Payesh
Year:2002 | Volume:1 | Issue:1|Papers Count:9

Prenatal care is an effective intervention for improving pregnancy outcomes, reducing its mortality and morbidity, saving mother's health and bearing a healthy newborn. Evaluation of prenatal care, in terms of its coverage and nature, and improvement of care standards delivered by care providers has an important role in promotion of mother and infant's health. In a cross sectional study, quality of prenatal care was evaluated in urban areas of kohgiloyeh and Boyerahmad province. Lot Quality Assurance Sampling (LQAS) was employed for quality assessment as well as for measuring the efficacy and feasibility of LQAS in evaluation of primary health care services. A checklist was completed for data collection via direct observation. Results showed that selected urban centers were classified as follows: 4 of 15 centers had lowest rate, 3 centers had highest rate and others had acceptable quality care. There was a shortage of Ferrous Sulfate tablets and Id. card in the area of the study. Quality of prenatal care in the following areas was unacceptable and required appropriate intervention: history taking, abdomen examination, edema examination, essential pregnancy education, weighting, high risk pregnancy diagnosis and referral. Quality of prenatal Care promotion through improvement of knowledge and performance of care providers in the province is an inevitable necessity, especially attention to the centers with lowest rate quality.  

A case-control study was conducted in Tehran to define the prevalence of low birth weight (L.B.W-weight less than 2500gr) and its associated risk factors during Feb. 1996to Jun. 1997. Out of 5893 deliveries in eight hospitals, 263(4.4%) resulted in L.B.W. These cases versus 277 controls who were born after every case composed the study sample. There was significant association between mother's age and rate of low birth weight infants (P<0.01). Birth order was an important risk factor and primigravidity was a greater risk factor for L.B.W delivery than muligravidity (odds ratio= 1.48, 95%CI= 1.04-2.11). Mother's education level and household socioeconomic status have shown significant association with L.B.W. Variables such as mother's age at marriage, abortion history and smoking did not show statistical significant association with L.B.W.  

There are many studies discussing the correlation between air pollution and human health hazards. Yet, in Tehran there is not a survey using time series methodology. Thus, we conducted a study based on time series data on the topic in Tehran, Iran. Mean levels of NO, NO2, NOX, CO, 03, SO2 and PM10 (particulate matters smaller than 10micrometer in diameter) were measured in one station of Tehran's Air Quality Control Corporation and were used as main independent variables. Mean temperature, mean humidity, day of the week, month and season were considered as potential confounders and deaths in people older than 64 years in Tehran was the dependent variable. All the variables were measured during Mar. 1998 to Dec. 1999. Concentrations of air pollutants were different between seasons and so were the means of daily deaths. Out of main independent variables, SO2, CO and PM10 showed statistically significant relations with the dependent variable (P<0.05). After controling for confounders, there was 3.4%, 2.6% and 3.36% increase in death rates, respectively, for each interquartile ascending (increase from 25th centile to 75th centile) in association to the mentioned pollutant centile concentration. No autocorrelation between residuals was observed (r= -0.059). The study showed that meteorological variables can confound the relation between air pollution and rate of deaths per day.  

A hospital based case-control study was conducted to determine the risk factors of Brucellosis and typing of detected Brucella from blood culture of patients in Chaharmahal and Backtiari province in 1999.A total of 100cases and 101controls were filled in the questionnaire and their blood samples were cultured in castanida. Controls were matched for sex and age with cases by frequency matching method. Biotype 1 Brucella mellitansis was detected in 34 of 100cases. After controlling for confounder factors and interaction between these variables by using logistic regression, it was found that the history of disease (Odds Ratio= 3.32, 95% CI= 1.03-5.23), contact with aborted fetuses of animals (Odds Ratio=3.82, 95% CI= 1.79-8.12) and consumption of at least one unpasteurized dairy product (Odds Ratio=2.96, 95% CI= 1.36-6.58) are associated with Brucellosis. In addition, in 34 cases with positive cultures, occupational contact with animals, has been considered as a risk factor (Odds Ratio=2.65, 95% CI= 1.15-6.1). Since in Chaharmahal and Bakhtiari province people add unpasteurized cream to buttermilk in traditional method, butter is associated with Brucellosis (Odds Ratio= 2.79, 95% CI= 1.56-5.01).  

Estimation of dental workforce is necessary for planning education and distribution of dental health care providers. To determine the required number of dental workforce, a cross sectional study was conducted in urban communities of Isfahan province in order to determine people's demand and utilization of oral and dental health services. The results were computed by using N = N=Σkpft/T. In all, 891 subjects were studied. The results revealed that in year 1998, of every 100 samples there has been 77.6 cases demand for dental services due to oral and dental problems. However, only 40.4 cases received these services. These numbers after population weighting go up to 91.97 and 47.88 times, respectively. Each dentist has delivered services to 7377 individuals in Isfahan in 1998. If all the people suffering from dental and oral problems had received these services, each dentist would have managed to cover 3846 individuals. In general, each dental service provider has offered services to 6900 and 12900 in urban and rural population, respectively. If oral and dental health services were available for the whole population, each 3600 persons in urban and 7500 persons in rural areas would require one oral and dental health worker to cover them.  

Since the mid 1970s, several studies have shown that the incidence of Squamous Cell Carcinoma of oral mocusa has been rising steadily. While oral cancer remains Longley a disease associated with older age groups, the increasing incidence has been particularly evident amongst younger adults. Because of severe illness and disability related to the disease and in order to determine the risk factors related to oral cancer type S.C.C. (Squamous Cell Carcinoma), a matched cas-control study was conducted. Data was collected from several centers and in all 52 patients and 104controls were included in the study. Cases and controls were matched according to sex and age (±4 years). Seventy three percent of lesions were in tongue. The ratio cases in women were more than men, but because of matching on sex, The significant test was not performed. There was no significant difference in the frequency of S.C.C type oral cancer between cases and controls with regard to smoking, average of cigarette used in the last year of smoking and over the years of smoking. Other risk factors that showed significant relationship in this study were: using denture, history of oral candidiasis and oral health status. People who had used meat and candies, showed higher probability of caseness more frequently than others. The study findings are in line with already published data.  

The main purpose of this study was to compare quality of life in blind school children and normal students in Tehran. 93 blind school children consisting of 18 girls and 75 boys were entered in to the study. The comparative group that consisted of normal school children (54 girls and 150 boys) was selected through mulistage random sampling. Quality of life was assessed using a validated questionnaire. The results showed that there was not any significant difference in quality of life between the two groups, except for mobility domain (P=0.02). However, There was a significant correlation between visual acuity and quality of life in blind students (r =0.3, P =0.02). To provide a better quality of life for blind school children, provision of facilities for individual and social transportation as well as utilization of appropriate instruments for prevention of visual disorders and correction of visual disturbances are proposed.  

A study was conducted to identify the relative frequency and factors associated with breast pain in Iranian females. In all, 1442 Patient's case records were studied. The most common chief complaints included: breast pain 466(32%), breast mass 349(24%), referred for screening 283(19%), breast pain and mass 119(4%), breast pain and discharge 46(3%).Use of oral contraceptive pills (QCP) (P=0.04) and the duration of lactation (P=0.03) in patients with breast pain was significantly more in patients without pain. Conversely educational status in patients with breast pain was lower than others. The primary diagnosis of normal breast or benign disease was more frequent in patients with pain than patients without pain. The frequency of some factors such as smoking, history of breast and other cancers in both groups was similar. The study findings suggest that there is a strong association between mastalgia, lactation and oral contraceptive use. It seems that to understand these relationships, precisely, further investigations are needed.