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Most cancer patients complain from pain in final part of their disease. One of the aims of health center, in the country is how to relieve pain from such patients. Therefore we tried to carry on a semi-experimental research to find out the effectiveness of Morphine by either continuous infusion or intermittence injection in such patients. We used non-random sampling, the total number of samples were 11 female and 9 male. These patients were on their final phase of disease. The process that we collected the information was based on the check-list which consist of two sections, in first part the demographic characterization of patients was recorded, using observation and interview with patients and in second part of these check-list the level of pain was assessed using visual analogue scale, which marked every two hours and finally the average of this scale in 24 hours is evaluated using as index in our study. Our results indicate that continuous infusion is more effective in relieving pain than intermittence injection (P<0.03). The results of this investigation showed that, age, sex and different type of cancer has got no meaningful variation in changing the main findings of this semi-experimental research.

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Compared with older children and adults, neonates are more sensitive to pain and more vulnerable to long-term effects. Despite the clinical importance of neonatal pain, current medical practices continue to expose infants to repetitive, acute, or prolonged pains. This specific intervention are necessary for reduced the neonatal pain experiences. This is an experimental study of determine the effectiveness of skin contact between mother and her healthy full-term newborn to reduce pain experience by the infant during intramuscular injection. The sample population was 30 healthy full-term newborns delivered at university hospital in Gorgan. The samples and controls were chosen randomly. During intramuscular injection case group was being helped by their mothers under cloth that directly were contact with their abdominal and chest skin and newborn in control group swaddled in crib on the bed before, after and during injection. Behavioral responses (Facial changes, crying, …) and physiologic responses (Heart rate and O2 saturation of arterial blood) of newborns were noted before, after and during intramuscular injection. The results show that there was no significant difference in behavioral and physiologic responses caused by pain between two groups, except crying time (38.2 second in control group and 35.5 second in case group). Finding from this study indicate that skin-to-skin contact has a clinically important effect on the pain of intramuscular injection, if we can prepare physically and emotionally a good situation.

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A great number of drugs have been used to inhibit preterm labor but none has been completely effective. This study has compared. The efficacy of Indomethacin and Mg-Sulfate for delaying delivery in preterm labor. In this randomized controlled trial study 120 pregnant women with intact membrane and preterm labor, cervical dilatation at least 2 cm were studied and if they had premature rupture of membranes, gestational age less than 24 or more than 32 weeks, complete cervical dilatation, severe hemorrhage, chorioamnionitis and triple or higher order gestation excluded from study. Subjects are randomly managed with Indomethacin 25 mg every 6 hours for 4 doses or Mg-Sulfate initially 4 gr/IV followed by 2 gr/h IU infusion until uterine activity diminished or decrease. The success of management was considered as either reduce or stopping the uterine contractions, and no increase in cervical dilatation or effacement. Statistical analysis were performed with Chi-square and T-test. The 2 groups understudy had the same inducer maternal matched maternal age, gestational age, parity, dilatation and effacement at initiation of study, frequency of uterine contractions. Delivery was delayed 24 hr in 66.6% and 48 hr in 58.3% by Mg-Sulfate, also delayed 24 hr in 40% and 48hr in 35% by Indomethacin (P<0.0001). No complications were reported in each group. Mg-Sulfate is more effective than Indomethacin in delaying preterm labor.

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Background and Objective: The association between discordant growth and the complication of twin pregnancy has been recognized for more than 30 years. Recent publications have presented evidence that 30% or even 40% discordance presents the threshold for significant. Our purpose was to define twin growth discordance on the basis of perinatal outcome and other factors like maternal age pariety and systemic disease. Materials and Methods: Twins delivered at age more than 32 week’s gestation between 1998-2000 at Deziani Hospital Gorgan was identified. Birth weight, pre-term birth, maternal age pariety and systemic disease and sex of Twins recorded. Discordance was calculated as: 100×larger BW-smaller BW/larger BW. Results: The mean discordance for 435 twins was 8.18±6.79, 96.4% of pre-term birth associated with discordance?20%. 10.6% of mothers had a systemic disease and mean discordance in twins term and pre-term of normal mothers was 5.8±4.5, 7.9±6.3 and in systemic disease was 9±9.2, 11.1±8.8 (P?0.008). There were no differences in pariety age and sex. Conclusion: Twin birth weight discordance had now clearly been demonstrated to be a risk factor for pre-term birth. The effect was found particularly with discordances?20% after 32 week’s gestation.

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Background & Objective: Preterm infants have less iron storage compared with the term one. Due to rapid growth they need more iron during infancy. This study was designed to evaluate the effect of early iron supplementation on hematologic indices and incidence of iron deficiency anemia in preterm infants. Materials & Methods: This experimental study was done on 20-days-old preterm breast-feed infants referred to the Gorgan-North of Iran primary health care services for vaccination, without any underline disease or growth retardation during 2005. They were divided to two groups (n=15 in each) and a questionnaire was completed for each case. Iron drop (2mg/kg) was given in the interventional group. Iron deficiency anemia was assesed in all sample T-student test and chi-square were used to analyze the independent variables and comparing the hematologic indices, after entering in SPSS-13 software and testing the normal distribution with komologrof-smearnoff test. Relative risk index (RR) was used to compare the two groups. Results: The relative risk of iron deficiency anemia in the interventional group was 0.4 folds [RR=0.4,CI %95 for RR=(0.091,1.749)]. No significant difference was seen between the two groups. Conclusion: The finding of this study showed that iron drop supplementation for preterm infant prevent the iron defeciency anemia, although this observation was not significant.

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Background and Objective: Patent ductus arteriosus (PDA) is a common problem in preterm infants which can result in serious hemodynamic changes causing respiratory and cardiac morbidities if not treated in the first week of life. The treatment options available are pharmacological treatment with cyclo-oxygenase (COX) inhibitors and surgical ligation. The cyclo-oxygenase inhibitors approved for use are indomethacin and ibuprofen which have been used with different routes of administration and dosages. This study was conducted to evalute the lower and standard dose of oral ibuprofen in patent ductus arteriosus closure in preterm infants. Materials and Methods: In this clinical trial study, 44 preterm infants (<35 weeks gestational age) were randomly assigned to receive either a low dose (0.2mg/kg/dose for 3 doses, 24 hours apart) ibuprofen or a standard dose (10mg/kg/dose for the first dose, followed if needed, at 24hours interval by one or two additional doses of 5mg/kg each). These premature neonates either had clinical signs of patent ductus arteriosus or were diagnosed by echocardiography before stabilization of clinical signs. Patent ductus arteriosus closure was confirmed by echocardiography. They were under observe for drug's side effects (oliguria/anuria, GI bleeding, serum creatinin, intraventricular hemorrhage) and their clinical course was recorded. Results: The patent ductus arteriosus closure rates were the same with both doses (74% in case group vs.76% in control), 5 infants in the case group (22%) and 3 infants in the control group (14%) did not respond to the first course of therapy and needed a new course. There was a significant more rate of reducing renal output with the standard dose 33% vs. 4% (P<0.05), but the serum creatinin level was not different between two groups. One infant (4%) in the case group and 3 infants (14%) in the control group had GI bleeding. There was not any difference in intraventricular hemorrhage grading between two groups. Conclusion: This study showed that inspit of lower renal side effect, the low dose oral ibuprofen in comparison to standard dosage did not have any meaningful difference in closure of PDA in preterm infant.

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Background and Objective: Cardiac arrest is responsible for half of the death cases, which is preventable in rapid and effective cardiopulmonary resuscitation (CPR). During the last years, a great amount of progress has occurred in this field, but there is still a lack of enough data for CPR. The aim of this study was to assess and compare the survival rate of patients undergoing CPR in two university hospitals in Tehran, Iran. Materials and Methods: In this retrospective analytical study, the survival rate of 178 patients undergoing CPR in the emergency department of two university hospitals (Taleghani and Shaheed Modarres) were assessed and compared during 2005. The related variables including the time delay for CPR, the time length for CPR and the outcome of CPR were analyzed. Results: 24 hours after the cardiac arrest, 7 cases of 54 (13%) survived in Taleghani hospital and 33 of 124 (26.6%) survived in Shaheed Modarres hospital (P<0.05). Conclusion: This study showed that the rate of short term survival of patients after CPR is similar to other parts of country but lower than the other parts of the world.

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Background and Objective: Respiratory distress syndrome is the most important lung problem during the neonatal period. Although the benefits of antenatal corticosteroids in neonates with a gestational age of less than 34 weeks have been demonstrated, the benefit of this treatment in neonates with higher gestational age is dubious. This study investigated the effect of Betamethasone on respiratory distress syndrome among neonates with gestational age of 35-36 weeks. Materials and Methods: This double blind randomized controlled trial study was done on 200 pregnant women who were of high risk for preterm labor in 35-36 weeks of gestation in Sanandaj city-Iran during 2007. 200 pregnant women randomly divided into treatment and placebo groups were received intramuscularly Betamethasone (12 mg/kg/BW twice) and normal saline, respectively. Data including age of mother, sex, weight, respiratory distress syndrome and newborns admission in hospital were recorded for each subject. Data was analyzed by using two-tailed T, Mann-Whitney, chi-square and Fisher exact tests. Results: There were no difference among two groups about age of mother, sex and weight of newborns. There were 8 (8%) and 20 (20%) newborns with respiratory distress syndrome in case and controls, respectively (P<0.01). Admission in hospital was 16% in Betamethasone group vs 28% in normal saline group (P<0.04). Conclusion: The study demonstrated that exposure to antenatal Betamethasone with 12mg/kg/BW twice between 35 and 36 weeks of gestation is associated with a significant reduction in the rate of respiratory distress syndrome.

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Background and Objective: Anesthetic agents effect on pregnancy in operating room personnel is a challenge in anesthesiology. This study was carried out to determined pregnancy complications among hospital operating room personals in Fars province – Iran.

Materials and Methods: In this case-control study, 122 women working in operating rooms of governmental Fars province hospitals during their pregnancies with different jobs considered as case group. 122 women working in internal and pediatric wards considered as control group. The history of pregnancy complications including infertility, abortion, preterm labor, fetal death, neonatal death and low birth weight obtained using questionnaire. Data were analyzed using SPSS-15 software and Chi-Square test.

Results: The incidence of abortion was 19.8% and 16% in case and control group respectively, this difference was not statistically significant. Infertility was significantly higher (8.2% versus 2.5%) in case group than control group (P<0.05). No significant differences in incidence of preterm labor, fetal death, neonatal death and low birth weight were seen between two groups.

Conclusion: This study showed that the incidence of pregnancy complications is similar between women working in operating room and those working in other hospital wards but the prevalence of infertility is higher in operating room personnel than those of other wards.

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Background and Objective: Respiratory failure is one of the most important respiratory problems in premature infants. Several studies have shown the efficacy of corticosteroids in gestational age less than 34 weeks. This study was done to determine the effect of prenatal betamethasone injection during 34 to 36 weeks of pregnancy on the prevention of newborn respiratory failure. Methods: This clinical trial study was conducted on 140 women with risk of preterm labor at 34 to 36 weeks of gestational age. Women in interventional group were received betamethasone 12 mg IM (2 doses, 12 hours apart). Women in control group were received the same volume of normal saline. Sex and birth weight, respiratory distress syndrome, requiring hospitalization in neonatal intensive care units and require respiratory support were recorded for each newborn. Results: No significant difference was seen in sex and weight of newborns between two groups. The precent of newborns with respiratory distress syndrome in the intervention and control groups was 12.5% and 22%, respectively. This difference was not significant. No significant difference was seen in the need to respiratory support, hospitalized in the NICU between intervention and control groups. Conclusion: Adminestration of betamethasone in 36-34 weeks of pregnancy has no effect on the prevention of respiratory failure in preterm infants.

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The kangaroo care method in newborn is a way of protecting the baby through skin to skin contact between newborn and their parents. This review study was done by using the keywords including kangaroo mothre care, neonatal, skin to skin contact and preterm. All related articles were published in Pubmed, Sience direct, Google scholar, SID, and Magiran were studied during 2000 to 2016. Finally, 36 articles were reviewed which were similar according to objectives, method of work, sample size, analysis method, and conclusion. Reviewing the selected articles showed that skin to skin contact among newborn and their parents regulated the body temperature of the neonate, increased the newborn's immune system, reduced infection and mortality rate, regulated heart and respiratory rate, increased the growth and weight gain in low birth weight neonates, reduced the stress and crying, increased prolong and stable periods of sleep, and also creates an emotional bond between the parents and the neonates. Kangaroo care method not only helps to care for the early stages of growth of premature neonate, but also increases the general health of the newborn and mother. This care can be used as an inexpensive and highly beneficial method for neonate's growth and health in human.

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Background and Objective: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. MS is more common among women. Gait pattern dysfunction is a relevant symptom in these patients. This study was conducted to compare the electromyography activity of selected lower extremity muscles and the ellipse area of center of pressure during unplanned gait termination in female patients with multiple sclerosis and healthy individuals.
Methods: This case-control study was performed on 10 female patients with MS (classified based on the EDSS scale) and 10 healthy subjects matched for height, age and weight. Electromyography activity of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), semitendinosus (SM), gastrocnemius medius (GM) and tibialis anterior (TA) and center of pressure (CoP) recorded using foot pressure system during unplanned gait termination. Subjects were instructed to stop, as soon as possible, in response to an auditory cue delivered when the heel strike phase accidentally.
Results: Vastus Lateralis muscle activity was significantly higher in able-bodied group than patients (P<0.05), whereas in the patient group gastrocnemius medius muscle activity increased significantly (P<0.05). Also, the ellipse area of center of pressure significantly reduced in MS group in compered to able-bodied group (P<0.05).
Conclusion: Increased gastrocnemius medius muscle activity in MS patients may be due to their attempt to slow down the displacement of the center of mass to limit the tibia forward translation consequently, attempting to control balance as a strategy to limit the ellipse area of center of pressure to prevent fall.

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Background and Objective: Non-Governmental Organizations (NGOs) have been active in the field of health for a long time and have played a key role in it, but these organizations are less known to the public for the promotion of social health and are not much considered by the planners and managers of the health system. This study was conducted to determine the challenges of NGOs’ to promote social health in Iran.
Methods: In this qualitative study, 15 Iranian managers and scientific and executive experts of the Ministry of Health, Ministry of Interior, Governorate, and Universities of Medical Sciences of the country were selected by purposeful sampling during 2021. Data were collected using an interview guide and semi-structured in-depth interview methods. After recording and transcribing, the data were analyzed by content analysis.
Results: The challenges of NGOs to promote social health in Iran were classified into six main themes of planning, organizing, functional, political, economic, and sociocultural challenges, and 33 sub-themes. Most of the participants emphasized the weak role of non-governmental organizations in improving social health and considered it a result of the mentioned challenges.
Conclusion: Empowering non-governmental organizations by formulating a strategic and operational plan and attracting financial resources from various government, private, and charitable sectors will greatly help to strengthen them to advance social health promotion programs.