[Telemedicine technology and its effect on "Iran's 20-yearvision plan" objectives and "Ministry of health and medical education" goals "Review of experts' views"]

The telemedicine technology has an interaction with many sciences and technologies. It has also much economical and social effect on society components. In order to have sustainable development and balanced use of technology, there should be attention on the orientation and the "Iran's 20 -year vision plan" objectives and the "Ministry of Health and medical education" goals. The aim of this study is to assess the effect of such technology on Iran's 20 -year vision plan objectives and "Ministry of Health and medical education goals from the view points of the experts. The method of this research was a descriptive survey. The data collection was done by the help of a library, document study and questionnaires including 2 parts about the effects of using telemedicine technology on "Iran's 20 -year vision plan" objectives and "Ministry of Health and medical education" goals. In this research, the sampling method was used. To analyze the data, the SPSS was used. The most capability of telemedicine in helping the government for realizing the objectives of "Iran's 20 -year vision plan" was in equity and social welfare, and the most capability of this technology in helping the health system is in providing a better access to health services. Telemedicine technology is effective and impoliant for both "Iran's 20 -year vision plan" objectives and "Ministry of Health and medical education" goals. The Demands of government and Ministry of Health and Medical Education from telemedicine technology should be based on equity and social welfare and providing a better access to health services

[Evaluation of blood and blood products consumption in Emam Reza hospital of Mashhad]

Blood bank Must try to provide high quality blood products with minimal wasting. This goal is achieved by optimal blood utilization management. For this purpose have to be aware of this process in the field. In a one year period during the year 1382, the amount of requested blood units and its components [FFP, cryoprecipitate, platelet] their usage, outdating and cross match to transfusion ratio [C:T] evaluated in different departments of Emam Reza a general hospital in Mashhad. We also estimated average daily, weakly and yearly usage of each ABO groups and Rh type. From 1243 Blood units, 2950 [23.8%] units were been expired in many of hospital departments especially in angiography, kideney transplant, heart, and obstetric/Gynecology; C:T ratio was greater than 2. Daily usage of blood in this hospital was 26 units. During this period, 7035 platelet units were used. The most usages were seen in hematology and internal emergency department. In addition, 11213 FFP units have been used. The most usage of FFP was seen in burn department. In comparison to international standards, Blood wasting rate was higher C:T ratio greater than 2 usually indicates excessive cross match requests. In order to decrease this ratio, usage from a local guideline is advised. Hospital transfusion committees have to supervised blood and blood components requests and consumptions

Spontaneous and active pushing in second stage labor and fetal outcome in primiparous women

Active pushing in second stage labor is acceptable, despite its complications for fetus and it has been noticed by midwifes and obstetricians. Recent studies have shown that spontaneous pushing decreases fetal acidosis. So, the objective of this study was to assess the effect of spontaneous and active pushing in second stage labor on fetal outcome in primiparous women. This clinical trial study was done on 108 primiparous women with uncomplicated labor that based on fliess table randomly assigned to spontaneous and active groups. In spontaneous group used her own urge to push and in active groups encouraged to take a deep breath, hold it and push for ten numbers. After delivery, cord arterial blood PH value and Apgar score [1 min and 5min] were measured. The results of this study showed that arterial cord PH was higher in the spontaneous pushing versus active pushing [p<0.001]. Apgar score [1min and 5min] had no significant difference between two groups. There was significant correlation between Apgar score [1min and 5min] and arterial umbilical pH [p=0.028, p=0.019]. Spontaneous pushing decreases fetal acidosis so it can be effective, healthy, and cheap method for improving neonatal outcome

Histologic evaluation of 120 infertile testicular biopsy

Testicular biopsy is a useful method in infertility diagnosis and predicting prognosis, especially in patients with azospermia and normal level of serum FSH that primary evaluating procedures can't differentiate spermatogenesis defect from obstructive one. If the etiology of infertility is an obstructive lesion the prognosis is often good and usually curable, by surgery. The purpose of this study was to evauate various histopathologic changes in incisional testicular biopsies of the infertile men in order to predict frequency of different tissue morphologies and especially interprete these histopathologic changes for better understanding the diverse etiology of infertility. In this clinicolaboratory study performed in Anatomic pathology department of Mashhad Emam Reza hospital, Testicular biopsies of 120 infertile men were histopathologically reevaluated and reclassified applying newly introduced criteria. Clinical data such as age, disease history, associated disorders and results of spermogram were gathered in designed forms. Final data were processed by descriptive statistical method and frequency distribution tables. Median age of the patients was 27 years and duration of infertility 2 to 15 years. 84% of patients had azospermia in seminal fluid analysis and 16% severe oligospermia. In 16 cases, bilateral testicular biopsy was performed in which 18.7% of their morphological features, in testicles were different from each other. Morphologic patterns were as follows: 15% normal spermatogenesis, 30.9% sertoli cell only syndrome, 17.5% complete and incomplete maturation arrest, 14.2% tubular atrophy, 14.2% hypospermatogenesis and 8.4% mixed atrophy. The most and least common histopathologic pictures in testicular biopsies of the infertile men observed in this study were Germ cell aplasia and Focal tubular atrophy respectively. Diverse diseases and etiologies could be associated with any of the histopathologic pictures so that it merits a logic interpretation of these histologic changes in regard to clinical findings to specify the true cause [s] of the infertility

[Ovarian neoplasm in childhood and adolescents: during 20 years at pathology center of Imam Reza Hospital]

Objective: ovarian tumors represent about 1.5% of all tumors in childhood and adolescence and about 95% of all gynaecologic tumors. This paper analyzes 79 cases of ovarian tumor in children and adolescents

Material and Method: in this retrospective study 79 cases with ovarian tumor in children and adolescents treated in Mashhad Imam Reza Hospital from March 1981 to March 2001 were evaluated

Result: all cases were under 20 years with median age 17.4 years, and the youngest was 13 months. The tumors were classified according to WHO classification. Of 79 cases 61 [77.3%] were benign and 18[22.7%]] were malignant. Forty [50.2%] were considered to be of germ cell, 34] [43.1%]] celomic epithelial, 3 [3.7%] sex cord-stromal origin, 1[1.2%] Burkit lymphoma and 1] [1.2%] mixed epithelial and germ cell origin. Forty cases had germ cell tumor: there were 26 teratoma, 9 dysgerminoma, 3 yolk sac tumor, 2 malgniant mixed germ cell tumor. Thirty-four cases had epithelial neoplasm, 25 benign serous nepolasm and 9 mucinous tumor. Two cases of mucinous neoplasm were borderline and malignant. Three cases had sex cord stromal tumor: 1 setroli -lydig, 1 juveinal granulosa cell tumor, 1 fibrotechoma. In 76 cases were tumors unilateral and 3 cases [2 patients with dysgerminom and 1patient with Burkit lymphoma]] were bilateral. Tumoral torsion accounted for 11.3%of diagnosis

Conculsion: cell tumors are the most common ovarian neoplasm seen in the pediatric and adolesent age group.] Epithelial and sex cord stromal tumors are less common.] These neoplasms are benign, borderline or malignant.] It is very important to sis exactly and to assess suitable treatment in this age group to protect fertility