نیره امینی ثانی

Adequate physical activity is essential to healthy aging. This study aimed to examine the construct validity of the Persian version of the Physical Activity Scale for the Elderly (PASE) among community-dwelling adults, which would be used as a screening tool at the Neyshabur longitudinal study on the aging (NELSA) Center.

This cross-sectional study was conducted in Neyshabur, Iran, as a pilot phase at the NELSA center between May and January 2019. The sampling method was a stratified random method. For explanatory factor analysis (EFA) and confirmatory factor analysis (CFA), 300 and 650 community-dwelling adults aged 50 and older were selected, respectively. EFA was used with the principal component extraction method, and Varimax rotation and CFA were performed with the maximum likelihood estimation method.

Of the 950 participants, 445 (46.8%) were male, and 505 (53.2%) were female. The mean age of participants was 63 ± 8.6 years. The mean physical activity score was 89.7 ± 70.7. According to the percentage of variance explained in EFA, all five extracted factors explained 62.7% of the total variance. The results of CFA showed that all item-scale relationships were significant (P < 0.05), except for household activity (Q8) and leisure time activity (Q2) (P > 0.05). The values of the fit indices showed that the model fits well with the data.

The EFA and CFA confirmed the construct validity of the Persian version of PASE. This questionnaire is suitable for measuring the physical activity level of older Persian adults.

Cognitive disorders affect the elderly’s personal and social life  by causing disturbances in their nervous system, and it is important to identify who is at the highest risk of these disorders; therefore, the present study aims to investigate demographic determinants of the cognitive status in the elderly visiting the Geriatric Cohort Center in Neyshabur.

This cross-sectional study was conducted on 3451 people aged 60 and above (52.5% women and 47.5% men) from 2015 to the end of 2017. The selection of statistical sample was done first by classification method, and then, by random method. Data collection was done using demographic questionnaires, and the questionnaires of Mini Mental State Examination (MMSE)and Montreal Cognitive Assessment (MOCA), and data were analyzed using independent t-test, ANOVA, and hierarchical multiple regression in software. were analyzed by SPSS16 software.

With MMSE, one fifth of the participants (20/3%) and with MOCA, almost half of the respondents (49/3%) did not have cognitive disorder. Cognitive disorder became more severe with aging. The severity of cognitive disorder was higher in women (P< 0/05)  those who were living alone(P <0/05), the women who only did housework(P < 0/05), and the cases who were illiterate (P< 0/05).

Screening of cognitive disorders in the elderly and early interventions including holding educational classes, especially for women with low literacy levels whose husbands have died, can prevent the progression of the disorder and improve their quality of life.

Aging has caused physical and cognitive defects in older adults, requiring serious intervention to support them. This research was conducted with the aim of investigating relationship between social support and cognitive status among older adults of Neyshabur city.

This cross-sectional study was conducted based on the data of the first phase of registration of the longitudinal Neyshabur Geriatric Cohort on 3451 people of 60 years and above. Data collection was done using demographic questionnaires, MMSE, MOCA and Duke social support questionnaire. .data was analyzed using SPSS v.16 software.

With the MMSE, one fifth of the participants (20.3%) and with the MOCA, almost half of the respondents (49.3%) did not have cognitive disorder. 84% of the respondents were satisfied with the social support received most of the time, and they were satisfied, had the least cognitive impairment. Education level was the strongest factor in predicting cognitive disorder, and MOCA was more influenced by demographic variables than MMSE.

Due to the high prevalence of cognitive disorders among older adults, careful examination and screening of cognitive disorders can lead to early diagnosis and prevention of disorder progression. Also, considering the relationship between social support and cognitive status, increasing the use of mass media, online technologies, designing programs and group recreational and sports activities can be effective in improving the cognitive status in older adults.

COVID-19 can be transmitted directly through respiratory droplets or indirectly through devices that transmit infection. SARS-CoV 2 has been identified on various environmental levels in hospitals and communities.

Sampling was done according to the instructions of the World Health Organization; environmental samples were taken using a swab with an artificial tip and a plastic shaft. In this study, sampling was done during the busy hours of the hospital and the total numbers of samples 48 samples were collected and finally the samples were analyzed by polymerase chain reaction-reverse transcription (RT-PCR) method.

The results showed that within 36 samples of the hospital, 8 samples were positive and in 10 samples of the comprehensive laboratory, two positive samples were reported. Due to the abnormality of the data, the Kruskal-Wallis test was used to compare datasets of different levels such as (plastic, metal, wood, glass, fibers and living body). According to the results, no significant relationship was observed between levels with different genders and the degree of positive tests (P value = 0.341)

Contaminated airborne droplets can be displaced by air currents and deposited on surfaces. Due to the type of surfaces and higher durability of these viruses on these surfaces, the need for regular and daily disinfection before and after shifts, and in case of exposure to virus infection, must be disinfected with appropriate antiviral compounds with the surface. No contamination has been observed on other surfaces such as fabrics and fibers, but due to the spread of this virus, necessary precautions should be taken.

Aging is associated with gradual erosive changes in the physiological function of many systems of the body. Ths study aimed to examine the physical functioning and limitation and its related factors in people aged 50 and older in Bukan, 2017. In this cross-sectional study 1201 elderly people aged 50 years and up were recruited from health recentres in Bukan city using stratified random sampling. Study information were collected by trained interviewers including demographic characteristics, socioeconomic status, fall history, visual and hearing status, comorbidities, BMI, physical activity (PASE), social support (DUKE), cognitive function (MMSE) and depression (CES-D-10) as well as physical functioning which was assessed by TUG test and and mobility limitation which was assessed using a 10 items questionnaire (MOS-PA). To analyze the data, we used various testes including analysis of variance, linear regression and logistic regression models. The mean of the physical functioning was 10.7 ± 3.53 seconds, and 14.2% of study participants had a severe physical limitation. The results showed that BMI, physical activity, fear of fall, economic and job status were significantly associated with physical function (respectively, β= 1.638-1.495- 0.3- 0.014- 0.148). Also, age, sex, cognitive function, depression, social support, visual status had a significant correlation with physical limitation (respectively OR=0.631- 0.929- 0357- 0.922- 0.415- 1.048). The results of this study indicate that psychological and socio-demographic factors are predictors of physical functioning and limitation in older adults. Therefore, it seems that improving the determinants factors, due to the better life and health in older adults.

Colorectal cancer can significantly cause physical, psychological and social problems. This study was done to determine the prevalence of anxiety and depression in patients with colorectal cancer in Babol located in north of Iran.
This cross-sectional, analytical study was done on 120 (75 males, 45 females) patients with colorectal cancer which registered in the Babol cancer registry in north of Iran during 2008-12. A questionnaire containing demographic information, aspects of the disease and HADS questionnaire was completed by interviewing to assess anxiety and depression for each patient.
The prevalence rate of depression and anxiety in patients was 23.4% and 30.8%, respectively. Gender, residency of rural area, and having comorbidities are related to depression among which location was identified as an independent predictor. Urban residency had 79% less risk of depression than rural residents (95% CI=0.06-0.67, OR=0.21, P The prevalence of anxiety and depression in colorectal cancer patients was high in this area. Therefore, interventions are recommended to increase awareness and greater attention to rural women and controlling comorbidities.

Colorectal cancer has a significant impact on physical، mental and social discomfort of patients. The aim of this study was to assess different aspects of health-related quality of life and its association with demographic characteristics and some clinical features in colorectal cancer survivors in the city of Babol. This cross-sectional study was conducted in 2013 among 120 colorectal cancer survivors identified in the cancer registry from 2007 to 2012. A questionnaire containing demographic data، disease characteristics and health-related quality of life (EORTC-QLQ-C30 standard questionnaire) was completed via face to face interview at patients’ homes. The mean total score of performance scale was significantly higher in men (69/24± 16/71) than in women (57/67 ± 17/87) (P=0. 001). Men obtained higher scores in all 5 performance scales which was statistically significant in the domains of physical، emotional and cognitive performance. Among the demographic variables، comorbidities، education and employment were identified as the independent predictors of quality of life. The patients had an average quality of life which was associated with employment، education and comorbidities. Therefore،، empowering the health staff، increasing the awareness of patients and their families as well as better management of comorbidities can help the patients to return to an active life.

Colorectal cancer is the fourth most common cancer in Iran with a diverse geographic distribution. The purpose of this study was to determine the incidence of colorectal cancer and assess the clinical and epidemiologic characteristics of survivors in the city of Babol، Iran.

In this cross-sectional study، all new cases of colorectal cancer، recorded by the Cancer Registry Center of Babol، were included for the assessment of the incidence of colorectal cancer during 2007-2012. Clinical and epidemiologic features of patients were investigated via interview in 2013.

A total of 237 patients were registered during the specified period، although only 120 subjects had survived until 2013. Age-standardized rate was 7. 7 per 100،000 people in 2007، which increased to 14. 6 in 2012. Overall، 54% of subjects were urban residents، 46% were illiterate، 30% were smokers، 16% used hookah، and 10% consumed opium. Family history of colorectal cancer was reported in 27 patients (22. 5%). The average age of survivors was 56. 74±14. 14 years; about a third of patients were younger than 50 years at the time of diagnosis. The mean interval between the presentation of symptoms and diagnosis was 10±13. 3 months، and the most common symptoms of the disease included altered bowel habits، rectorhalgia، abdominal pain، constipation، and weight loss، respectively.

The obtained results showed the increased incidence of colorectal cancer in Babol city. Considering the significant number of young people and the long interval between the onset of symptoms and definitive diagnosis، it is recommended that training courses on the warning signs and screening of colorectal cancer be planned.

Diabetes Mellitus is a metabolic disorder in which lacking of control and suitable care lead to disability and mortality. American Diabetes Association (ADA) has emphasized the medical care of diabetic patients and has suggested several objectives to increase survival and improve health outcomes with low complications by controlling the glycemic، lipids، nerupathy and hypertension as well as foot care، nutritional therapy and screening of cardiovascular disease. The aim of this study was to evaluate the quality of care in diabetic patients from Ardabil and its concordance to the standards recommended by ADA. In a cross sectional study، 100 diabetic patients referring to a clinic of diabetes in Ardabil (2005) were randomly selected and enrolled. The study was conducted according to a questionnaire with 90 questions and physical examination and Final lab tests. Data were collected and analyzed with Spss version 12. ANOVA test was used to compare groups. The 12 months recorded lab tests for diabetic patients were as follows: Hb A1C in 33%، MicroAlbuminuria in 16%، HDL in 58% and LDL in 55% of patients had been checked. Foot and peripheral pulses exams were only recorded in 9 and 5% of patients respectively. In final lab tests، 24% of patients had favorable FBS level (90- 130mg/dl). 46% of patients had suitable Hb A1C and 32% patients had MicroAlbuminuria. Aspirin was recommended to 45% of patients over 50 years old. Only 10% of patient for three lab tests (FBS، LDL cholesterol، Hb A1C) achieved the intended aims. According to ADA recommendations 22% of patients for three risk factors (BP، LDL cholesterol & Total cholesterol) were in optimal level. There is a high difference between current diabetes care in our clinic and ADA goals.

Cerebrovascular disease mortality rates have declined in some countries during recent decades. Changes in mortality rates over time could be attributed to changes in disease incidence or case fatality rate. Very few studies have provided information regarding survival after stroke. We aimed to determine the case-fatality rate (28 days) among patients with first-ever stroke from a population-based study in Ardabil province, Northwest of Iran. This study was conducted between May 2005 and February 2006, all individuals with an acute stroke who were residents in Ardabil province and hospitalized at Alavi Hospital, were registered prospectively and assessed according to standardized diagnostic criteria. The data were analyzed through SPSS, Chi square and variance analysis. A total of 352 patients with first-ever stroke were registered, and 346 (96%) were followed up. 288 (81.8%) ischemic stroke, 16.2% (57) ICH and 2% SAH. By 28 days, 70 patients (20.3%) had died. Hypertension, diabetes and cardiac disease history were reported in 61.6%, 16.8% and 26.1% respectively and 19.8% of patients were smokers. Mean age of survivors was different from patients who died at 28 days after index event (64.2±12.9 VS 69.1±10.9, p=0.03). The proportion surviving 28 days varied from 16.2% among patients with ischemic stroke to 43% among ICH and SAH. For ischemic stroke, Survival rates were similar for men and women, whereas men with ICH had lower survival than women. Case fatality rate after first-ever stroke is substantial. Rates of mortality differ according to patients diagnosis, age, sex, and heart disease. These data highlight the importance of long-term secondary prevention.

One of the most common gastrointestinal diseases is gallstone and its complications, that leads to hospitalization and expensive cost. Since Causative factors in this disease are so many that some of them can be preventable and there has not been a study on the risk factor and gallstone, this study investigates the relationship between riskfactor and gallstone, This was a case-control. study A total of 150 patients with gallstone using the simple nonrandomized method were selected and were compared with 150 hospital controls with which they were matched. The risk factors for gallstone formation (age, gender, family history, parity, obesity, diabetes mellitus, hyperlipidemia) were assessed in all of subjects. The association of gallstone with all these risk factor was evaluated with statistical tests including chi-square, ANOVA. In this study, 117 cases (78%) were female and the other 33 cases (22%) were male. 42 persons (28%) were between 40-49 years old and about body mass index 63 persons (42%) were at the range of 25-299 (overweight). The mean serum level of triglyceride in women of case-group was 152.7±7.5 in comparison with 117.8±57.7 mg/dl in control group (p=0.001). Mean duration of oral contraceptive pills in case was 6.9±4.9 in comparison with 3.1± 2.9 years in control group. There was a positive correlation between Goldstone, BMI and mean serum trighyceridz level in women (p=0.001, p=0.001). There was not any arelationship between the parity, smoking, hyper chlostrolemia, hypertriglyceride (in men), positive family history and gallstone. In this study, bidy mas index, the period of taking oral contraceptive pills and triglyceride play roles in gallstone formation. Since these factors can be interventional, it is essential that good plannings be devised to improve them.

The high incidence of low birth weight (LBW) occurs in developing countries, and diarrhea and respiratory infections are the main causes of infant mortality and morbidity. This study was done to find out whether there was a growth or morbidity response to zinc supplememttion, among LBW infants during the first 6 mo of life. The study was a randomized, placebo-controlled, and double-blind trial study. LBW infants were given daily for 6mo 5mg zn, or a placebo. Questionnairs were filled out during the study by a pediatrician and a GP. Anthropometric measurements were made at 0, 4, 8, 12, 16, 20 and 24 wk via home visits by trained interviewers. Baseline characteristics were similar in zinc and placebo groups. Weight gain in zinc group was significantly higher that of placebo group between 1 to 6 months (p=0.036). Length and head circumference gain were also greater in zinc group than in placebo groups, (p=0.04, p<0.001). The episodes of upper respiratory infections was greater in placebo group than zinc group (mean Episodes in zinc groups= 1.7 and in placebo group was 3) and there was significant difference between two groups (p=0.005). 8 Cases of lower respiratory infections in placebo group and 5 cases in zinc group were observed, but it was not significan diarrheal episods were observed only in placebo groups. It was found that low birth weight infants had better growth and lower morbidity during the first 6 months of life by receiving zinc supplementation.

Visceral leishmaniasis is a reticulo endothelia system and it is known as 'black fever' by Indians. According to WHO every year there are 500 thousand new cases of it in the world. The province of Ardabil, with 25-40% from all the country's leishmaniasis has a major part in the country and is considered as one of the main focuses in Iran. Due to its importance, this study was done to identify clinical signs and demographic characteristics of the patients. This was a descriptive cross-sectional study which was done retrospectively 110 children who were hospitalized in three different active hospitals between 1375-1382 entered in this study. Disease definition include parasite detection in bone marrow aspivation or special clinical signs (fever, spleenomegal, pansytopenia and weight loss) in addition direct agglutination test was positive. The samples were investigated in terms of demographic information. Place of living, clinical signs and the length of time between the symptoms of the disease and its diagnosis. To get to the results, simple descriptive statistics was used. 37.8% of the patients were diagnosed from the beginning of symptoms with in a month. There were 56.4% boys and 43.6% girls of all the 110 children. DAT test was done in 97 patients which was positive in 91 cases (minimum positive titer 1/400). In 42 patients biopsy and bone marrow aspiration was done which was positive in 26 cases (lishman body detection). The age of the patients was 4 months -14 years. The most common findings were fever 97.3% and anorexia 97.1%. There was anemia in 90% thrombocytopenia in 60.8% and leukopenia in 24.8%. There was death in 6 patients (5.5%) and unresponsiveness to the treatment in 3 cases (2.7%). The results of the present study nearly corresponds to those of other studies. The main vulnerable community of visceral lieshmaniasis are mainly children. In order to decrease the mortality and morbidity its early diagnosis is essential. It is necessary that the physicians working in endemic regions be familiar enough with the disease.

The ischemic stroke is defined as cerebral dysfunction due to brain infarct which is induced by vascular obstruction. The related risk factors including hypertension, diabetes mellitus, cardioembolism and hyperlipidemia are investigated in several studies. The aim of this study was to determine the etiology of cerebral infarction in young adults (- year-olds). All the patients in the age rang of - admitted to the neurology ward of Alavi Hospital in Ardabil between 2004 and 2005 with a diagnosis of cerebral infarction were included in this study. A questionnaire including demographic data, personal and family history of stroke and cardiac infarct, hypertension, diabetes, smoking and hyperlipidemia was filled out for all patients. Blood sugar, cholesterol, anticardiolipin antibody and beta- glycoprotein were examined. The patients underwent echocardiography. The data were analyzed using SPSS software (release). The total number of the patients was, including females (71.1%) and males (28.9%). The mean age was (SD=). The etiologic factors based on their frequency were: cardioembolism (40%), positive antiphospholipid antibodies (35.5%), hyperlipidemla (22/2%), smoking (22/2%), hypertension (20%), oral contraceptive use (15/6%) and diabetes mellitus (13.7%). The most frequent etiologies of the cerebral infarcts in the young adults in this study were cardiogenic embolism and positive antiphospholipid antibodies. Other background factors were hyperlipidemia, smoking, hypertension, oral contraceptive use and diabetes mellitus respectively. Most of these etiologies can be intervened and prevented. The identification of these factors before occurrence of cerebral infarction can prevent this debilitating event.

Benign prostatic hyperplasia is one of the most common diseases in males and Transurethral Resection of Prostate (TUR-P) is a standard method for its surgery. Distilled water is used to clean the field of operation from blood and debris. The overabsorption of this washing fluid can lead to hemodynamic disorders and neurological complications called TUR-P syndrome. Because of hemolysis and ATN, most of the urologists, nowadays, prefer to use non-hemolytic solutions such as cytol and glycine 1.5%. Distilled water is widely used in Iran. Replacing this water with a nonhemolytic and hypoosmolar solution with reasonable price such as manitol 3% seems reasonable. This study was carried out to campare manitol 3% with distilled water during TUR-P. In a double-blind randomized clinical trial, we studied 78 patients with BPH who were admitted to Shahid Moddares hospital in Tehran for TUR-P. These patients were allocated to disstiled water group and manitol 3% group. Na, K, Cr, BUN, CBC, U/A, U/C, 24 hr urine volume and creatinine were checked preoperatively to determine GFR, Na, K, BUN and CBC were checked right after, 4 hours after and on the morning after the operation. Clinical signs of TUR-P syndrome were recorded in the patients as bradycardia, hypertension and neurologic sign. Mean age was 68.6 in distilled water group and 66.4 in the manitol group. Mean weight of resected tissues, mean volume of the solution used and mean resection time were 19.8 gr, 19 litre, 50.8 minutes respectively in distilled water group and 20.2 gr, 20.3 litre and 51 minutes in the manitol 3% group. These differences were not statistically significant. The difference between decrease in serum Na and serum osmolality was not significant in two groups, however, hemolysis rate in two groups was statistically significant (p<0.01). The incidence rate of TUR-P syndrome was 34% in the distilled water group and 18% in manitol group. This difference was not statistically significant. Postoperative creatinine increase was 0.625 mg/dl in distilled water group and 0.04 mg/dl in manitol group. This was not statistically significant. Regarding the role of distilled water in hemolysis and ATN and due to the unavailability of non – hemolytic solutions such as glycine and cytol in Iran, the use of manitol 3% soluion which is a cost-effective, non hemolytic and hypoosmolar solution is recommended.

The incidence of neonatal hyperbilirubinemia disease is noticeable. Studying neonatal hyperbilirubinemia and its related factors is a step to reduce its incidence and remarkable treatment expenses. On the other hand, due to lack of on time recognition and suitable treatments, this disease can cause irreversible neuro-cerebral complications. This study was conducted to examine the etiology of neonatal hyperbilirubinemia and its associated signs, in order to provide on time and suitable treatment measures. This cross-sectional study was performed in 2003 on neonates affected by neonatal hyperbilirubinemia in Ardabil Sabalan hospital. The data obtained from their conditions, clinical examination, and measurment of total and direct bilirubine was used to fill out a questionnaire. The data were analyzed by SPSS software (release 10). From among 132 neonates affected by neonatal hyperbilirubinemia, 50% were male and others were female. 85.6% of these subjects were fullterm births and the rest were premature. 56% of these neonates were born by C/S. 6.8% of hyperbilirubinemia cases, which were considered as “pathologic”, occurred during 24 hours after birth. 72% were related to the second to seventh days of birth, 17.2% to second week of birth, and the rest (4%) had prolonged Icter. 65% of these neonates were the first children of the family. The average time of hospitalization was 4.8 days. 34.8% of these neonates had pathologic signs beside hyperbilirubinemia and had a clinically serious condition. About 23% of these neonates were born by C/S and only 11.8% of them were vaginal births. 46 cases (34.8%) had accompaynig pathologic problems in addition to Icter, among whom 33 children (25%) had evident infection. The causes of hyperbilirubinemia were Crigler-Najjar syndrome in one case, ABO in 11 cases (8.33%) and RH discord in 4 cases (2.8%). Generally speaking the precise cause of 36.89% of Hyperbilirubinemia was determined. Some factors such as children by C/S, neonatal infection, prematurity, ABO discords and RH discords play an important role in hyperbilirubinemia incidence and severity.

Providing, maintainance and promotion of neonatal health as a special high-risk group has a special role in heath services. According to statistics, 4 million out of 130 million neonates, born every year, die in the first week of their life. 99% of this mortality takes place in developing countries. 38% of the deaths below the age of 5 belongs to neonatal deaths. To decrease this mortality, some factors such as mother condition (including health care both before and after pregnancy), perinatal factors and life-threatening factors in the first 28 days after birth. This study was performed in hospitals under Ardabil University of Medical Sciences to determine the related factors of neonatal mortality. This case-control study was conducted on 160 neonatals (80 cases of neonatal deaths and 80 live births as controls). The demographic data of two groups were separately analyzed to obtain descriptive results. Also the most common causes of neonatal mortality were obtained through studying cases. Moreover, the parents of live neonates were asked questions to evaluate the effect of social factors. Finally all of these related factors were compared. From 160 neonates under study, 71 (44.4%) were female and others were male. Neonatal mortality in males was 1.3 times as much as that in females. 16(12.1%) mothers had history of still birth. 18(11.3%) mothers were illiterate and 27 (16.9%) had college education. 31(19.4%) neonates were under 1500gr, 42 (26.3%) 1500- 2500gr and others above 2500 gr. 37 (46.3%) mothers in case group and 24(30%) in control had no access to transportation facilities. The most common causes for neonatal mortality were prematurity with 44 (55.1%) cases and aspiration, septicemia, asphyxia each one with 4 (2.5%) cases. There were statistically significant relationship between neonatal mortality rate on the one hand and birth weight, access to transportation facilities and mothers, living place (rural or urban) (p=0.023). According to the results, factors such as birth weight, access to transportation facilities as well as the mothers’ living location (rural or urban) were determining factors in the neonatal mortality. Some measures seem necessary to by taken in order to decrease the effect of thses factors.

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.

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.

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.

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.

cervical dysplasia indicates the growth disorder of cervix and is characterized by the appearance of cancerous and precancerous cells in cervix. Cervical dysplasia often has no symptoms but can progress to cervical cancer in 5 % of the cases. Early diagnosis of these pre-invasive lesions with pap smear can prevent, to a great extent, the progress of lesion to cancer. The prevalence of cervical dysplasia is different in different parts of the world and depents, to a great extent, on its etiology. This study was an attempt to determine the prevalence and types of cervical dysplasia in 5000 cases of pap smears. This descriptive cross-sectional study was conducted on 5000 cases of pap smears selected randomly from among 8249 pap smears in the period between March 2003 to August 2004. Some samples were studied retrospectively and some others prospectively. The population of the study was composed of women referring to Ardabil health care centers for pop smear test. The data were collected with questionnaires and were analyzed using SPSS software (ver.11). Cervical dysplasia was found in 56 cases (1.12%) 0.66% of which was CIN I, 0.3% CIN II and 0.16% CIN III. The total percentage of cervical displasia in this study was 1.12%. This prevalence in other similar studies varies between 0.4% in Scotland and 12% in USA. Nevertheless, the prevalence found in this study is in line with most of the similar researches.