Payesh
Year:2002 | Volume:1 | Issue:3|Papers Count:12

Objective(s): To assess the cesarean rate and related factors in maternity hospitals in Tehran. Material & Methods: This was a cross-sectional study using data from 824 pregnant women via a two step random sampling. A standardized form was completed for each mother, collecting past and present obstetric history and demographic characteristics. Results: 66.5% of mothers delivered by cesarean section & 33.5% vaginaly. 72% of cesareans were elective. Of these 22% were done because of maternal request and 71% of mothers who requested cesarean had no logic reason for their request. Also 65% of doctors suggested cesarean for their patients without any true medical indications. The majority of cesarean sections were performed in private hospitals (84% in private vs. 47% in public hospitals (P<0.0001). Conclusion: The results show significant variability among hospitals when opting for cesarean section. Also, the results indicate that, cesarean section is widely performed for non-medical reasons.

Objective(s): To determine age-specific rubella seroprevalence in the 0 to 45 years-old unvaccinated population in Uremia, Iran and also to propose a vaccination strategy against rubella this study designed. Material & Methods: A total of 770 unvaccinated persons 0 to 45 years old were selected for the study with cluster sampling. Sera from 392 females and 378 males were tested for rubella IgG antibody using enzyme linked immonosurbent assay (ELIZA) technique. Rubella seropositivity was defined as serum rubella IgG antibody level> or = 13IU/ml. Results: Of the 770 cases, 58.1% were seropositive. Due to maternal derived antibodies, 100% of the newborns was seropositive. This figure decreased with time until it became zero in children aged 9 months. Then from years 4 increased with age gradually until it peaked at 93.4% in the age group of 15- 19 years. The seropositivity decreased to 85.7% in the age group of >35 years. Of women in the reproductive age groups (15-45years old), 89.6% were seropositive. Conclusion: Because a substantial proportion of women in their childbearing years are susceptible to rubella, immunization efforts should be directed at infants and/or prepubertal children.    

Objective(s): To evaluate the outcomes of pregnancies complicated by umbilical cord entanglement. Material & Methods: We selected pregnant women who referred to Niknafs maternity hospital with singleton, vertex and term pregnancy. Pregnancies with infants with no umbilical cord entanglement served as comparison group. Results: Of the 478 deliveries, the frequency of umbilical cord entanglement was 40.17%. The frequency of nuchal cord entanglement was 34.3% and around limbs or trunk was 5%. The frequency of two or more cord entanglements at delivery was 6.49%. Pregnancies with umbilical cord entanglement were more likely to exhibit an abnormal fetal heart rate pattern (P<0.001). The mean numbers of umbilical cord enlargements in infants who had mecunium was more than infants without mecunium (P=0.024). Conclusion: Umbilical cord entanglement was associated with a greater risk of mecunium, an abnormal fetal heart pattern during labor. It is possible to detect this problem with Doppler ultrasonography during prenatal scan.    

Objective(s): To assess reproductive risk factors for breast cancer patients in Iran. Materials & Methods: A case- control study was conducted in Imam University hospital (a large teaching and general hospital) from April 1997 to April 1998. Eligible cases were patients with a pathological confirmation of breast cancer diagnosis. Female patients without any history of breast problems and neoplastic diseases were recruited as controls. Using a short questionnaire demographic data and reproductive related risk factors were collected. Results: In all, 321 cases and 300 controls were interviewed. In multivariate analysis marital status and age at first pregnancy showed significant increased risk for breast cancer (never married: OR= 3.04, 95% CI= 1.4- 6.4, pregnancy more than 30 years old: 3.1, 95% CI= 1.8- 8). Conclusion: The findings suggest that marital status and age at first pregnancy are the most important reproductive risk factors for breast cancer in Iran.  

Objective(s): To assess mental health in medical students. Materials & Methods: 460 medical students in different educational grades from the IUMS have selected by random sampling. All subjects completed The General Health Questionnaire-28 (GHQ-28). Results: 206(44.8%) male and 254(55.2%) female with mean age of 19(2.5) years were mentally disordered. The prevalence were as high as 42.6%. The results showed that marital status, sex and financial problems have significant relation with student s mental health (P=0.029). Conclusion: This study showed that mental disorders in medical students are prevalent and should not be neglected.    

Objective(s): To translate and to test reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Iran. Material & Methods: Using standard" backward - forward "translation procedure, the English language version of the questionnaire was translated in to Persian (Iranian language). Then, a sample of 748 young people aged 18 to 25 years old completed the questionnaire. In addition, a short questionnaire containing demographic questions and a single measure of global quality of life (ranging from extremely poor to excellent) was administered. Results: The mean age of respondents was 21.1 (sd=2.1) years and most were female (76%), single (84%), and college/ university student (51%). Employing the recommended method of scoring (ranging from 0 to 12), the mean GHQ score was found to be 3.7 (sd=3.5). However, the single measure of global quality of life indicated that many (28%) experiencing neither good nor bad and 31% moderately good, quality of life. To test reliability, the internal consistency of the questionnaire was assessed by Cronbach s alpha coefficient and it was found to be 0.87. Validity was performed using known groups comparison analysis, The results of the ANOVA of GHQ score with global quality of life status (as the grouping variable) indicated that there were significant differences between groups in the expected direction, Those with a better global quality of life scored lower on the GHQ and those with an extremely poor or poor global quality oflife reported more psychological problems (F=58.6, P<0.00001). Finally, to suggest a cut -off score for case ness, it was found that the mean GHQ score for the whole population of respondents provided a rough guide to the best threshold. Conclusion: The findings of this study indicated that the Iranian version of the GHQ-12 is an acceptable, reliable and valid instrument of measuring psychological well- being in young people in Iran, where more than 50% of populations are under 30 years old in age.    

Objective(s): The main objective of this research was to determine the prevalence of anxiety among high school teachers in Tehran. Material & Methods: This was a cross-sectional study in which by multistage random sampling, 500 teachers were studied. Data collected via a questionnaire containing items on demographic characteristics and a standard Cattle test for measuring anxiety. Results: Of 500 teachers under study, 125 peoples (25%) were without anxiety and the remaining 375 (75%) had some degrees of anxiety: 44.8% with slight anxiety, 22% with medium anxiety and 8.2% with intense anxiety. Also, it has been observed that the anxiety was related to age, sex, marital statue, satisfaction with job, having interest in religious matters, family history of anxiety, consulting a psychologist and death of family member in recent six - months (father- mother- brother- sister). Conclusion: The findings are alerting and show that anxiety in high school teachers can be prevented.    

Objective(s): This study reports data from a survey carried out in the Iranian center for breast cancer to examine patient satisfaction. Material& Methods: During a three months period a self- administered questionnaire was distributed to all women attending the Iranian center for breast cancer. Overall, 425 women were interviewed. The mean age was 40.41 years. (SD= 11.61) and mostly had higher education and 81% were married. Results: The results indicated that 83% and 85% of the patients were satisfied with accessibility and time of visit respectively. In overall evaluation, 81% of women were very satisfied with health care provider and 82% of patients were satisfied with physical environment. There was a significant agreement between the patient's overall satisfaction and physical environment (kappa=0.236) and nursing care (kappa=0.217). There was greatest agreement between patients with high level of education and overall satisfaction with personnel communication (kappa= 0.240, P<0.000).There was greatest agreement between patients with low level of education and overall satisfaction with physical environment (kappa=0.293, P=0.000). Conclusions: The findings of this study suggest that the level of education is an important indication of patient s satisfaction. Higher education relates to satisfaction with personnel communication and low level of education relates to satisfaction with physical environment.  

Objective(s): To evaluation of five free Medline versions, this study designed. Material & Methods: This research was a cross - sectional study in nature and conducted to evaluate the five famous Medline versions (BioMedNet, Dimidi, Infotrieve, Grateful Med and Pub med) that are available freely on the Internet. For this purpose 36 topics requested for searching at the information center of the university of Kerman medical sciences were searched in the title field. Results: The results were analyzed statistically by using paired t-test and repeated ANOVA. There was no significant difference in recall and precision between under studied versions in both types of natural and structural language searching. But in each version there was a significant difference in recall and precision between natural and structural language searching (P<0.05). Conclusion: Based on the results, natural language searching has the higher rate of real and precision compared to structural language searching.