SAT Hospital Research Articles

Gambaran Faktor Risiko Kejadian Penyakit Jantung Koroner di Poliklinik Jantung RSI Siti Rahmah Padang Tahun 2017-2018

Introduction: CAD occurs indirectly, usually a person will experience a process of narrowing of the coronary arteries in quite a long period of time. Primary survey results that researchers have done at Siti Rahmah Padang Hospital, recorded from 2017-2018 the number of CAD events as many as 115 cases. Aims : To obtain information about an overview of risk factors for the occurrence of coronary artery disease in the heart policlinic of Siti Rahmah Hospital Padang in 2017-2018. Method: This research covers the field of internal medicine and cardiology, this study was conducted at the Islamic hospital Siti Rahmah Padang in May to November 2019. This research used a descriptive method with a cross sectional approach using secondary data from medical records. The affordable population of this study is CAD patients who seek treatment at Siti Rahmah Hospital in Padang in 2017-2018 with 51 samples using Total Sampling technique. Univariate analysis is presented in the form of a frequency distribution table. Results: Based on the results of the study the most age was at the age of 50-59 years, 21 people (41.2%), the most sex was female, 26 people (51%), hypertension, 27 people (52,9%), experienced DM 26 people (51%) were obese, 16 people (31,4%) and hyperlipidemia, 13 people (25,5%). Conclusion : Most age 50-59 years, most sexes of women, most have hypertension, less than half are obese, most have DM and less than half have hyperlipidemia.

Evaluation of QRS, QTc, and JTc intervals in Congenital Heart Disease with Pulmonary Hypertension

Background Pulmonary hypertension (PH) in congenital heart disease affects the patient’s prognosis. Prolonged QRS and QTc intervals in ECG may intensify life-threatening dysrhythmia in patients. We aimed to investigate the correlation between QRS, QTc, and JTc intervals prolongation in ECG with PH in Congenital Heart Disease (CHD) patients. Materials and Methods: This cross-sectional study was performed in the pediatric cardiology clinic of Be’sat Hospital in Hamadan, Iran, in 2016-2018. Patients with CHD and PH were compared with CHD patients without any evidence of PH as the control group. Afterward, QRS, QTc, and JTc intervals in ECG, RV MPI, and TAPSE echocardiography were compared between the case group (PH group) and the control group. We also compared the ECG and echocardiographic results between mild and severe PH patients in the case group. Results: In this study, 40 patients in the case group (with CHD and PH) were compared to 40 patients in the control group (only CHD without PH). There was a significant difference in QRS (p=0.005) and QTc (p=0.036) intervals between the two groups, but no significant difference in the JTc interval was observed. Of 40 patients with PH, 19 were in the mild PH subgroup, and 21 were in severe PH subgroup, in which 9 patients had irreversible PH or Eisenmenger syndrome (ES). QTc (p<0.001) and QRS (p=0.018) intervals in the severe PH subgroup with ES were significantly different from the mild PH subgroup, but the JTc interval was not significantly different. Conclusion Despite longer QRS and QTc intervals in the PH group of CHD, JTc interval did not show a significant prolongation.

Description of Anemia Case on Referral Patients At Mother and Child Hospital Siti Hawa Padang in January – December 2018

Anemia is the most common hematological disorder in pregnant women, primarily caused by iron deficiency. Many factors affect hemoglobin levels such as socioeconomic, educational level, age, parity, etc. Globally, there are 40.1% of women who experience anemia in pregnancy, with more than half due to iron deficiency.This study is a descriptive study using a cross sectional design with a population of anemic obstetric patients who were treated at Siti Hawa Hospital Padang from January 2018 to December 2018. All populations that met the inclusion criteria were taken as samples, so that 50 samples were obtained. Total population of hospitalized obstetric patient was 1994 patient.The results showed that the most obstetric patients with anemia found in 20-35 years old patients, in the second and third pregnancies. Most commonly found in non-bleeding patients with moderate degrees of anemia. The most patients came from Lubuk Begalung, Padang Timur, and Pauh. In addition, 3 patients were referred from outside the city of Padang, which are from the Mentawai Islands, Dharmasraya, and Pariaman.Keywords: anemia, age, parity, diagnosis, area

Description of Anemia Case on Referral Patients At Mother and Child Hospital Siti Hawa Padang in January – December 2018

Anemia is the most common hematological disorder in pregnant women, primarily caused by iron deficiency. Many factors affect hemoglobin levels such as socioeconomic, educational level, age, parity, etc. Globally, there are 40.1% of women who experience anemia in pregnancy, with more than half due to iron deficiency.This study is a descriptive study using a cross sectional design with a population of anemic obstetric patients who were treated at Siti Hawa Hospital Padang from January 2018 to December 2018. All populations that met the inclusion criteria were taken as samples, so that 50 samples were obtained. Total population of hospitalized obstetric patient was 1994 patient.The results showed that the most obstetric patients with anemia found in 20-35 years old patients, in the second and third pregnancies. Most commonly found in non-bleeding patients with moderate degrees of anemia. The most patients came from Lubuk Begalung, Padang Timur, and Pauh. In addition, 3 patients were referred from outside the city of Padang, which are from the Mentawai Islands, Dharmasraya, and Pariaman.Keywords: anemia, age, parity, diagnosis, area

Serum magnesium levels in normal pregnant women, severe preeclampsia, and severe preeclampsia with complications; a consideration for early supplementation?

This study aims to compare serum magnesium levels of normal pregnant women, severe preeclampsia and severe preeclampsia with complications in the third trimester of pregnancy so that they can be used as a basis for earlier consideration of supplementation in pregnancy. This study was an observational study with a comparative cross-sectional design conducted in July-September 2019 in four hospitals in Makassar, namely Dr. Wahidin Soedirohusodo General Hospital, Hasanuddin University State University Hospital, Sitti Khadijah I Hospital and Children Hospital Siti Fatimah's Mother and Child Hospital. Respondents in this study were three-trimester pregnant women who were divided into three groups, 30 mothers with normal pregnancies, 30 mothers with severe preeclampsia, and 12 women with severe preeclampsia with complications. Criteria for respondents in this study were single pregnancy and not with systemic disease. Data collected included age, education, occupation, body mass index (BMI) before pregnancy, parity, the distance of pregnancy, history of preeclampsia, family planning history, history of antenatal care examination and pregnancy planning. Serum magnesium levels were determined using a Magnesium Assay Kit with a colorimetric method that was assessed for absorption by spectrophotometrics. The mean serum magnesium levels were the lowest in the severe preeclampsia group (0.61mmol/L) compared to the severe preeclampsia group with complications (0.72mmol/L), and the normal pregnancy group (0.92mmol/L). Magnesium levels of the three groups differed significantly (p=0.008, p<0.05) CONCLUSION: Serum magnesium levels should be considered as a prognostic factor and supplementation intervention for pregnant women with preeclampsia.

Association of CYP2C19 and HSP70 Genes Polymorphism with Aspirin- Exacerbated Respiratory Disease in a Kurd Population.

CYP2C19 a metabolizing enzyme and Heat Shock Proteins (HSP) are induced in stress conditions, such as hypoxia and ischemia. Recently, polymorphism in the CYP2C19 and HSP genes has been established in Aspirin-Exacerbated Respiratory Disease (AERD). We investigated the polymorphism of these two genes in Kurdish patients with AERD. This study involved 306 subjects, referred to the Be'sat hospital in Kurdistan Province, which were divided into three groups, (i) Aspirin Induced Asthma (AIA), (ii) Aspirin Tolerant Asthma (ATA), and (iii) healthy subjects as control. The subjects as control and ATA\AIA groups were verified by the physician. The demographic data of each subject with respect to age, sex, parental education, and residence was collected. Spirometry was performed on subjects and blood samples were collected for serum Immunoglobulin E (IgE) estimation and molecular tests. Genotyping was done for CYP2C19 681G>A، CYP2C19 636G>A, and HSPA1B1267A>G by using PCR- Restriction Fragment Length Polymorphism (RFLP) and for HSPA1B-179C>T by High Resolution Melting (HRM). Demographic statistics were not significantly different between the three groups (p>0.05). Further, genotypes were also not observed to be significantly different in the genes of CYP2C19 681G>A, CYP2C19 636G>A and HSPA1B1267A>G (p>0.05). However, the heterozygote genotype in HSPA1B-179 C>T in AIA group was higher than the control group (p<0.05). Notably, 92.8 % of the subjects showed heterozygote genotype in HSPA1B1267 A>G. In clinical tests, FEV-1, FVC, and asthma severity in the AIA group were higher than control and additionally IgE levels were lower in this group (p<0.05). The results confirm the association of polymorphism in the HSPA1B-179C>T and HSPA1B1267A>G with AERD in the Kurdish population.

A CLINICAL COMPARATIVE STUDY BETWEEN MISOPROSTOL (PGE1) AND DINOPROSTONE (PGE2) FOR INDUCTION OF LABOUR AT TERM - A PROSPECTIVE RANDOMISED CONTROLLED TRIAL

Background: Comparative study beween misoprostol and dinoprostone for induction of labour at term has been done at various centres which showed misoprostol to be more effective. This study was done, 18 years back in 2001, when the most common method of induction was dinoprostone. Since then both the drugs has been used equally for induction of labour at term. But in recent past, PGE1 is not being used widely because of fear of untoward effect. Hence, the importance this article which shows misoprostol to be more effective with less side effects, easy for storage and low cost. This study is to compare the effectiveness between the two molecules of prostaglandins PGE1 and PGE2 for induction of labour in term. The complication can be reduced by proper selection, 1 to 1 and continuous fetal monitoring.&#x0D; Methods: It was a prospective RCT. 200 Women at term in whom induction of labour was indicated with no contraindications for the use of prostaglandin attending labor room in a tertiary care centre (SAT Hospital Government Medical College Trivandrum) for a period of five months, from September 1St 2000 to January 31st 2001 was chosen to compare the effectiveness of Misoprostol and Dinoprostone for induction of labour at term. Both the groups were comparable in age, parity and bishop score.&#x0D; Results: Among 200, 123(61%) were primigravida and 146 (73%) were in the age group of 21 – 30 yrs. Median induction delivery interval was about 9 hrs shorter in PGE1 group. Only14.14% required oxytocin augmentation in PGE1 Group compared to 50.54% in PGE2 group. There was 8 failures in PGE2 and there was one case of hyper stimulation in PGEI group for which LSCS was done. PGE2 costs 10 times more than PGE1.&#x0D; Conclusion: Misoprostol is faster acting with low induction delivery interval and requirement for oxytoccin augmentation. Misoprostol is low cost drug, affordable to most of our patient from low socio economic status.&#x0D; Keywords: Term pregnancy, Tab Misoprostol, PGE1, Dinoprostone gel, PGE2, Induction of labour.

Association between breastfeeding practices and anemia in children aged 6-60 months

Background: Anemia is one of the most common nutritional problems in India. Anemia is significantly influenced by dietary factors. Objective was to study the association between breast feeding practices and occurrence of moderate to severe anemia in children aged 6-60 months in relation to those without anemia, admitted to SAT Hospital.Methods: Case control study done at SAT Hospital. 85 moderates to severe anemic children and 85 non anemic children were enrolled in the study. Detailed history was taken including dietary history stressing infant and young child feeding practices. Physical examination was done including anthropometric measurements. Relevant haematological investigations were done.Results: Highest percentage of cases 76.4 % were from the age group 6 months to 24 months. Out of 85 cases 58.8% were with exclusive breastfeeding&lt;6 months and among controls is 37.6%. Association of lack of exclusive breastfeeding for 6 months and anemia is statistically significant. Lack of timely introduction of complementary feeding, poor score for infant and young child feeding practices, male gender, lack of iron rich foods, small for gestational age babies were also significantly associated.Conclusions: Maximum number of anemic children were belonging to 6 months to 24 months, Lack of exclusive breastfeeding for 6 months was a major risk factor for developing anemia in children. Lack of timely introduction of complimentary feeding at 6 months and poor infant and young child feeding practices were significant risk factors for developing nutritional anemia.

GAMBARAN KERASIONALAN PENGOBATAN PADA PASIEN DEMAM BERDARAH DENGUE DI RUANG RAWAT INAP RSI SITI KHADIJAH PALEMBANG TAHUN 2017

The case of dengue fever (DF) is one of the health problems in the world which its prevalence increased hence the accuracy of therapy is needed to reduce morbidity. One one aspects that related to this is rationality treatment. This study aims to obtain an overview of rationality treatment in patients who suffered dengue fever (DF) in the Islamic Hospital Siti Khadijah Palembang in 2017. This research is a non-experimental research. The research subjects were all the patients who were diagnosed with dengue fever at the Siti Khadijah Islamic Hospital Palembang in 2017. The data was take based on medical record, the used data were retrospective data which were taken by using purposive sampling technique. The obtained data were 30 respondents who met the inclusion-exclusion criteria. The data analysis used is univariate analysis. The result showed that there was an inaccurate dose of (6.66%). A description of the rationality of treatment carried out from 30 patient stated that treatment rationality was (93,33%) and treatment irrationality was (6,66%). It is suggested that efforts be made to increase compliance for health professionals in hospitals in the completeness of recording in medical records.

Comparison of the effect of entonox gas and aromatherapy with lavender on the severity of labor pain

Introduction: Pain is one of the main and unavoidable stages of labor. The purpose of this study was to compare the effects of entonex gas and aromatherapy with lavender on the severity of labor pain. Methods: The present study was a double-blind randomized controlled trial with random allocation on 60 nuliparos women in Sanandaj-Kurdistan Be’sat hospital. The intervention was performed in two groups of 30 in active phase of labor. In the Entonox group, Entonux gas was smelled by the mother in contractions. In the lavender group, aromatherapy with lavender was performed in contractions. The severity of pain was measured in dilatations of 4-5, 6-7, 8-9, and 10 cm before and after the intervention with vas instrument. Results: The severity of pain before and after intervention was significantly different in each group (p<0.05). The severity of pain was significant between the two groups in dilatations of 8-9 and 10 cm. After intervention, the mean pain severity in the Entonox group was 6.8 in dilatations of 8-9 cm and 8.3 in the lavender group (p<0.05). Also it was 7.7 in dilatation of 10 cm in Entonox group and 8.9 in lavender group (p<0.05). Entonux gas significantly increased maternal complications including mouth dryness, dizziness, nausea, and headache (p<0.05). Conclusion: The present study showed that Entonox gas and aromatherapy with lavender both can reduce the severity of labor pain. But the effect of Entonux gas is greater in reducing labor pain than lavender.

FACTORS INFLUENCING CONTRACEPTIVE UTILIZATION IN POSTPARTUM IN MOTHER AND CHILD HOSPITAL SITI FATIMAH MAKASSAR

Introduction : Postpartum contraception is defined as utilization of contraceptive within 42 days after a labor to prevent close interval of pregnancy. After a live birth, WHO recommended interval before attempting the next pregnancy is at least 24 months in order to reduce the risk of adverse maternal, perinatal, and infant outcomes. Several factors influence maternal in utilizing contraception after giving birth. Objective : To recognize factors influencing contraception utilization in postpartum period in Mother and Child Hospital Siti Fatimah Makassar. Study Method : The study was observational analytic study with cross sectional method. Seventy respondents were obtained with consecutive sampling technique. Chi square test was used to determine linkage value. Result : The result showed that factors affecting contraception utilization in postpartum period in Mother and Child Hospital Siti Fatimah Makassar were knowledge about contraception (p value 0.000, OR = 24.5 (2.995 – 200.437)), number of children (p value 0.004, OR = 4.182 (1.541 – 11.347)), education (p value 0.002, OR = 4.915 (1.770 – 13.646)), and husband encouragement (p value 0,000 ,OR=6,240 (2,211-17,608)). Resources variable was not related to this study. The most affecting variable was knowledge about contraception. Conclusion : Factors influecing contraception utilization in postpartum period were knowledge about contraception, number of children, education, and husband encouragement. The most affecting factor was knowledge about contraception. The most affecting factor is knowledge about contraception.

Evaluation of the Prevalence of Nosocomial Infection in Different Wards of Be’sat Hospital of Hamedan

Background: The nosocomial infections are the ones that arise between 48 to 72 hours after patient’s reference to hospital, shortly after hospital discharge, or 30 days after an operation. This study aimed to evaluate the prevalence of nosocomial infection in different wards of Be’sat hospital of Hamedan. Methods: This prospective cross-sectional study was conducted (during April-July 2016) on admitted patients that suffered from nosocomial infections based on CDC (Centers for Disease Control and Prevention) criteria. During the time of the study, patients who referred to different wards of the hospital (except for the pediatric ward), showed clinical signs of nosocomial infection 48 hours after the admission. Their tracheal, urine, blood, and surgical wound samples were transferred to laboratory for culture and identification of infectious agent. Patients’ demographic information were encoded as confidential records, then, the data were analyzed using SPSS software. All ethical principles of the Helsinki Declaration were observed. Results: Out of a total of 10332 hospitalized patients, 266 (2.6%) of them acquired nosocomial infection of which 183 (69%) of them were males and 83 (31%) were females. The patients’ mean age was 58.14. There was no significant relationship between the age and the type of nosocomial infections (P=0.052). The mean period of hospitalization was 28.2 days. The most common nosocomial infection was ventilator associated pneumonia (VAP) with 110 cases (41.3%) and the rarest of them was catheter associated-urine tract infection (CA-UTI) with 23 (8.64%) cases. Fifty-nine cases (53.6%) out of 110 VAP patient cases survived and 51 (46.4%) of them died. The overall mortality rate was 30%. Among 242 bacterial strains isolated, Escherichia coli was the most common strain with a prevalence of 61 (22.9%). Most of the death cases (57.9%) were caused by Proteus nosocomial infections. Conclusion: The high values of nosocomial infections and mortality in Be’sat hospital represent a need to reinforce the preventive and control program on nosocomial infections. In future studies, in order for better presentation of nosocomial infection in terms of latest events, infection and organism type, and antibiotic resistance pattern, novel indexes like device utilization ratio (DUR) and incidence density of device-associated infections (IDDI) are suggested.

Causes and Outcomes of Respiratory Distress in Neonates Hospitalized in the Neonatal Intensive Care Unit of Be’sat Hospital in Hamadan, Iran

Background Neonatal respiratory distress is one the most common problems in the first few day of neonatal life. The present study intended to determine the frequency of the causes and outcomes of respiratory distress in neonates hospitalized in the neonatal intensive care unit (NICU) in Hamadan city, Iran. Materials and Methods In this descriptive and cross-sectional study, all the neonates with respiratory distress (RD), who were hospitalized in the NICU of Be’sat Hospital in Hamedan city, Iran, during 2014 to 2015, entered the study. The required demographic information was extracted from patients’ dossiers. The collected data were analyzed using SPSS version 16.0. Results The mean neonatal age upon admission, mean gestational age and mean birth weight were 5.22±7.18 days, 36.58±3.54 weeks and 2743.9±727.9 grams, respectively. According to the results, intercostal retraction (75.3%), tachypnea (67.7%), and grunting (61.3%) were the most common symptoms of neonatal respiratory distress (NRD), while respiratory distress syndrome (RDS) (36.6%), pneumonia (30.1%), and transient tachypnea of the newborn (TTN) (%14), were the most common causes of respiratory distress. Furthermore, about 19.3% of the neonates died of the disease. The results of logistic regression for the independent risk factors associated with RD outcomes showed that the death rate of neonates with RD had a significant correlation with respiratory failure requiring mechanical ventilation (odds ratio[OR]: 33.49, 95% confidence interval [CI]: 6.95-161.38), and incidence of apnea (OR: 5.87, 95% CI: 1.072-32.167). Conclusion It was found that RDS is the most common cause of respiratory distress in the hospitalized neonates. Moreover, infant mortality rate increased due to respiratory failure requiring mechanical ventilation and occurrence of apnea.

The effect of perineal massage during the second stage of birth on nulliparous women perineal: A randomization clinical trial.

BackgroundChildbirth and puerperium are of the most important periods in women’s lives and can affect different aspects of their lives.ObjectiveTo determine the effect of perineal massage in the second stage of labor on perineal lacerations, episiotomy, and perineal pain in nulliparous women.MethodsThis randomization clinical trial was conducted at Be’sat Hospital in Sanandaj, Iran, from 2013 to 2014. A total of 195 nulliparous women were included in the study. The participants were selected through convenience sampling, and randomly assigned to two groups: intervention and control groups. The intervention group received 30-minute perineal massage during second stage of labor. Subsequently, we analyzed perineal laceration, episiotomy, and perineal pain among the two groups. All of them were taught about postpartum perineal pain and its severity, and the researcher followed them up 3 days, 10 days, and 3 months after childbirth by telephone. The data were analyzed using SPSS version 18. We used descriptive statistics and analytical statistics, including t test, Chi-square test, and Fisher’s test.ResultsFrequency of episiotomy was 69.47% in the intervention group and 92.31% in the control group, and the difference was statistically significant (p<0.05). The results revealed 23.16% of first-degree perineal laceration and 2.11% of second-degree perineal laceration in the intervention group, and no vestibular laceration or third- and fourth-degree lacerations in the intervention group. However, there were 5.13% of vestibular laceration, 7.69% of first-degree laceration, 2.56% of second-degree laceration, and 1.05% of third-degree laceration (one woman) in the control group. Based on the results, the postpartum perineal pain was significantly different in both groups.ConclusionRegarding the results of this study and those of other studies, perineal massage during the second stage of labor can reduce the need to episiotomy, perineal injuries, and perineal pain.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct.ID: IRCT2013090314556N1.FundingThis study received by financial support of Kurdistan University of Medical Sciences, Sanandaj, Iran.

Hubungan Antara Usia dan Paritas Ibu Bersalin dengan Bayi Berat Lahir Rendah (BBLR) di Rumah Sakit Islam Siti Khadijah Palembang

Low Birth Weight is the birth weight of 1,500-2,500 grams. According to the data of Siti Khadijah Palembang Islamic Hospital in 2016 babies born in LBW from January to September of 2016 both live and die amounted to 172 babies from 1,000 births. The purpose of this study is to know the relationship between maternal age and parity with low birth weight babies at Siti Khadijah Palembang Islamic Hospital in 2016. The method used is an analytical survey with cross sectional approach. The population in this study is all mothers of maternity in Islamic Hospital Siti Khadijah Palembang in 2016 with a sample of 91 people. Based on the univariate analysis of 91 respondents who are not BBLR of 64.8%, low risk as much as 53.8%, low parity 54.8%. The result of bivariate analysis of low risk age that gave birth to LBW was 20,4%, low parity giving birth of LBW by 24%. Age of mother get p value 0,003 <0,05, parity of mother get p value 0,025 <0,05. There is a relationship between maternal age and parity with LBW. For the institution, it is expected that the results of this study can provide benefits for students about the relationship between maternal age and parity with Low Birth Weight. Hospital Parties can provide more intensive information and counseling to the community about the age and parity relationship of delivery mothers with low birth weight babies.

Effectiveness of baby friendly hospital initiative implementation on timely initiation of breast feeding - a comparative study

Background: Breast milk is unquestionably the best milk for new born baby. As per UNICEF and WHO, immediate initiation and exclusive breast feeding for six months are essential for reducing infant and neonatal mortality and malnutrition and improving young child survival. In a study conducted by Indian Association of Pediatrics (IAP) in 2009 showed that there has been an alarming decline in breast feeding practices over years. This created great concern and Ministry of Health and Family Welfare decided to revive the BFHI programme, a global movement that aims to give every baby the best start in life by creating a health care environment where breast feeding is the norm. We, the Department of Obstetrics and Gynaecology, Sree Avittom Thirunal Hospital, Government Medical College, Trivandrum, Kerala conducted a study to compare the breast-feeding practices prior to and after implementation of BFHI programme.Methods: This was a comparative study done in 2013 -14 among 320 post-natal mothers delivered at SAT hospital before and after BFHI implementation to study the improvement in Breast feeding practices.Results: The revamping programme of BFHI brought significant change in timely initiation of breast feeding within one hour of delivery. Knowledge of mothers increased in the post implementation group. Proactive approach from the part of health workers also showed significant improvement.Conclusions: The campaign has initiated a positive response highlighting the benefits of breast feeding and dangers of bottle or animal milk feeding. A well-organized community awareness programme involving obstetrician, pediatrician and other health personnel will help in promotion of breast feeding through periodic review of the status and progress of the programme.

THE COMPARISON OF DYADIC ADJUSTMENT RATE AND SEXUAL FUNCTION OF INFERTILE AND FERTILE FEMALES REFERRING TO BE’SAT HOSPITAL OF SANANDAJ CITY

Introduction and purpose: pregnancy and childbirth are mentally and physiologically required by females, and gestation is the symbol of their self actualization and identity. The stress of infertility causes impairment of dyadic satisfaction, diminution of confidence and depletion of couple's sexual communication times. In this study the purpose was to compare the dyadic adjustment rate and sexual function of infertile and fertile female referring to Be'sat Hospital of Sanandaj city. Articles and Methods : This research method was the kind of scientific-comparative study, and selecting method of samples was voluntary, therefore 240 female 120 of whom were fertile female referring to Be'sat Hospital Clinic of Sanandaj and 120 infertile ones referring to Be'sat Hospital infertility center of Sanandaj were selected. The Data collection tools include Spanier's Dyadic Adjustment Scale (DAS) questionnaire and Female Sexual Function Index (FSFI), and the U Mann Whitney Test is used to analyze the data. Findings: The result of the study didn't demonstrate significant differences between the dyadic adjustment rate and the sexual function of fertile and infertile female. In the sub scales of dyadic adjustment the significant difference (p≤0/01) was only seen in the sub scales of double consistency, agreement and love expression. In the female's sub scales of sexual function, only the vaginal moisture with (P=0/024) was significant and there were no significant differences in other sub scales. Conclusion: according to the result of this study, the infertility is not supposed to have considerable effect on the dyadic adjustment rate and the infertile female's sexual function, and even in some sub scales the infertile female's dyadic adjustment and sexual function is better than fertile ones.

Frequency and related factors of tubal patency after methotrexate treatment in women with ectopic pregnancy.

Ectopic pregnancy is a medical emergency. The classic treatment for this condition is surgery but early diagnosis allows for non-surgical treatment. In recent years, intramuscular methotrexate has been considered, due to easy administration, its less invasive nature and low complications, but there are arguments about its effects. The aim of this study was to evaluate tubal patency after treatment of ectopic pregnancy with methotrexate and related factors. This cross-sectional study was conducted on 80 women with ectopic pregnancy who were admitted to Sanandaj Be'sat Hospital in 2014. Patients who had successful treatment for ectopic pregnancy with single or multiple doses of methotrexate 50 mL/m(2) were enrolled. Three to 6 months after treatment, the patients were evaluated for tubal patency by hysterosalpingography. Data were analyzed using spss, t-tests, χ(2) -test and logistic regression. The tubal patency rate after treatment of ectopic pregnancy with methotrexate was 75% in hysterosalpingography. The average size of the ectopic pregnancy mass of women with open fallopian tubes was 22.5 ± 7.0mm and for women with closed fallopian tubes it was 34.7 ± 10.0mm (P = 0.0001). β-human chorionic gonadotropin levels were 642.1±850.5 in women with open fallopian tubes and 3816.3±4487.3 for women with closed fallopian tubes (P = 0.0001). There was no significant correlation statistically between tubal patency with a history of stillbirth and number of pregnancies (P > 0.5). There was a statistically significant relation between tubal patency and the number of births and also methotrexate dose (P < 0.05). Treatment of ectopic pregnancy with methotrexate is effective for saving tubal patency. Levels of human chorionic gonadotrophin-β<1745, the treatment regimen of methotrexate (single or multiple doses) and ectopic pregnancy mass size smaller than 33.5 mm are significant predictors of tubal patency.

Maternal Stress and Maternal and Foetal Outcome: A Comparative Study

Pregnancy is a period of excitement, expectancy, anxiety and even fear for the pregnant woman. She has to cope with the physical and psychological changes that occur during pregnancy and for this she needs the support of family members. This study of social, economical and family back ground of pregnant women was conducted to see if there are any stress factors that influence the health of mothers and newborns. A care comparative study of 120 antenatal and postnatal women was taken up in SAT hospital in Trivandrum.

A Study of Methadone-Poisoned Children Referred to Hamadan's Besat Hospital/Iran.

Increasing use of methadone in withdrawal programs has increased methadone poisoning in children. This research aimed to study the causes of incidence of poisoning in children and its side-effects. In this research, The hospital records of all methadone-poisoned children referred to Hamadan's Be'sat Hospital from June 2007 to March 2013, were studied. Children with a definite history of methadone use or proven existence of methadone in their urine, were studied. During 5 years, 62 children with the mean age of 53.24±29.50 months were hospitalized due to methadone use. There was a significant relationship between delayed referral to hospital and increased bradypnea. According to their history, 25.8% and 58.1% of the children had been poisoned by methadone tablet and syrup, respectively. The most common initial complaint expressed by parents, was decreased consciousness (85.5%). During the initial examination, decreased consciousness, meiosis, and respiratory depression were observed in 91.9%, 82.3%, and 69.4% of the cases, respectively. Nine patients required mechanical ventilation. There was a significant relationship between the need for mechanical ventilation and seizure with initial symptom of emesis. There were two cases of death (3.2%), both of which were secondary to prolonged hypoxia and brain death. There was a significant relationship between poor patient prognosis (death) and presence of cyanosis in early symptoms, seizure, hypotension, duration of decreased consciousness, and duration of mechanical ventilation. This research indicated that the occurrence of seizure, hypotension, and cyanosis in the early stages of poisoning is associated with an increased risk of side effects and death and are serious warning signs. Early diagnosis and intervention can improve outcomes of methadone-poisoned children.