hossein alikhah

Food and nutrition literacy has become increasingly important in food and nutrition research in recent years and is considered a key factor in population health and complex public health problems. The purpose of this cross-sectional study was to investigate the status of nutrition literacy of 10-12-year-old Kurdish children in Kurdistan province in western Iran. In this cross-sectional study, data were collected using a food and nutrition literacy tool. In 2022, based on targeted cluster sampling, primary school students were used. The total number of samples was 390 (male=195 and female=195). The same number of people from grades 4,5, 6 were randomly selected from 52 elementary schools. A total of 10 schools were selected from north, south, east, west and center of Baneh city in Kurdistan province, half of them were boys and half were girls. Among the seven areas of food and nutrition literacy, the highest score was related to the area of knowledge of healthy eating (84.5) and the lowest score was related to the area of nutrition label literacy (26.9). About 10% in the cognitive field and about 33% in the skill field had low food and nutrition literacy. The results of this study show the gap between the knowledge and skill areas of food and nutritional literacy levels at young ages, that is, although the level of literacy and nutrition of children is relatively favorable in the field of knowledge, it is not suitable in the field of skills.

Inadequate pain management after lumbar disc surgery may result in increasing morbidity and duration of hospital stay. This study aimed to evaluate the efficacy of analgesic effect of diclofenac sodium in reducing the total dose of morphine after lumbar disc surgery.

This study was conducted in Shohada Teaching Hospital. Eighty-four patients with mean age of 51.74 ± 5.76 years were included in this double blinded clinical trial study. Patients were premeditated with diclofenac sodium supposition or placebo before surgery. After surgery, patients randomly assigned to 1 of 2 treatment groups: group A: diclofenac sodium supposition and group B: placebo. Visual analog scale and morphine consumption were recorded at 6 hours intervals up to 24 hours.

The base line mean pain relief and nausea and urinary retention were not statistically significant between groups (P>0.05). Weakness and fatigue, dry mouth and total morphine dose were statistically different (P<0.05).

Premedication with diclofenac sodium supposition in the patients underwent lumbar disc surgery, can reduce total dose of morphine consumption after lumbar disc surgery and some adverse effect of morphine such as dry mouth, weakness and fatigue.

Early cervical spine clearance is very important in trauma settings. Waiting for cervical spine clearance by CT scan mandates prolonged cervical spine immobilization and consequently, the delay in subsequent emergency procedures in polytrauma patients.

The study aimed to assess the value of cervical spine ultrasonography (US) for detecting cervical spine injuries in severe polytrauma patients.

A cross-sectional analytical study was conducted on 172 severe polytrauma patients with Glasgow coma scale (GCS) score of < 12 or triage revised trauma score (TRTS) of < 8. The researcher performed bedside cervical spine US without impeding the ongoing routine trauma management. The researcher was blind to the computed tomography (CT) scan findings. The data were analyzed by SPSS software and sensitivity, specificity, and positive/negative predictive values were determined based on CT findings. The results were also compared between children (≤ 14 year) and adult (> 14 year) age groups.

Bedside US had a sensitivity of 74.5%, specificity of 97.6%, positive predictive value (PPV) of 92.1%, negative predictive value (NPV) of 91%, and accuracy of 91.3% in detecting spinal injuries in comparison with CT findings. Moreover, US had a sensitivity of 100%, specificity of 87.6, PPV of 50%, NPV of 100%, and accuracy of 88.9% in detecting spinal injuries with the movement of fractured or dislocated particles. Also, it had a sensitivity of 33.3%, specificity of 87.58, PPV of 100%, NPV of 97.2%, and accuracy of 97.2% in ≤14-year-old patients. The modality had a sensitivity of 76.2%, specificity of 94.7, PPV of 91.4%, NPV of 84.4%, and accuracy of 86.9% in > 14-year-old patients.

The diagnostic value of bedside US was higher in adults and injured patients with the movement of fractured or dislocated particles.

Patient safety has become one of the main concerns of healthcare provider organizations, given that it is one of the basic principles of health care; because the error in the care process can sometimes lead to injury or even death. The present study aimed to investigate the patient safety culture from the viewpoint of nurses working in Sina Tabriz Educational Center in 2017. The present descriptive-correlation study with simple random sampling was conducted to assess the nurses' view using a standard and validated questionnaire and HSOPSC (hospital survey on patient safety culture) in 12 dimensions. The average percentage of positive responses to dimensions of the safety culture was 56.85%. The mean score of "Teamwork within the ward" with the highest score were 82.22% and the average "Transfer and shift in hospital" in the hospital with the lowest score was 28.15%. There was a significant reverse relationship between safety culture and work experience in the hospital (P<0.01, r=-.480)‏. Reporting errors with a non-reciprocal response approach and encouraging self-reporting errors in order to correct processes need for culture is more than ever. Considering the positive impact of hospital management on the development of the dimensions of the safety culture and the removal of barriers to patient safety, it is necessary that the problems associated with each dimension of safety culture are identified and low safety culture dimensions are promoted.

In Islamic countries, the prenatal diagnostic procedures are planned considering legal and religious limitations. We aimed to evaluate the indications of presentation and problems related to religious and legal limitations for presentation of Muslim parents for prenatal screening of chromosomal abnormalities. A cross-sectional study was performed on consecutive 920 pregnant women presenting for screening of congenital and chromosomal anomalies to Educational Medical Centers of Tabriz University of Medical Sciences, Tabriz, Iran, between 2011 and 2015. Previously prepared questionnaire forms were utilized for collection of information from patients and their medical records. In total, 153 cases had an indication for amniocentesis, and this procedure revealed that 141 fetuses (92.2%) did not have any congenital abnormalities, but 12 cases (7.8%) had some sort of abnormality, requiring pregnancy termination. These cases included 8 fetuses (5.2%) with trisomy and four (2.6%) with single gene diseases. Of 12 patients, the justifications for pregnancy termination were issued for 7 women by the provincial Legal Medicine Organization. However, the remaining 5 patients could not obtain legal justifications for termination of their pregnancies, mostly because of late presentation, obligating them to choose illegal methods for pregnancy termination. Regarding the legal and religious limitation of pregnancy termination after 18th week in Islamic countries, it is highly recommended that the first trimester screening programs be performed in Islamic countries in order to obtain early decision-making.

Background Due to the growing number of elderly population, evaluation of the mental health problems of this group of people is important and identification of factors affecting coping self-efficiency is helpful in this age group. The study was aimed to assess the effective factors on ?coping self-efficiency? of the elderly living in nursing homes.
Methods A total of 110 elderly aged >60 year is selected randomly with multi stage method from East Azerbaijan nursing homes. Data collecting process was done using World Health Organization Quality of Life (WHOQOL-BREEF), Coping Self Efficiency Scale (CSES), Nurenburg?s Social Support Scale Questionnaire (NSSQ) and Mindfulness Attention Awareness Scale (MAAS). Analysis of variance, Spearman and Pierson correlation coefficients and regression analysis was implemented for data analysis.
Results The age and educational attainment of the elderly were associated with the quality of life variables, social support and coping self-efficiency. Females achieve higher scores in mindfulness and coping self-efficiency (problem solving and stopping unpleasant emotions) in comparison with males (PConclusion Based on the results of the present primitive study, the quality of life and mindfulness were the predictors of the coping self- efficiency in the elderly.

As an essential part of antenatal care, pregnant women of all ages should be offered screening for chromosomal abnormalities before 20 weeks of gestation. This study was aimed to evaluate the type and frequency of chromosomal abnormalities following pregnancy screening tests, so that we can compare the actual pregnancy outcomes with test results, helping us in practical decision making. A cross-sectional study was conducted on 557 pregnant patients, presenting for prenatal diagnostic amniocentesis for chromosomal abnormalities, to Al-Zahra hospital, Tabriz, Iran, since 2012 to 2015. Amniocentesis was conducted by an expert obstetrician at second trimester between 16 and 22 weeks of gestation. An interview was set for pregnancy outcomes to assess the test results. Of 557 cases, the mean maternal age in amniocentesis was 31.84 ± 6.92 years (range: 15-47 years). Amniocentesis revealed the presence of chromosomal abnormalities in 32 cases (5.7%). The most common diagnosed chromosomal abnormality was Down syndrome (50.0%) followed by other chromosomal abnormalities. Following up the patients, 92.4% of newborns did not have any congenital abnormality, but the remaining (7.6%) had both chromosomal and non-chromosomal abnormalities. No fetal loss was reported in this study. Assessment of total costs revealed that $US100 had been spent for hospitalization, and about $US500 for genetic tests. There is still no consensus on the most cost-effective strategy that should be implemented to diagnose chromosomal anomalies. Therefore, we did not have an actual gold standard to compare with amniocentesis. More studies analyzing natural outcome after prenatal diagnosis of these chromosomal abnormalities are needed

Discharge against Medical Advice (DAMA) is a global problem with unpleasant consequences, mandating to conduct studies for its Predictors and outcome. This study aimed to investigate the reasons of DAMA from a general referral hospital.

A cross-sectional descriptive study was conducted in Sina Hospital. A researcher-made questionnaire was used after determining its validity and reliability. All patients who wanted to DAMA, completed the questionnaire. The data was analyzed by SPSS 19, using descriptive and inferential statistics.

DAMA was more seen within men, married, native, and under diploma patients with age range of 19 to 39 years. Prolongation of hospital stay (13.2%), other hospital staff’s suggestion (6.8%) and dissatisfaction with the facilities (12.3%) were among the main reasons for discharging. The reasons of DAMA had only significant relationship with hospital wards.

Improvement of training, providing innovate facilities for young people, providing more advanced facilities and equipment, and continuing the necessary treatment as outpatient are important factors that must be prepared in order to decrease the rate of DAMA.

Being the first-line treatment of patients, emergency units have an especial importance. The mortality of patients in the emergency department is a problem that has been exacerbated in recent years. Further studies on the causes of death are required in the emergency for correct judgment. This study is conducted in order to better understand the causes of death, in patients referred to emergency unit of Tabriz Imam Reza hospital in 2014 – 2015.
This cross-sectional study was carried out on the profiles of all patients admitted to the emergency department of Tabriz Imam Reza hospital. Demographic data and causes of death were extracted.
Of the 604 patients who died in the emergency department, 60.6% were men, 54.6% married and 31.5% had over 75 years. The most common causes of death were internal illnesses (22.2%) and trauma (19%). In total, 39.1% patients were died before in the emergency department and 32.1% of patients were referred from anther hospitals.
It seems that internal illnesses and trauma are the most common causes of death in the emergency department. The high rate of mortality shows the importance of early aids and proper referral system.

Tramadol is an analgesic medication. High prevalence of tramadol abuse has been frequently reported. This study was aimed to evaluate the common and serious complications and death cases due to tramadol intoxication.

A cross-sectional study was performed on 420 patients hospitalized in poisoning ward of Tehran Loghman Hospital for four months period. Patient’s characteristics and medical complications were recorded during hospitalization and subsequent visits.

Convulsion (31.3%) and apnea (6.2%) were the most serious side effects in patients using with tramadol intoxication. The incidence of apnea was correlated with the drug doses (P

The high prevalence of tramadol abuse, and its high and dangerous complications in our country that requires careful vigilance of physicians and pharmacists in prescribing and selling tramadol, and families’ awareness about the arbitrary use of his youth.

Otomycosis is a superficial fungal infection often involves the pinna and external auditory canal. It is a pathologic condition, with Candida and Aspergillus, the most common fungal species. It is common worldwide but more prevalent in tropical and subtropical countries. The aim of this study was to determine the etiologic agents and local epidemiologic pattern of otomycosis in northwest Iran.Patients and A series of 140 patients with clinically symptomatic otomycosis were studied in 21 cities, towns, and villages throughout northwest Iran between 2009 and 2011. Clinical samples were collected by swabs and then assessed by mycological investigation. Otomycosis was diagnosed in 129 cases (92%, 76 male, 53 female) with the highest prevalence of cases occurring in males between 21 - 40 years of age. From an etiological point of view, 116 patients (90%, 21 - 40 years old) were infected by saprophytic mold and 9 patients (7%) were infected by yeast. Three cases (2%) involved dermatophytes, and in one case (1%) the subject was infected with Eurotium (the perfect stage of Aspergillus fumigatus). Aspergillus niger was the most common mold that was isolated, followed by A. flavus, A. fumigatus, Penicillium spp., Fusarium spp., and Rhizopus spp. A total of 2 yeasts belonging to genus Candida, C. albicans and C. tropicalis, were isolated. Our study showed a high prevalence of otomycosis in the northwestern area of Iran. As such, proper diagnosis and treatment by aseptic techniques for this disease is urgently needed.

Vitronectin (VN), malondialdehyde (MDA) and high-sensitivity C-reactive rotein (hs-CRP) are cooperative agents involved in the atherosclerosis process. The study was conducted to assess the correlation of VN, MDA and hs-CRP with the severity of coronary artery disease (CAD). Parameters such as serum VN, MDA and hs-CRP were measured in 250 subjects including 200 patients with angiographically diagnosed CAD (50 subjects with non-significant CAD, 50 with single vessel disease, 50 with double vessel disease, and 50 with triple vessel disease) and 50 CAD-free subjects as a control group. Serum VN was measured with ELISA; MDA was measured based on reaction with thiobarbituric acid (TBA); and hs-CRP level was measured by a Commercial Kit by Immunoturbidimetry. Serum VN, MDA and hs-CRP were significantly higher in patient groups compared to control group (P <. 05). The mean value of MDA between 1 vessel and 3 vessel groups had significant difference (P =. 01), also mean value of MDA between 2 vessel and control group and normal group showed significant difference (P <. 001). The difference of MDA between 3 vessel and normal and 1 vessel and control group was significant (P <. 001). The association and correlation between VN, MDA and hs-CRP indicate their involvement in the atherosclerosis process that may lead to progression of CAD. Also, these findings suggested that serum levels of VN, MDA and hs-CRP can help as diagnostic and monitoring markers in CAD patients and as markers of disease severity.

Surgical treatment is increasingly finding a place in the treatment of unilateral obstructive uropathy. This study was designed to investigate the recoverability of renal function following surgical treatment of adult patients with unilateral obstructive uropathy using Lasix 99mTc-diethylenetriaminepentaacetate renography (DTPA-R) for measurement of glomerular filtration rate (GFR) before and after surgery.
This was a prospective study which included 29 (20 males and 9 females) consecutive adult patients with a diagnosis of unilateral renal obstruction and a normal contralateral kidney. The obstruction and malfunction of the contralateral kidney were confirmed with Lasix DTPA-R. For all the patients, surgical treatment of the unilateral kidney obstruction was performed, and post-surgical measurement of the function of the treated kidney was also applied using Lasix DTPA-R.
The mean age of the patients was 42.24 years. According to our results, the average of pre-operation GFR was 17.48 ± 9.10 ml/minute/1.73 m2 and post-operation GFR was 26.4 ± 11.2 ml/minute/1.73 m2. It is approved that the GFR increased 8.92 ± 6.30 ml/minute/1.73 m2 after surgery. The most increased rate of GFR was observed in the group with the impaired kidney with GFR > 20 ml/minute. It is approved that the rate of recovery in the patients with preoperational total GFR > 75 ml/minute and also 50 Our findings demonstrated that in unilateral obstructive uropathy if the GFR of the impaired kidney is > 10 ml/minute/1.73 m2 or total GFR > 25 ml/minute/1.73 m2 the functional recovery of damaged kidney could be expected following the removal surgery.

This study aimed to investigate different methods used to provide necessary supplementations for pregnant women and obtain reliable data about the general status of health promotion during pregnancy. This descriptive, cross-sectional study was conducted on 401 pregnant women referring to different women’s hospitals of Tabriz, including Alzahra, Taleghani, 29-Bahman, Zakariya, Shafa, and Shams from March 2011 to September 2013. Subjects were selected using simple random sampling and had prior experience of childbirth. In this study, prenatal care was provided for all the pregnant women at public (55.8%) and private sectors (44.2%). Iron supplementation used by the subjects included ferrous sulfate (150 mg) + folic acid (0.5 mg) (20.2%), regular-release ferrous sulfate (325 mg) (70.4%), folic acid (0.1 mg) + ferrous sulfate (200 mg) (6.5%), and vitamin B12 (15 mg) + ferrous fumarate (350 mg)+ vitamin C (150 mg) + folic acid (1 mg) (1.6%). Supplementations were provided before (56.7%) or after (43.3%) the onset of pregnancy. In total, 40.9% of the subjects received family planning care, 44.7% of whom referred to medical centers, 34.6% referred to health houses, 12.3% consulted gynecologists, 2.8% consulted midwives and 5% received traditional care. According to the results of this study, general status of iron and folic acid supplementation, their provision and average use of these substances were suboptimal. However, status, provision and use of iron were significantly more efficient than folic acid.

Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran.
In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012). They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses) following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946).
The satisfaction score (satisfied or very satisfied responses) were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future.

Radiology is a complex health science and profession, requiring experienced use of academic technology, beside the ability of thinking critically, independent judgment, solving problems creatively and communicating effectively to make the best clinical performance. The present study was designed to evaluate the practical capability of radiology technologists working in radiology wards, for determining the level of association between capability and academic education.
In a cross-sectional analytical study carried out at Tabriz University of Medical Sciences, Iran, in 2010-2012, the radiology technologists were asked to fill the previously-designed questionnaires which was included a checklist related to the participants’ social and demographic characteristics, and a questionnaire on the radiology technologists’ performance regarding the medical applications of X-ray.
The mean age was 35.03 ± 8.01 year, and 64 (53.3%) were male. The technologists’ capability had a significant relation with their educational degree, and the capability of staff with BS was more than those with an associate degree (P A great majority of the technologists do not seem to base their capability on the recognized scientific sources. Teaching or familiarizing the students with the true concept of performing on the basis of the prior training, and the significance of implementing such training in professional activities is one of the approaches, which could lead the technologists to appreciate the relationship between classical training and their providing quality services.

We decided to investigate the effects of injecting Indomethacin on reducing complications of Patent Ductus Arteriosus (PDA) and the need for prolonged mechanical ventilation. During this randomized clinical trial, 70 premature infants with matched gestational age and birth weight were divided into case and control groups. In the study group, intravenous indomethacin started from the first 2-12 hours of birth. All patients were followed by echocardiography at the fourth day and skull ultrasound in the second week. Symptomatic PDA rate was significantly higher in the control group (25.7% vs. 0%; P≤0.001). Incidence of grade 1-3 intraventricular hemorrhage was higher in the control group and the ratio of needed time for respiratory support in the control group to the case group was approximately 2.1. Intravenous Indomethacin reduced the number of PDA cases and incidence of grade 2 and 3 intraventricular hemorrhage, without any short term side effects.

Tinea versicolor is a superficial mycosis caused by Malassezia furfur, and is exclusively localized in the corneal layer of adults epidermis.. To evaluate the epidemiological features of tinea versicolor, including its incidence among different age groups, genders and other personal status.. The study was conducted between 2009 and 2011 on 1023 patients who presented skin disease suspected to tinea versicolor. Of all patients; 671 females (66%) and 352 males (34%) were studied for this mycosis and the fungal distribution from the view point of age and anatomical region of mycosis were analyzed.. The disease was more prevalent in 21-40 years old age group in both genders. The most infected anatomical regions were posterior surface, the body trunk (shoulder, supra scapula and lumbar region), anterior thorax and abdomen, respectively. The number of female cases was significantly more than males; this probably reflects the concern of females about their skin health.. Patients who regularly use the local saunas had poor personal hygiene and greasy skin, and were more suspected to tinea versicolor infection..

Myrtus communis L. is an evergreen perennial shrub belonging to the Myrtaceae family that is spontaneously growing throughout the Mediterranean area. Myrtle has demonstrated important antimicrobial and antifungal activities to treat bacterial and fungal diseases.

This study was aimed to develop a new method to evaluate the anti-fungal activity of hydroalcoholic extracts of Myrtle on dermatophytes by bioautography.

The species used for this study were: Microsporum canis, M. gypseum and Trichophyton mentagrophytes. The fungi were kept on Sabouraud dextrose agar (SDA) slants at 4°C and subcultured monthly throughout this study. Various fractions were prepared from hydroalcoholic extracts based on polarity. The antifungal assay of different solvent extracts was performed by agar disc diffusion method. A thin layer chromatography (TLC) method was developed to carry out bioautography TLC, the same solvent system as that of bioautography was used.

Ethyl acetate and total methanolic extracts respectively had the best antifungal effects against three tested genera of dermatophytes. The ethyl acetate extract and methanolic extract that had the most inhibitory effect compared with any other fractions, were separated by solvent system (trifluroacetic acid, ethyl acetate, methanol, water: 0.1: 10: 0.04: 0.04) by TLC method. The best antifungal effects of the three fungi extracts was obtained in Rf: 0 - 0.3.

The active compound may be a flavonoid. Existence of flavonoids in tested fractions could be the important medicinal properties of M. communis leaves. Further work is required to evaluate the exact effect of these biological compounds on animal model or human volunteers.

Problem-based learning (PBL) method has progressed as an alternative to lecture-based learning (LBL) method in recent decades. Benefits of PBL clearly supported by researches however several items remain unclear especially in Iranian medical universities. The aim of this paper is to compare the learning outputs of PBL and LBL methods. In this cross- sectional study public health course was prepared for three groups of students. Group 1 included medical students (n=101), Group 2 dentistry students (n=54), and Group 3 was formed of pharmacy students (n=112). Scores of final exam as well as 10 similar- root questions as a short-term outcome, scores in national basic science exam, recent similar informal exam as a mid-term output in addition to course evaluation by students, and assessment of attitude about PBL were compared between groups. Data analysis was performed by SPSS-11 using means’ comparison. Scores of students in PBL group was significantly higher in final exam (P<0.001). The percentage of correct responses to 10 same- root questions in PBL (M= 6.68) were significantly higher (M=6.54). Faculty members were evaluated better in PBL group (P<0.001) in all aspects of teaching. Totally, the students who evaluated teachers in PBL group had 2 points more than LBL group (P<0.001). Scores of students in national exam (after two years) and the recent survey (in the third year) were higher in PBL group (P<0.001). Results of using PBL method indicated the higher rate of scores and better recalling of learned materials in this method.

Modification in medicine and medical education has led to the use of new teaching methods and learning-based tendency in education. Continuing medical education, as an indispensable part of a physician’s life, is one of the best fields of medical education that can use electronic learning. Regarding the increasing development of these programs, this study aims to examine the satisfaction of the participant with the program. This descriptive, cross-sectional study includes 50 participants. A questionnaireincluding questions about personal characteristics and satisfaction of the participants withthe program was distributed. The gathered data was analyzed by SPSS. Reliability of scaleby Cronbach’s alpha was 0.90. Using Friedman test the highest score was for the clarity of educational objectives, advantage of electronic programs and satisfaction with registration method and the cost and the lowest one was that of the cost compared to classroom programs. No significant difference between men and women satisfaction level was observed (p=0.265). There was significant correlation between satisfaction and degree of study (p=0.038). Based on the results of the study the participant were satisfied with the program. If there is a well designed e-learning program, it will motivate the learners to be active participants.

Premature Rupture of Membranes (PROM) occurring before 37 weeks of gestation is referred to as Preterm Premature Rupture of Membranes (PPROM). This study was aimed to identify whether home caring of mothers، while they are under tight medical control، has any serious side effects on mother and fetus or not?

Patients with 26-32 weeks of gestational who complicated with PPROM were hospitalized for seven days and were treated with antibiotics and Betamethasone. Then patients were divided into two groups. “Group-I” were sent to home (Outpatient) and observation was continued and “Group-II” were hospitalized till the end of their pregnancy (Inpatient). All patients in Group-I were also hospitalized again at the beginning of the 32nd week and if it was possible، all pregnancies were ended on the 34th week.

The time interval between PPROM and delivery، prevalence of child hospitalization in neonatal unit، and intra-ventricular hemorrhage (IVH) were lesser in inpatient group. The rate of cesarean، need for ventilatory support، the period of child hospitalization in neonatal unit، prevalence and hospitalization period in NICU، and neonatal mortality were higher in inpatient group. The rate of metritis، chorioamnionitis، one and five minutes’ Apgar scores، premature placenta detachment، average of umbilical arteries base excess (BE) and pH، and the last biophysical profile (BPP) score were similar in both groups.

For patients who are well trained to know the risky symptoms and have immediate access to the hospitals and medical care centers، if they has a amniotic fluid index (AFI) more than 5cm، and the period between their PPROM and 34th week of their pregnancy is so long، they can be followed through the protocol in their homes.

Atrial Fibrillation (AF) is the most common cardiac arrhythmia which represents a major public health problem. The main purpose of this research is to evaluate the Radiofrequency (RF) ablation effects in the patients with chronic AF scheduled for cardiac surgery because of different heart diseases. The descriptive and prospective study was conducted on 60 patients with AF scheduled for surgery along with RF ablation. The data were collected by questionnaire and included: patient's age, sex, NYHA class, operation type, past medical history, type and cause of valvular heart disease, preoperative ECG (electrocardiogram), duration of surgery, clamping time, cardiopulmonary bypass, and RF ablation time. RF ablation was followed by the main operation. The follow up examination, ECG, and echocardiography were performed 3 and 6 months after operation. The mean age of patients was 48±10 years (18-71 years). Forty one patients had permanent AF and 19 had the persistent AF. The left ventricular ejection fraction was 48.27±9.75 percent before operation, and reached to 56.27±7.87 percent after the surgery (P<0.001). The mean NYHA class before the surgery was 2.83±0.68 which decreased to 1.34±0.46 6 months after the surgery with RF ablation (P<0.001). One patient (1.6%) died after surgery. Complete relief and freedom from AF recurrence was observed in 70% of patients in the mean follow up in 7 months after the surgery. The sinus rhythm with efficient atrial contraction was established in 100% of discharged patients. RF ablation is an effective procedure to cure atrial fibrillation in patients undergoing cardiac surgeries.