[ Study of appendix position in patient with previously appendectomy in Kerman medical centers in 2003-2005]

Background: identifying the exact position of appendix and completion of its anatomic information has great importance in both of basic aspect and clinical value. Whereas, acute appendicitis is the most common and emergency in the surgical abdomen, the identification of the variations of the appendix position can be very useful to surgeons

Materials and Methods: in a cross sectional retrospective study, 1041 files of patients with previously appendectomy in the Kerman medical centers in 2003-2005, were studied

Results: the number of patients which they were under appendectomy was 336[32.3%] males and 705[67.7%] females that their range of ages was between of 12 to 70 years old. The analysis of the data is indicated: in the males, 325[96.7%] patients have posterior position appendix and 11 [3.3%] patients have anterior position appendix. In females, 684[97%] patients and 21[3%] patients have posterior position and anterior position appendix, respectively. The most common posterior position in both genders was the subcaecal which was observed 81.5% in males and 84.9% in females. The rarest posterior position in both genders was the retroileal which was observed 0.6% males and 0.1% females. The most common anterior position in both genders was the preileal which was observed 45.4% in males and 57.1% in females. The rarest anterior position in males was the pararectal which was observed 9.1% and in females was the precaecal which was observed 4.8%

Conclusions: in the posterior position, the most type of appendix was the subcaecal and the least type of appendix was the retroileal and in the anterior position, the most type of appendix was the preileal, in both genders. But, in the anterior position, the pararectal in males and the precaecal in females were the the least type of appendix

Effects of training programs of pregnant women on their delivery type selection: a single blind randomized control trial

There has been an increasing demand for cesarean section delivery [C/S] by pregnant women in recent years. This increase in demand, not only adversely affects the rate of delivery complications, but also imposes a great amount of extra expenses on families, government and insurance companies. It was assumed that by training programs for pregnant women during their prenatal care visits, they can play an active role in the process of decision-making regarding their type of delivery. The goal of the present study is to determine the effect of such training programs on pregnant women in selecting the type of the delivery and to specify if the current rate of C/S can be change by such training programs. In this single-blind randomized control trial, 200 primi-par pregnant women [age 18-30 years old] with gestational ages of less than 30 weeks, referring to the Ob-Gyn clinic of Be'sat general Hospital [IRIAF central hospital] for prenatal care were included.These pregnant women were randomly divided into two groups: Group A which received planned training program during their pregnancy and group B with no training program. None of the assessors knew about the women's status in the mentioned groups. Distribution of women in both groups were equal considering factors like age, education, profession and selected method of delivery at their first interview. In group A, films and pamphlets were used for training. Pamphlets were explained by professional midwives. Patients visited the Ob-Gyn department and delivery ward and spoke to women in their post-delivery phase. At their 36 week of gestational age, all patients in both groups were interviewed again and data were collected and analyzed by proper software using chi square test. In group A, the level of patient's awareness regarding Normal Vaginal Delivery [NVD] and cesarean section [C/S] was markedly increased, expectedly [78%vs.4%] and [71% vs. 4%], while in group B the level of patient's awareness did not changed on their second interview. The rate of selecting C/S in group A [test] was markedly reduced [25%vs. 39%], [p < 0.05], while there were no changes in this rate among patients in group B [40% vs. 41%]. can be concluded that basic trainings for pregnant women can effectively reduce the rate of demand for C/S delivery. It is therefore, recommended that this kind of training to be available for all patient [regardless of their level of education] referring to prenatal care clinics