Journal of Arak University of Medical Sciences

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Cesarean Section Rate and Indication in Markazi Province

Vahid Goharian , Leila Moghareabed, Homeyra Fazelniya ,
Volume 1, Issue 5 (Winter 1997)

Abstract

Introduction: Cesarean section is the most common surgery in obstetric department and the most common causes are subsequently dystocia, repeated cesarean section, breech presentation and fetal distress .Cesarean section surgery has many complications and decrease in the rate of cesarean section can direct to safe delivery. In this study we researched to determine cesarean rate and its causes in Markazi Province for planning to give safe delivery.
Method: In this descriptive study, all mothers that delivered during the time of research (20 days) in all centers of delivery in Markazi Province were evaluated We investigated the mothers age, delivery, type of delivery location of delivery and etiology of cesarean.
Results: The study has investigated 721 mothers with the mean age of 25.5 cesarean section rate was 29.3% .The most common causes of cesarean section were subsequency distotia (33%), repeated cesarean section (24.17%) and fetal distress (10.9%) .The rate of cesarean section in private centers (74%) was more than university centers.(26%)
Discussion: The rate of cesarean section in Markazi province is more than other countries(29.3% to 22.7%) . Distocia and repeated cesarean are the most causes but fetal distress is the third etiology to fourth etiology in other studies. This study also shows the effect of socioeconomic status in increasing the cesarean section rate.

A Rare Genetic Syndrome Case Report: Cockayne Syndrome

Homeyra Azymi, Minoo Rafeei, Payam Kabyri, Ali Karami,
Volume 2, Issue 6 (Spring 1999)

Abstract

Today's considerable improvements in health scince and medical fields, preventing infectious diseases and the lack of missfeeding, inherited disease and abnormalities caused by it have appeared much more seriously, specially in advanced countries. Accoreding to our statistics 30.000 to 40.000 abnormal infants are born in Iran every year and a considerable number of them go on plant with living difficulties, however in order to considerable improvement in diagnosing-preventing and curing the inherited diseases, detecting these disease in embryonic satage has become possible and so we can do our best not to have abnormal infants any more. Since in Iran medical universities clinical genetics and genetic syndromes have received little importance, we are to report a rare syndrome case considered in central genetics-medical consulting in Behzysti organization of central province in Arak. It was finally diagnosed.
In this investigation s four- years boy affected by Cockayne syndrome is reported. He was the result of a family marriage (daughter of uncle- son of aunt) grade three and inherited austosomal recessive. Some symptoms are: dwarfism, mental and movement relationship, protruded ears, sunkened eyes, beak nose, carioused teeth, deafness, retini pigmentosa, retina degeneration, butterfly rush on the face, photosensitivity and progeria, defect in DNA transcriptions. The goal of this investigation is getting more acquaintance of this rare syndrome, enhancing the role of diagnosing this disese and putting more importance on consulting before marriage and after the abnormal infant is born, and making the students and doctors of clinical genetics acquainted with this case more, as well.

Evaluation the Effect of Chlorhexidine Mouthwashe on the Ventilator Associated Pneumonia: Pathogens, Incidence and Mortality

Hadi Darvishi Khezri, Tahmasebi Homeyra ,
Volume 17, Issue 10 (1-2015)

Abstract

Background: Ventilator-associated pneumonia is the most frequent infection occurring in mechanically ventilated patients in the intensive care unit. Ventilator-associated pneumonia is a serious issue and remains a significant clinical problem for critically ill patients. The aim of this review article is to evaluate studies to conclude the best existing evidence for providing oral hygiene to intensive care unit patients receiving mechanical ventilation, determine the clinical evidence considering chlorhexidine, and to document a research to improve care interventions used for oral care in the critical patients.

Materials and Methods: Searching was performed in the databases: Sciencedirect, SID, CINAHL, Google Scholar, Cochrane Library, Springer and PubMed for accessibility to the studies carried out regarding with chlorhexidine mouthwash and ventilator-associated pneumonia between 1991 to 2014 years by using keywords: chlorhexidine mouthwash and ventilator-associated pneumonia.

Results: Although oral care with chlorhexidine cause a reduce the incidence of ventilator-associated pneumonia, but no evidence exists on decrease of mortality in patients undergoing mechanical ventilation admitted in the intensive care unit following its using. Conclusion: Base on this current review article can be said that protective effect of chlorhexidine mouthwash has proved in oral health and prevention of ventilator-associated pneumonia in the critical patients, but unfortunately no evidence exists to the appropriate protocol for using of chlorhexidine mouthwash in these patients.

Identification of Clinical Isolates of Candida using Duplex PCR

Homeyra Babaei, Javaher Chabavizadeh, Parvin Dehghan, Rasoul Mohammadi,
Volume 19, Issue 8 (11-2016)

Abstract

Abstract

Background: Candida albicans is still the main etiologic agent of candidiasis. However, infections of non-albicans Candida species are increasing. Candida dubliniensis is similar to C. albicans phenotypically and must be identified due to the better management of infection. The aim of the present study is to defferentiate and identify Candida species by Duplex PCR for getting an epidemiological data of Candida species among clinical specimens.

Materials and Methods: DNA was extracted using phenol-chloroform method from fresh colonies. Internal Transcribed Spacer region was amplified by polymerase chain reaction using specific primers. Based on differences of bands sizes on agarose gel electrophoresis, species were identified.

Results: Ninety four out of 100 patients (49 males and 51 females) had predisposing factors in the present study. Diabetes (73.4%), use of antibiotic (6.3%), vitamin deficiency (4.3%) were the main predisposing factors. The most specimens belonged to mouth (75%), vagina (5%), and blood (4%). All isolates were identified as C. albicans.

Conclusion: Duplex PCR is a rapid and precise method for the detection and differentiation of Candida species carefully, and in this method, phenotypic tests like germ-tube and chlamydoconidia production, as well as biochemical tests are not required for clinical laboratories that have limited resources and time for response to the patients, and it can replace with the traditional methods.

The Assessment of Correlation between Blood Products Injection with Ventilator- Associated Pneumonia in Trauma Patients under Mechanical Mentilation in ICU

Homeyra Akbarzadeh, Abbas Alipour, Abolfazl Firuozian, Hadi Darvishi Khezri, Ghahraman Mahmoudi,
Volume 19, Issue 12 (3-2017)

Abstract

Abstract

Background: Ventilator-associated pneumonia (VAP) is one of the most important causes of mortality in intubated traumatic patients admitted in ICU. The aim of current study was to determine correlation between blood products transfusion with incidence of VAP in traumatic patients under mechanical ventilation in ICU.

Materials and Methods: This study was a prospective descriptive-analytical study. Current study was carried out on traumatic patients under mechanical ventilation admitted to Imam Khomeini hospital ICU wards of Sari city, from September 2015 to September 2016. In addition to demographic data, patients' clinical information were daily recorded.

Results: Of total of 2304 patients admitted to ICU, 186 traumatic patients under mechanical ventilation longer than 48 hours were reviewed and analyzed. Among patients infected with VAP, 36 persons(87.8%) had transfusion of blood products before VAP incidence. Blood products transfusion (before and / or after 48 hours) had the highest adjusted risk ratio in the incidence of VAP (Odds ratio; OR=3.58). Also, amount of injected Packed Red Blood Cells and platelet were significantly higher in patients infected with VAP (p<0.005).

Conclusion: Considering remarkable increase in incidence of VAP following blood products transfusion and its correlation with injected PRBC and platelet, considering these modifiable risk factors for controlling and preventing the incidence of VAP in traumatic patients under mechanical ventilation in ICU is necessary and reasonable.

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