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  Hydatic cyst is caused by Echinococus worm, that involves any part of the body, sometimes it is presented in organs such as thyroid, breast and other organs. Axillary that may be consider adenopathy or metastasis and do biopsy, which so there is danger of leakage, anaphylaxis or relaps.

 The reported case was 39 years old female presented with painless axillary mass without inflammation since 19 years ago that slowly enlarged. Physical findings suggested hydatid cyst which was confirmed with ultrasonography and IHA for Echinococus granolosus and other diseases ruled out. She was operated and she had no relapses after 1.5 years follow up.

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  Background & Objectives : Coronary artery disease is one of the most important mortality causes in developed and developing countries. Many risk factors can influence coronary artery disease some of which can be controlled and prevented. Information should be given to people for controlling these factors and prior to this information – giving, the primary awareness of them about risk factors needs to be ascertained. This research is a study of the knowledge, attitude and practice of Ardabil people about CAD risk factors.

  Methods : This descriptive analytic study was done on 384 individuals (female and male) over 20 years old. These subjects were selected from five clusters. Synthetic questionnaire was used for data collection through direct interview at home. The collected data was then analyzed by SPSS software.

  Results : 50.5% of samples were females. 27.3 % of the subjects were high-school graduates. Most of them (70%) were aware of stress and lesion as risk factors. 66.9% of them were aware only of the effect of immobility on coronary artery disease but 13% of them had regular physical activity. 52.1% of them were aware of the harmful effect of salt on CAD, but 15% of them had low salt intake. 48.2% of people were aware of benefit of liquid oil on health, but only 25% of them consumed it. Results showed that, 48.2%, 51.3% and 40.9% of individual had moderate knowledge, positive attitude, and weak practice, respectively. The relationship among variables was significant (P<0.0001), and practice of people has been increased with increasing of knowledge and attitude.

  Conclusion : Regarding these results, regular programs are necessary for increasing awareness and practice of people as primary preventive steps for controlling CAD.

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 Background & Objective: Breast cancer is the most common cancer occurring among women and the second leading cause of death from cancer among them. The mortality rate of breast cancer is directly related to the stage of the disease when diagnosed, and is reduced by regular breast cancer screening program. This survey is carried out to identify the knowledge, attitude and practice of women in Ardabil about BSE.

 Methods: In this descriptive study, 150 women with 20-25 years of age, were selected through systematic cluster sampling. Knowledge, attitude and practice of them about BSE were investigated through face to face interview, and the obtained data were analyzed using descriptive and analytic statistics.

 Results: 44% of women had some information about breast cancer. 44.7% of them had average information about BSE. There was statistically significant relationship between knowledge of BSE on the one hand and age, marital status and history of previous breast examination on the other. 52% of them believed in BSE for early detection of breast cancer. Their attitude towards BSE was positive (51.3%) and there was a significant relationship between their knowledge and attitude. 18% of the subjects practiced BSE at least once, and their overall practice was in a weak level (46.7%).

 Conclusions: Qualitative researches could be recommended to recognize the factors effective in the improvement of acceptance of breast cancer screening methods among women.

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  Background & Objective : In order to prevent maternal mortality and morbidity, midwives should be able to implement community cares for women and their families. The aim of this study is to investigate midwives ’ knowledge, attitude and readiness to practice community oriented midwifery (COM).

  Methods : In this cross sectional study, all 280 midwives working in Kerman hospitals and health service centers were selected. The questioner for data collection had two parts. The first part intended to describe the characteristics of samples and the second part was used to evaluate midwives ’ knowledge, attitude, and readiness to practice community oriented midwifery. Correlation and chi - square tests were used to analyze the data.

  Results : Mean of knowledge score was 21.13 and 16.4% of the subjects had a good knowledge of COM. Mean of attitude score was 77.07 and 61.8% of the samples had a positive attitude towards COM. 79.2% of samples announced their readiness to practice COM.

  Conclusions : Based on the findings of this study it seems that the professional knowledge of midwives should be promoted, regarding COM.

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  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.

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  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.

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  Background & Objective : Palpable thyroid nodules are found in almost 5% of the adults. Regarding the high prevalence of this condition, recognizing and evaluating them are important for physicians. Fine Needle Aspiration (FNA) is the first easy and cost-effective way for recognizing pathologic nature of the nods. The present research was an attempt to investigate the epidemiology and evaluate the pathological findings among patients using FNA.

  Methods : This is a descriptive study conducted on all 145(113 female and 32 male) patients referring to the endocrinology clinic of Ardabil in the period between October 1999 to October 2002. The data were collected using a questionnaire, the physical examination of the patients, noting down the clinical finding, doing FNA and its report presented by a pathologist. The data were then analyzed with descriptive statistics and frequency tables using SPSS software.

  Results : Most of the patients (36.5%) were 30-40 years old. FNA of 115 patients (79.4%) was reported as benign and that of 6 patients (4.1%) was malignant, 16 patients (11%) had a doubtful FNA, and in 8 patients (5.5%) the sample was not enough. Among patients with benign FNA, 102 cases (70.6%) had nodular goiter, 8 cases (5.5%) had colloid cyst, 3 cases (2%) had follicular adenoma and 2 cases (1.3%) had thyroiditis. Among patients with malignant FNA 1 case (0.7%) had follicular carcinoma and 5 cases (3.4%) had papillary carcinoma.

  Conclusions : The results indicated that most of the malignant lesion is papillary carcinoma, which has a lower prevalence compared to similar studies. Regarding the higher prevalence of thyroid carcinoma in middle ages it seems necessary to investigate the thyroid nodules in this age- group.

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  Background & Objective : Malignant skin tumors are highly prevalent cancers all over the world. Iran can be regarded as an area in which skin malignancies are so common because of severe sunlight, and occupational requirements of farmers with long exposure to sunlight. This study was an attempt to evaluate the frequency of malignant skin tumors in Urmia.

  Methods : In this descriptive and retrospective study 61496 pathological reports collected from pathology centers in Urmia between March 1991 and March 2001 were examined. Among these reports, 1099 cases with skin malignancies (including BCC, SCC and CMM) were identified and classified based on factors such as age, sex, job, the location of lesion and patient ’ s, residential area. In order to accomplish the incomplete data, the researchers referred to cancer registry center in health deputy of the province.

  Results : Among 1099 cases, 1076 patients (97.9%) had solitary lesion and 23 cases (2.1%) had multiple lesions. The ratio of male to female is 1.7:1 in all skin tumors. Most patients were farmers (28.02%). BCC was mainly observed on nose (26.2%), SCC was around mouth (36.78%) and CMM was mostly in extremities (45.09%). BCC was mostly on upper half of the face and SCC on the lower half. Most patients age ranged from 60 to 69 years. BCC was the most common histopathological type of tumors (71.62 %). 52.61% of patients lived in Urmia and the rest were from other cities. Comparing the first and second 5-Year periods of this research indicated a 25% increase in the frequency of tumors.

 Conclusions: According to the increased incidence of malignant skin tumors in this area some measures should be taken to prevent this disease, reduce the risk factors and diagnose these tumors earlier.

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  Background & Objectives: Preeclampsia is still one of the leading causes of maternal and fetal morbidity and mortality. Despite active researches over the past many years, the etiology of this disorder in human pregnancy is an enigma. Oxidative stress has been implicated in the pathophysiology of preeclampsia. Essential nutrients such as vitamin C can scavenge free radicals inducing cellular damage. The present study was designed to investigate the plasma levels of vitamin C in patients with preeclampsia (case) and normotensive pregnant women (control).

  Methods: In this case-control study vitamin C as an antioxidant was estimated and compared spectrophotometrically in 40 preeclamptic and 80 normotensive pregnant women referring to Alavi Hospital of Ardabil province, Iran. The collected data were analyzed using descriptive and inferential statistics.

  Results: The plasma levels of vitamin C were significantly lower in patients with preeclampsia (0.147 ± 0.030 mg/dl) compared to controls who were normotensive pregnants (0.347 ± 0.119 mg/dl).

  Conclusion: Attempts at prevent preeclamsia are justified but since no reliable screening test has been offered as yet for women at risk, assessment of plasma level of vitamin C in patients prone to preeclampsia is strongly suggested.

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Recurrent meningitis is a rare incident and is likely to have multiple etiologies, which could lead to repeated admissions to the hospitals. A detailed investigation of congenital and anatomic anomalies facilitating bacterial entry into the subarchnoid space is mandatory in these patients. A proper diagnosis can often be obtained through taking a complete history, previous admissions, and complete clinical and radiological examinations. The present case is a 25-year-old woman with 8 admissins because of meningitis. After being hospitalized for a long time and relative improvement, she was operated for the first time. The surgery was repeated due to rhinorrhea and the diagnosis of mondini congenital dysplasia in direct relationship with intranasal space. This led to the complete recovery of the patient. Anosmia her only problem at the present time.

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Background & Objective: Ectopic pregnancy (EP) is the most common cause of maternal mortality in the first trimester. 10% of maternal death is due to EP and only one-third of women with previous ruptured ectopic pregnancy could have a normal delivery in future. Research about prevalence and risk factors of this kind of pregnancy, could help early diagnosis and treatment of EP and improve the prognosis of fertility rate in the future.

Methods: In this retrospective, descriptive and cross-sectional study, seventy-two patients with EP diagnosis admitted and treated in Yazd hospitals were studied. The data were collected using a questionnaire and hospital records. Sonography and laparoscopy confirmed the diagnosis. The data were analyzed by SPSS using Chi-Square test.

Results: 11176 pregnancies were recorded in Yazd between March 1999 and March 2000 and seventy-two of these pregnancies were ectopic. So prevalence of EC in yazd was found to be 0.5%. Most of the patients (58 cuses) were 20 to 39 years old. 52.8% of the patients had primipar. 25% had a history of one to three times abortion. From 43 patients who used contraceptive, 19 ones used OCP (oral contraceptive). 39 patients had a history of previous surgery, 7 patients had a history of EP and 25 patients had a history of treatment of infertility. The most common symptom of patients was abdominal pain. Only 4 out of 72 patients were treated with a medical method using methotraxe and the rest of them were operated. Three out of these four patients were finally obliged to undertake surgery.

Conclusion: The prevalence of EP was 0.5%, which is lower than the national scale. 

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Ulnar nerve involvement is the second most common local mononeuropathy. The ulnar nerve consists of motor and sensory fibers that arise in C₈-T₁ roots and extends to the lower trunk and medial cord of brachial plexus. Manifestations of this nerve involvement range from elbow pain and intermittent hand paresthesia to marked sensory loss, wasting and weakness  of hand muscles and a claw hand. Ulnar nerve lesion in the elbow region commonly follows surgery in which general anesthesia is used (particularly in patients with coronary artery bypass graft surgery). The patient presented in this article was a 56-year-old male who was involved in left ulnar nerve lesion after undergoing coronary artery bypass graft. In electrodiagnostic study we noticed diffused demyelination lesion of the ulnar nerve with dominancy in elbow region along with secondary axonal degeneration. Therefore, suitable positioning of elbow is recommended to avoid the  nervous complications of these operations.

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 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.

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  Background & Objectives: Patients in unstable condition with blunt abdominal trauma require rapid evaluation of abdominal organs to assess the need for laparatomy. Ultrasonography is a fast technique which can be used in the resuscitation area to detect free intraperitoneal fluid as an indication of intraabdominal injury. This prospective study was designed to determine the efficiency of emergency abdominal sonography for evaluating patients with blunt abdominal trauma and to compare the accrurcy of ultrasonography with the results of diagnostic peritoneal lavage and CT scan.

  Methods: Emergency sonography was performed prior to diagnostic peritoneal lavage and CT scan on 174 patients with blunt abdorminal trauma. Sonography was performed with FAST ( Focused Abdominal Sonography for Trauma) technique and six area of the abdomen where examined to detect free intraperitoneal fluid.

  Results: The results of this study revealed that ultrasonography has a sensitivity of 95% a specificity of 80.8%., and an overall accuracy of 89.4% for detecting free intraperitoneal fluid. The positive and negative predictive value of sonography was 89.4% and 90.1% respectively.

  Conclusion: Ultrasonography is a reliable method for the emergent evaluation of blunt abdominal trauma and can be used instead of diagnostic peritoneal lavage.

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 Background & Objectives: Cholangiocarcinoma is a malignant tumor of the biliary tract epithelium. Although it is not a common tumor, it has a high mortality rate so that the five-year survival of the patients is only 5%. Most patients are found to have irresectable tumor on initial presentation. These have led to an emphasis on the role of palliative treatment.

 Methods: 43 patients with Cholangiocarcinoma (from 1996-2003) based on ERCP were included in this study. Demographic aspects, clinical and Para clinical manifestations as well as the risk factors were investigated and survival rates of the patients were compared with or without stenting of the biliary tract.

 Results: 27 patients (62.8%) were male and 16(37.2%) were female with mean age of 65. Ulcerative colitis accompanied with PSC was diagnosed in just one case. Jaundice, weight loss and pruritus were the main complaints of the patients. Twenty-seven cases received stent in biliary tract through ERCP while no treatment was performed in other patients due to technical failure or patients’ disagreement. Mean survival time for all patients was 125 days. There were no statistically significant difference between survival rate of the patients with stent and without it.

 Conclusion: In this study cholangiocarcinoma in our patients was less frequently seen to accompany UC and PSC. Curative surgical resection is not possible in the majority of cases, and palliative treatment only decreases the severity of the symptoms but has no significant effect on survival.

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  Background & Objectives: Hearing is perhaps the most important sense in human beings without which communication with the environment would greatly diminish. Chronic perforation of tympanic membrane, ossicular erosion and tympanosclerosis are major causes of hearing diorders. Nevertheless, a conducting hearing loss is the commonest complication of chronic otitis media. Cholesteatoma which is the most dangerous complication of chronic otitis media is treated by surgery. Tympanosclerosis is also one of the most important complications of chronic otitis media, which leads to conductive hearing loss through ossicular fixation. This study is an attempt to determine the effect of different kinds of chronic otitis media on the hearing of the patients.

  Methods: In this survey, 440 patients with chronic otitis media, who were surgically treated in the department of otolaryngology between 1998-1999, were studied in terms of various pathology of middle ear and the resultant level of hearing impairment.

  Results: 37 patients (8.4%) were involved bilaterally with otitis media. The number of operations on the left ear was 10% more than those on the right. The most common pathology recognized in examination was nonprulant perforation of tympanic membrane in 179 cases (40.7%) and the most common pathology recognized in surgery was cholesteatoma in 140 cases (30.2%). From 440 patients, 430 cases had conductive hearing loss and 92 cases (20.9%) had sensorineural hearing loss. Cholesteatoma of middle ear caused the highest proportion of conductive hearing loss and majority of the cases with sensorineural hearing loss (about 30%) whereas tympanosclerosis caused the most severe sensorineural hearing losses.

  Conclusion: The findings indicated that cholesteatoma and tympanosclerosis were the most common causes of both conductive and sensorineural hearing loss with tympanosclerosis as the cause of the most severe sensorineural hearing loss. However granulation tissue is the most common histopathology in patients with chronic otitis media at references and papers.

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 Background & Objectives: Some special characteristics of mycobacterium tuberculosis such as long time incubation period in culture media needed for colony appearance, unavailability of serologic methods for diagnosis, along with necessity of starting treatment in the patients with severe conditions as well as isolation limitations requires the introduction of rapid and innovative diagnostic tests. On the other hand, some diagnostic tests such as Polymerase Chain Reaction (PCR) require special experimental conditions which are not easily available to clinicians. This study was designed to determine the diagnostic value of serum adenosine deaminasae in pulmonary tuberculosis and evaluate its efficacy in pulmonary tuberculosis diagnosis.

 Methods:�This cross-sectional study started in spring 2002. Continuous sampling was done and admitted patients were observed, examined and interviewed using a diagnotic test. All patients admitted with a suspected pulmonary tuberculosis diagnosis based on physical examination, history and chest X-Ray results were followed up for six months to ensure that mycobacterium tuberculosis infection was appropriately diagnosed. Blood samples were taken for serum ADA and complementary diagnostic tests. Following certain necessary tests and work-ups patients with or without tuberculosis were identified.

 Results: 131 Patients were evaluated completely. 103 had tuberculosis and 28 patients had other diseases. No statistically significant difference was found between mean level of serum ADA in two groups. But a serum level of ADA greater than 51 ^U/_L was associated with 90% positive predictive value and specificity in differentiating two groups.

 Conclusion: Serum ADA is not a suitable test for pulmonary tuberculosis diagnosis.