Background & objective : Recovery state or post - anesthetic awakening is one of the most dangerous anesthetic stages . Respiratory, cardiovascular and other complications such as nausea, vomiting, shivering, pain and restlessness have been reported . This study designed to investigate prevalence of this complications and its probable risk factors in Ardabil Fatemi and Alavi hospitals.

  Methods : In this prospective study, 160 patients were selected in Alavi and Fatemi hospitals during winter of 2001. We completed a sheath for everybody about their history of medical diseases, pervious history of anesthesia, addiction, drug abuse, smoking, physical class of ASA, type of anesthesia, time and place of surgery . Data was analyzed by SPSS software.

  Results : These results were obtained in patients after surgery in recovery room: shivering
36.3 % , pain 26.9 % , restlessness 21.3 % , respiratory complications 13.8 % , cardiovascular complications 12 % , nausea and vomiting 8.8 % . We found significant correlation between some risk factors with complications, e. g: shivering with history of medical diseases, drug abuse and place of surgery and so, pain with restlessness, respiratory complication and place of surgery .

  Conclusion : This study according to similar studies revealed higher prevalence of some of post - anesthetic complications as shivering, pain and restlessness in our samples .

 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: The quality of services given to emergency patients at a hospital as well as these patients ’ satisfaction of the services is an index of overall services in that hospital. This study is an attempt to evaluate the degree of satisfaction among the patients referring to the emergency rooms of the hospital of Ardabil University of Medical Sciences during fall and winter 2000.

 Methods: In this cross-sectional prospective study, 600 emergency patients referring to emergency rooms of Alavi, Fatemi, Buali and Aliasghar hospitals were selected. They filled a questionnaire. The data were analyzed by SPSS software.

 Results: The findings indicated that 78.1% of the whole subjects were generally satisfied with the services. The greatest degree of satisfaction belonged to specialty services (93.8%) and the physicians ’ and nurses ’ contact (92.3% and 91.8% respectively). The least degree of satisfaction belonged to hospital charges (40.2%), and unavailability of non-emergency drugs in hospital pharmacy (42.9%).

 Conclusions: According to the results of this study the medical centers need to offer more coverage of national health insurance services. Furthermore it seems necessary to equip these emergency rooms with round the clock pharmacies and provide the required drugs.

  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: Nitroglycerin is found to have vasodilatory effect. It has also a relaxing effect on the smooth muscles of other organs including uterus. This study investigates the effect of intravenous nitroglycerin in emergency cesarean sections in which rapid and transient uterine relaxation for rapid and nontraumatic extraction of the fetus is necessary.

  Methods: Sixty pregnant women who were candidated for emergency cesarean and needed rapid uterine relaxation for different reasons were selected. These subjects underwent spinal anesthesia and at the time of uterine incision, 100 micrograms of nitroglycerin was injected to them intravenously. The time lapse between nitroglycerin administration and fetal extraction, the degree of uterine relaxation, the amount of intraoperative hemorrhage, uterine tone after fetal delivery and APGAR scores of the infants were all controlled and recorded. Also with regard to the vasodilatory effect of nitroglycerin and probably its resultant homodynamic problems, blood pressure, heart rate and arterial O₂ saturation were recorded before and after nitroglycerin injection and throughout the surgery.

  Results: The results showed that in 53 (88.3%) of the patients the uterus was acceptably relaxed and the fetus was delivered very easily. Only in 7 patients (11.7%) uterine relaxation was not acceptable. The mean decrease in systolic and diastolic blood pressures after nitroglycerin administration compared with before injection BP was 12.97 mmHg (12.210 %) and 7.86 mmHg (12.208 %), respectively. There was not seen any prolonged effect of the drug such as uterus relaxation tone or abnormal bleeding. Also, none of the delivered infants had low APGAR scores. Besides, in patients with acceptable uterine relaxation the first and fifth minute APGAR score of infants were higher (p = 0.008, p = 0.000).

  Conclusion: This study shows that nitroglycerin can relax uterine smooth muscles very rapidly and transiently and in emergencies it can be an appropriate alternative to the other tocolytic agents with prolonged effect or onset time.

  Background & Objectives : More than one hundred countries face the problem of malaria disease. Studies have indicated that thalassemic individuals are relatively more resistant to malaria. The present research set out to investigate this hypothesis in Iraushahr where these is a high prevalence of moralia. The goal of this study is to compare the prevalence of malaria in thalassemic individuals with non- thalassemic ones in Iranshahr.

  Methods: In this case-control study 100 thalassemic individuals (case) and 100 non-thalassemic case (control) were selected. In addition to serum specimen, their blood sample from their fingertips were also taken to prepare peripheral blood smear. The tests were performed on 200 random samples in July (the peak time of malaria transmission). In this study, both indirect immuno flurecance Assay (IFA) and direct amear technique were used. The data were analyzed in SPSS software using descriptive and analytical statistics including T- test, chi-square and ANOVA.

  Results: In IFA 20 subjects had positive titer while 80 ones had negative titer. Direct microscopic examination indicated that these, 20 cases had malaria parasite, 10 of whom were affected by p. vivax and 10 whit p. falciparum. In the non-thalassemic people (control group), 75 subjects had positive titers and 25 had negative titer. With respect to the direct smear anamination in non-thalassemic subjects, 18 had malaria parasite, of whom 7 had p.falsiparium and 11 had vivax. The results of malaria antibody titer indicated that the history of being affected by malaria the thalassemic subjects was 92% less than the non-thalassemic ones and this difference was statistically, significant (p<0.05) however, no significant relationship was found in terms of the results of direct microscopic examination and Ginsastaining.

  Conclusion : Since thalassemic people are more resistant againt malaria futhure researches are required to investigated the resistance to malaria in other blood disorders.

 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 & Objectives : Providing health services for all population subgroups of a community is a major hallmark for health administration. Little is known about health status of Ashayer population in Iran. This study aims at evaluating health status and quality of health service delivery to them.

 Methods: In a cross-sectional research 320 households (1800 persons), entered the study. Moreover, blood samples from 458 dogs were taken and studied with both Direct Aglutination Test (DAT) and a newly presented dipstick test . All children under 12 were also studied with DAT. In computing the sample size the generalizability for 63 variables with a minimum and maximum probability level of 90% and 97% respectively were taken into account and since the cluster sampling was employed, the Design Effect would be at least 1.56 and for different variables in the first sample it would be at most 4.

 Results: Only 30 households(9.7%) used piped water supply inside their houses while most of the other families (41%) obtained their water from mobile water tanks. Residual water chlorine was measured to be zero in 88.7% of the samples taken from drinking water of Ashayer. 89 (27.8%) households had lavatories and 22 (7%) households had bathrooms inside their houses. 90.4% of those using raw vegetables washed them only with plain water. Monthly incidence rate for accidents was 230 per 10000. 18.1% of women in reproductive age had a history of abortion. Unwanted pregnancy rate was 38.9%. 47.1% of women with a labor history in past three years had never been visited by any person legally allowed to do so. Women in reproductive age had a poor knowledge about contraceptive methods. The minimum delay for vaccination was 16.9 (SD= 19.26) days regarding the third dose of OPV and the highest delay in vaccination was 46.44 (SD=60.7) days belonging to the third dose of HBV. From all 503 persons above 12 years old, 77 cases had hypertension. Periodontal easy bleeding was observed in 13.7 % and pyorrhea in 19.3%. 10.2 % had aching neck, 18.7% had backache and arthralgia was shown in 13.5%. The unmet need for physician's visit was 64.8%. The frequency of positive cases of leshmaniasis was 3.4% and 3.06% for boys and girls respectively. 28 male and 6 female dogs were positive in DAT test making an overall positive rate of 7.4%. Sensitivity of dipstick test was higher than 80 percent only when golden standard was considered to be DAT ≥ ¹ /₆₄₀.

  Conclusion: Many of the health indices of Ashayer except for vaccination were suitable. This requires further attemps on the part of govermental and health outhorities. Kale-azar disease can spread to the north of the province as well as the neighboring provinces due to the migration of these tribes. It is predicted that Bilesavar and Parsabad cities will be added to the andemic regions of this disease in coming years. Using dipstick test recently offered by WHO is recommended to be used to screen the infected dogs.