Tehran University Medical Journal

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Over a period of 4 years 325 infertile women were evaluated by diagnostic by laparoscopy, which included 250 cases of primary and 75 cases of secondary infertility. The aim of the present study was to find out the probable causes of infertility by collecting qualitative and quantitative data from laparoscopy results of the secondary infertility group so as to give precautions for decreasing the predisposing factors. The results of this study showed that pelvic adhesion was the most frequent pathologic findings (57 cases), which could be due to complication of PID or surgical trauma. 14 cases had other problems and only 4 cases showed no apparent pathological anomalies.

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Prosthetic valve re-operation has greater mortality and morbidity than primary valve replacement. By recognition of factors influencing on causes of redo operation and preoperative survival, one can select appropriate prosthesis at primary valve replacement and when operation performed at appropriate time, surgical risk can be reduced.
Methods and Materials: Two hundred patients that underwent prosthetic valve re-operation from October 1991 through November 2001 were included in this study. There were 68 men and 132 women with the mean age of 42:tl 1.8 years. Structural failure was the commonest cause of bio-prosthesis replacement (93%). Valve thrombosis was the common cause of mechanical valve replacement (32%). Age younger Than 50 (P= 0.01) and interval after the first implantation more than 10 years (P= 0.01) affected bio-prosthesis degeneration.
Results: Atrial fibrillation (P<0.01), Older age especially more than 40 (P<0.05) and mitral position (P<0.01) affected mechanical valve thrombosis. Cross clamp time (P= 0.005), Tricuspid insufficiency (P = 0.001), NYHA IV (P = 0.005) and emergent operation (P= 0.001) were independent determinants of hospital mortality.
Conclusion: In conclusion, in patients with more than 10-years life expectancy and age younger than 50, mechanical valve can be selected for primary valve replacement. If operation performed before patients reach deteriorated condition, preoperative survival would be excellent.

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Background: The first duty of any government is to ensure the health of its children and neonates. Today's countries are classified as declining mortality in this group. To increase neonatal survival rate, classified causes of newborn mortality are the core strategy and policies. This study was aimed to determine the classification of causes of neonatal death in Iran.

Methods: Neonatal mortality refers to deaths of young children. It is measured by the neonatal mortality rate (NMR), which is the number of deaths of neonates per 1000 live births. This study was used data from 11693 neonatal deaths (from 22 weeks gestational age to neonatal death less than 30 days), in Iran's hospitals in 2012 that registered in the perinatal mortality surveillance system (hospital-based system). Demographic characteristics and other factors associated with neonatal death were investigated. To aid in cause of death analysis, burden of disease analysis, and comparative risk assessment we classified the causes of death according to international statistical classification of diseases version 10 (ICD 10), divided into three cause mortality strata.

Results: Results showed the most common cause of neonatal mortality was "certain conditions originating in the perinatal period" (77.92%) with the highest incidence of "disorders related to length of gestation and fetal growth" (37.7%) in this group. Also it shows that 20.82% of deaths caused by "congenital malformations, deformations and chromosomal abnormalities" and 1.26% cases had occurred as a result of "accidents and injuries". The greatest cause of death in the neonates with weight over one thousand grams was "certain conditions originating in the perinatal period" (71.29%), with the highest percentage in the disorders related to "length of gestation and fetal growth" (29.65%).

Conclusion: According to this study the "certain conditions originating in the perinatal period" special "disorders related to length of gestation and fetal growth" was the main cause of neonatal mortality. Also "congenital malformations, deformations and chromosomal abnormalities" was the second cause of neonatal mortality.