospital for two years (2002-2003). The data from 257 hysterectomized patients collected through interview and studying their records were entered into previously-designed questionnaires. The collected data were then analyzed using SPSS software.

 Results: The number of hysterectomies decreased 38.4% in 2003 compared to 2002. The mean age of patients was 45.8±8.09. The most common indication of hysterectomy was lyomyoma in 42.2% of cases. Abdominal hysterectomy and vaginal method were done in 93% and 7% of the cases respectively. In patients who were operated for pregnancy and delivery complications, the most common indication for hysterectomy was placenta increta (50%). The most common complication was hyperpyrexia (25.7%). The prevalence of complications of abdominal hysterectomy and vaginal method was 26.3% and 16.6% respectively.

 Conclusion: Lyomyoma is the most common indication of hysterectomy in patients referring to Alavi hospital. Besides, abdominal operation is the most prevalent method of hysterectomy in this hospital. Complications of vaginal method are less than those of abdominal method.

 Background & Objectives: One of the most common ways in intubation without muscle relaxant is using propofol and remifentanil. The common practice is injection of remifentanil and then propofol. This occasionally produces severe hemodynamic changes. The aim of this study is to inject propofol followed by remifentanil for evaluating the effect of the order of injection on decreasing these complications.

 Methods: 40 patients with American Society of Anesthesia (ASA) class I-II, who underwent minor elective surgery with airway mallampati class I-II entered the study. Patients were randomized into 2 groups each with 20 patients. The first group received 2.5mg/kg propofol followed by 1.5 g/mg remifentanil while the second group received 1.5 g/mg remifentanil followed by 2.5 mg/kg propofol. Laryngoscopy and hemodynamic changes were compared in two groups.

 Resutls: There was no difference between two groups in laryngoscopy attempts (P=0.145) but the frequency of easy laryngoscopy in the first group (85%) was more than the second group (60%) (P=0.031). Systolic blood pressure changes after laryngoscopy in the first group (20 7.7 mmHg) was less than the second group (28 6.7 mmHg) (P=0.001). There was no statistical significant difference between two groups in diastolic blood pressure and heart rate changes (P=0.88, P=0.86 respectively).

 Conclusion: Administrations of propofol before remifentanil during anesthesia induction produces acceptable hemodynamic changes in patients.

 Background and Objectives: Food insecurity and hunger not only affect physical health, but also have social and psychological consequences. Therefore, monitoring food security and fighting against food insecurity and hunger is necessary in a society. This study was carried out to investigate the determinants of food insecurity in northwest of Tabriz (Asadabadi region).

 Methods: This cross sectional study was conducted on 300 subjects in 2004-2005. The prevalence of food insecurity was assessed using a short questionnaire. Information regarding the socio-economic and cultural status of the subjects was collected through a questionnaire. In order to assess the status of food security on the basis of income, occupation, education level and family size, distribution of secure and insecure groups was individually determined, and then Chi-Square test was used to test the significance of the relationship between these groups. Nutritional status was assessed using food frequency questionnaire. Food groups that had significant correlation with income (relationship between groups and subgroups of foods with income was determined using Pearson correlation coefficient) were selected as a criterion for comparing secure and insecure groups. Mean frequency of criteria foods consumption in two groups was compared using independent-sample t-test.

 Results: The prevalence of food insecurity was 36.3%. Food insecurity increased with family size and declined with income, education and job status of the head of the family (p<0.01). The results of food frequency showed that the mean frequency of bread and potato consumption in food insecure group was meaning fully higher compared to food secure group. Mean frequency consumption of rice, vegetable, fruit, red meat and dairy products in food insecure group was significantly lower compared to food secure group (p<0.001).

 Conclusion: The results of this study confirmed the impact of socio-economic and cultural status of the families on food security. It also indicated that nutritional problems are prevalent in society. Therefore, it is necessary to give practical solutions to fight against food insecurity as a major problem in society.

  Background and Objectives: A great amount of evidence shows that Oxidative stress is high among hemodialysis patients. The purpose of present investigation is examination of the effect of zinc supplementation on improvement of oxidative stress in chronic hemodialysis patients.

  Methods: In this double blind clinical trial 65 chronic hemodialysis patients were studied in two groups Group one (35 patients) received placebo and group two (30 patients) received 100 mg elemental zinc (as zinc sulfate) daily for 2 months. The placebo and supplement discontinued in next 2 months. Then, the study continued for two other months in the cross-over from. The levels of serum zinc, total glutathione, malondialdehyde (MDA), total serum antioxidant capacity and the activity of whole blood superoxide dismutase (SOD) were determined on 0^th, 60^th,120^th,180^th days, in fasting, predialysis samples. Food record was recorded for one day prior to dialysis in above-mentioned days and their dietary zinc was assessed.

  Results: Basal serum zinc levels in both groups were below 80 μ g/dl. The zinc upplementation led to significant increase in the levels of serum zinc in both groups .The levels of serum total antioxidant capacity, total glutathione and activity of whole blood SOD increased significantly during zinc supplementation period. The concentrations of serum MDA decreased significantly in zinc supplementation period in both groups. During the placebo period the levels of MDA in first group increased significantly, whereas the concentration of glutathione in second group decreased significantly. The body mass index (BMI) values did not change significantly during the study.

  Conclusion: It can be concluded that in patients undergoing hemodialysis the oxidative stress enhanced during nonsupplementation period (zinc sulfate). Low serum zinc levels are improved by zinc administration and zinc supplementation improves oxidative stress.

  Backgrond & Objectives: Oligohydramnios is a disorder which is followed by unpleasant outcomes for fetus that can lead to termination of pregnancy before term and preterm delivery. For these patients' increase in gestational period and prevention of preterm delivery is the most important act. In this study the effect of intravenous and oral hydration therapy in increasing duration of gestation in patient with oligohydramnios was evaluated.

  Methods: In this study, the population was devided into two case and control groups with 30 female individual who were found to have oligohydramnios in course of hospital admission according to on sonographic results. Patients were randomly put in case or control groups. Case group were given 3-4 liter normal salin for 1 week and then were given oral hydration solution until the end of pregnancy, In each group whenever it was found that pregnancy was not possible the pregnancy continuance was stopped. Data collection was through history, physical examination completing relevant questionnaire and findings of sonography and in order to see the relationship among finding s, kitest and t-test from SPSS software were used.

  Results: The age means of case and control groups were 25 and 24 respectively. The mean of pregnancy duration from the diagnosis time in case group was 30.2 weeks and in control group 31.8 weeks. The mean of pregnancy terminatior in case group was 34.6 weeks and in control group 34.2. In increasing duration of pregnancy in case and control group. It was concluded that intravenous and oral Hydration therapy cause incerease in duration of pregnancy in patients suffering from oligo Hydraminos. According to the results of this study and significance of the difference.