مجله دانشگاه علوم پزشکی اردبیل
پیاپی 12 (تابستان 1383)

Research has always been considered as a powerful tool in creating change and development and like any other process it demands careful planning, providing facilities and special resources. Investigating research trends can pave the way for systematic thinking in this regard. This study was conducted to examine trends in research methodology in order to promote the research quality in Ardabil University of Medical Sciences. In this cross-sectional descriptive study, data regarding research methodology and its administration was evaluated by a questionnaire during six years from 1997 to 2003. The data regarding the author of the research were collected through the interview. These data were then analyzed by SPSS software (release 12) using descriptive statistics. Between 1997 and 2003, 196 research proposals were approved. The number of research designs increased from 3 to 45 during this period. Most of these studies (58.2%) had cross-sectional design. The experimental researches came second with 43 cases (21.9%). During this period the number of trials and analytic studies increased, but descriptive studies were still in the highest rank. Only 32% of the proposals were completed properly and in most of the cases they were not completed in the proper way and some subsections of the forms such as design, variable table, methods of data analysis, data collection procedures and administration problems were incomplete or missing in most of the designs. These problems were more evident before the establishment of research consultation office in 2001. 75% of the researchers had attended research workshop before conducting any research. The findings indicated a remarkable increase in the number of researches compared to the preceding years. Moreover, they have been more analytically-oriented. However, descriptive researches are in the top rank. Some necessary measures have to be taken in order to improve the present condition.

Cesarean section is one of the most common surgeries in women. In developed countries the rate of cesarean section is reported to be 21.2%. In Iran, the rate of cesarean section is even higher than the international norms. In a study in Ardabil, in 2001, cesarean section rate came out to be 42.86%. Postoperative pain after cesarean is one of the complications that all mothers experience in one-way or another. Besides bothering mother it can disorder newborn feeding, ambulation of mother and bonding between newborn and mother if it is not controlled effectively. This study was conducted to compare the effect of intramuscular Methadone and Diclofenac suppository for pain relief after cesarean section in Alavi hospital, Ardabil. This study was a double blind clinical trial. 56 women who experienced cesarean section for the first time were randomly divided into two groups. Diclofenac suppository (100 mg every 8hr) was given to first group and Methadone (5 mg every 8hr) was injected to the second group for 24 hours. Then, the severity of pain was measured with numerical scoring in serial postoperative visits. The data were analyzed by SPSS software using descriptive and analytical statistics such as chi-square and ANOVA. The findings indicated that the severity of pain in 2nd, 3rd and 4th postoperative visits was significantly lower in patients who received Diclofenac suppositories than the other group (p<0.05). But overall, there was no statistically significant difference between the pain severity in Methadone receiving group (Mean & SD= 5.85 ± 3.5) and Diclofenac receiving group (Mean & SD= 6.46 ± 2.9). There was no significant difference between Diclofenac suppository and Methadone in terms of decreasing the postoperative pain after cesarean section. However, regarding the restrictions in the use of opioids, Diclofenac can be a suitable replacement for these drugs.

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. 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. 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. 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.

Renal poly cystic sinus is a rare disease which is bilateral and has benign course. It usually breaks out after the fifth decade of life. The cysts in this disease are mainly of lymphatic origin. They can be associated with inflammation, stone or obstruction. Unlike the multicystic and polycystic kidney in which the cysts are formed in the cortex, in this disease they are seen in the sinus of the kidneys. What makes this case unique and necessery to report is its rareness and differentiation from other renal cystic lesions. The author could not find any previous report about the coexistance of edema of mons pubis with renal polycystic sinus. This study reports a bilateral poly cystic sinus which exists with intermittent edema of mons pubis. The patient is a 24-year-old female who complained of a mild pain in the flank area with intermittent edema of the mons pubis. The patient underwent urologic and gynecologic examinations which lead to the final diagnosis of renal bilateral poly cystic sinus disease. The disease had a benign course and the patient is under observation after the biopsy.

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. 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. 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. 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.

Mother ’ s milk is the best food for the newborns and has positive effects on both mother and infant health, decreasing infant mortality, satisfying emotional needs of mother and infant and economizing the domestic as well as social expenditures. Unfortunately, because of different economical, social and cultural reasons in many parts of the world breast feeding and its length of time has decreased. WHO emphasizes breast feeding in the first six months of life in developing countries. This study is an attempt to determine the causes of unsuccessful breast feeding in the first six months after birth in Ardabil. This descriptive analytical�study was conducted on 160 mothers who had 2- month- old or younger infants and did not have exclusive breast feeding until the end of 6 months. The researchers referred to 4 health centers, selected based on cluster sampling, in order to select the qualified mothers and complete the questionnaires in their presence. Most of the mothers (37.5%) have begun feedings supplementary nutrition to their infants at the age of 2-4 months. The most common (90.5%) cause for the lack of the exclusive breast feeding was found to be insufficiency of mother milk.Most of the mothers (67%) stated the infant cry as the main reason for this insufficiency. There is a significant relationship between exclusive breast feeding on the one hand and the delivery, time of first feeding, occupation and mother ’ s education on the other (p<0.05). Social and economic conditions and misbeliefs have all affected the success of exclusive breast feeding. Most of these problems can be prevented through proper trainings.

Establishing centers to stop addiction in our country is one of the measures taken to confront this problem. Unfortunately, it has been shown that about 80% of the addicted people who refer to these centers relapse. The present study set out to investigate the possible causes of this problem. This is a case control study in which a questionnaire was used to collect the required data. The subjects were all addicted people who referred to Shahid Mellat Doust and Shahid Family treatment centers in 2000. The criterions for entering the study in case group were the last record of the addicted person ’ s abandonment in Tehran ’ s welfare center (based on the patients ’ records) and using narcotics at the present time. The control group subjects, on the other hand, had abandoned using narcotics at least four months before and had never used any substance so far. The mean age for case group was 35.99 and that of the control group was 35.09. Regarding the age distribution 98.59% of the case group and 100% of the control group were men. 88.7% of the case group and 97.2% of the control group were urban residents. Considering the job, 40.8% of the case group and 19.4% of the control group were unemployed. 52.1% of the case group and 61.6% of control group were living with their spouses. Opium was the most commoly used narcotics in both groups. In studying the relationship between the variables under study through logistic regression the job was not a main factor in the relapse. The duration of time being away from addiction had a deductive effect on the relapse, and this effect was statistically meaningful (p=0.001). Adding one month ’ s time to the period of being clear (not using the narcotics) caused 98% deduction in returning to narcotics. Because 80% of the patients who referred to the related centers began using narcotics again during the first 6 months after abandoning, it is necessary to improve the preventive measures to help the patients pass this critical period.

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. 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. 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). 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.

Senile cataract is one of the most common diseases in the world and a common cause for reduced visual acuteness and blindness. It is due to many factors the most important of which is aging. Other risk factors include gender, smoking, sunlight, living environment, high risk professions, family history, systemic diseases, etc. The present study was an attempt to investigate this disease epidemiologically and draw a general profile for it in order to pave the way for further research. This was a cross-sectional descriptive and retrospective study. The files of the patients who had received senile cataract surgical operation in Alavi hospital from March 1999 to February 2000 were investigated to collect the required data. The data were analyzed using appropriate statistical methods. 218 patients were studied. The prevalence of this disease was found to be 83.9% which was observed among males more than females and was more common in the 6th decade of life. The disease was mostly seen in the left eye and reduced visual activity to the light perception was the most common clinical complaint among the patients. 29% of the patients were diabetic and 22.1% of them had hypertension. Because of high prevalance of cataract, it is necessary to have good medical care and management. Moreover, some training and guidelines seem necesarry.

Postpartum depression, as a mental disorder, is seen in some women and can threaten their mental health as well as their infants. At least 7% of mothers suffer from this problem after parturition. Studies indicate that many variables are associated with this disorder during and after the gestation period. The aim of this study was to achieve the rate of postpartum depression and its relevant variables among women who referred to the parturition ward of Buali and Emam Hossein hospitals in Tehran. In this cross-sectional descriptive study a questionnaire construced by researchers as well as Beck 21- item depression inventory were used to collect the data. The subjects (100 cases) responded to the questions individually in the hospitals. According to the type of variables, X2 nonparametric test was used in the data analysis. The results of this study indicated that 17% of the subjects were suffering from moderate and severe depression and among the 14 predictive variables of the postpartum depression four variables, namely, matrimonial dissatisfaction, unwanted gestation, unemployment and low economical status of family have significant relationship with the postpartum depression. In comparison with the previous studies, the prevalence of postpartum depression is in higher level therefore, it is necessary to increase the information of parturition ward staff about this disorder and inform them to refer any cases of depression to the counseling centers.