Iranian Journal of

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Background and objectives: The scattered state of villages both from their geographic aspect and the distance between residential units within a single village has made the task of supply, distribution and monitoring the quality of water a difficult one. Ideas of experienced people in the field of rural water quality control, has been obtained to reach gain a view on existing difficulties in supplying safe water to villages and the ways to overcome them.
Methods: Using a three-iteration Delphi procedure, consensus was built and measured among eleven managers and experts of rural water quality control. Given the large number of opinions and views ,the problems were discussed and were given priority according to the alphabetical order of the names of the participants.
 Results: The difficulties were summarized as of being, the main source of water supply, economic, human resources , facilities, cultural and extra organization issues.
Conclusion: The cooperation rate was 100% in this study and most of the problems were concerning no credible financial support in supplying of costs for the maintenance facilities, upkeep of networks and the incorrect choice made in selecting of the water resource. We can overcome to these problems by implementing reforms, teaching, retraining, constant supervision and efficient management of the working staff , supervision of special operations projects including mending of breaks in pipelines and thus could lead to a more efficient distribution to the villages on time.

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Knowing the population size of rare diseases or special subpopulations like injection drug users (IDUs) is one of the most important challenges in public health and health surveillance systems but it is difficult to estimate these groups. During the last few years, new methods have been suggested to estimate hidden or hard-to-reach populations, one of which is the network scale-up method (NSUM). The NSUM itself includes measuring the personal network size and estimating the prevalence of hidden and hard-to-count populations. In this paper, we basically discussed the indirect methods of calculating the population size, and the history of NSUM and its concepts, and then addressed the estimation of hidden populations with NSUM and the applicable notes for such populations.

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Background and Objectives: The cancer of the pancreatic head and Ampulla of Vater is a malignant disease usually seen in advanced stages with symptoms caused by stomach and biliary obstruction. Curative treatment is possible in the early stage. Unfortunately, most symptomatic patients are in the advanced stage and have an unrespectable tumor; therefore, they should undergo palliative surgery. This study was performed to determine the complications and survival rate of patients who underwent palliative surgery for advanced stages of cancer in the Ampulla Vater and pancreatic head.

Methods: In this study, 49 patients with advanced stages of cancer in the Ampulla of Vater and pancreatic head who had undergone palliative surgery from 2003 to 2014 at Baqiyatallah Hospital were studied and the complications and survival rate were determined.

Results: Eleven patients (22.44%) underwent biliary bypass, 6 (12.24%) underwent gastric bypass, and 32 (65.32) underwent both procedures. Twelve (24.49%) patients developed complications. Anastomotic leak and peritonitis were the most common complications seen in 6 (12.2%). Seven patients (14.28%) died in the hospital. The mean survival was 5.47 ± 8.38 months. Upon follow up, survival was significantly longer in older patients (P=0.01).

Conclusion: In one-fourth of the patients with advanced stages of cancer, palliative surgery of the pancreatic head and Ampulla of Vater caused complications, and the mean survival rate was less than six months. The results of this study recommend the use of less invasive procedures such as biliary stenting in the advanced stages of the disease.