The global trend of infertility: an original review and meta-analysis

Background and aims: Infertility is one of the most important conditions in reproductive system and there is no reliable estimates for global prevalence of infertility. Therefore, knowing the prevalence of infertility is important and can be effective in decision making. Methods: We systematically reviewed all published papers in Medline database and Scopus (1988–2010). Univariate and multivariate approaches were applied to assess the causes of heterogeneity among the selected studies. Meta-regression was used to examine the relationship between the prevalence of infertility and the year of study. Data manipulation and statistical analyses were performed using Stata 11.1. Results: The study population was not similar in all papers. Studies evaluated the prevalence of infertility in the general population, the total female population, women and couples. Some studies defined infertility as failure to conceive within 12 months of regular sexual life without contraception methods while other studies defined it as failure to conceive within 24 months of regular sexual life without contraception methods. Overall, 52 studies met our inclusion criteria and the pooled worldwide of infertility was obtained about 10. The correlation between prevalence of secondary infertility and year of study was significant (P=0.039). Conclusions: Approximately 10 of the world's population suffers from infertility. Due to the negative impact of infertility on couples in various aspects of life, and the need for treatment and support programs, accurate estimate of infertility is essential worldwide

ATTRIBUTION OF MENTAL DISORDERS IN SUICIDE OCCURRENCE

The present study aimed to determine attribution of mental disorders in suicide occurrence. By a cross-sectional study, all suicide records (n = 5188), between 1993 and 2009 in Ilam province, were investigated. Multiple logistic regression analysis was adopted. Totally, 27.5 of the suicides occurred due to mental disorders. This was significantly higher in males (29.3), individuals born in 1996(44) and 1990s (30.3), those aged 30 years and above (33.2) and suicide attempters (28.3), respectively and separately. The risk of suicide due to mental disorders was observed for females (OR = 0.85, CI = 0.74-0.97), those born in 1994 (OR = 2.82, CI = 1.27-6.24), completed suicides (OR = 0.81, CI = 0.68-0.97) and the age group 25 to 29 years old (OR = 0.82, CI = 0.66-1.01). Suicide due to mental disorders was higher among males compared to females, the rate of which was directly proportional to attempted suicide and age. It is therefore recommended that health educations be seriously carried on targeted groups

Prevalence of internet addiction among university students in Ilam: a cross-sectional study

Background and aims: Internet addiction is one of the problems emerged with the development of technology. Considering the potential negative effects of internet addiction on health, the present study aimed to determine the prevalence of internet addiction in university students in Ilam, west of Iran, in 2014. Methods:In this cross– sectional study, 1066 university students in both public and private sectors were assessed in 2014. The samples were selected by multi-stage random sampling method. Data were collected by a two-part questionnaire: the personal characteristics and Internet Addiction Test (IAT)-20. This 20-itemed questionnaire measures internet addiction in mild, moderate and severe levels. Each answer is scored based on a Likert scale from 1 to 5. The higher score represents a greater level of addiction. The total score between 20 and 49 represented mild, 50-79 showed moderate and 80-100 was severe addiction. Results:Overall, 466 (43.7) of students were placed in the Internet addiction group. Generally, 39.6 of students had mild and 4.1 had moderate addiction. No case of sever Internet addiction was seen. Prevalence of internet addiction in the medical students was higher compared to nonmedical students (P< 0.0001). Conclusion:Based on the results, internet addiction should be considered as a serious problem in adolescents and young adults. So, it is necessary that proper use of internet to be educated to adolescents and young adults to prevent the risk of internet addiction

Comparison of Artificial Neural Network and Logistic Regression Models for Prediction of Psychological Symptom Six Months after Mild Traumatic Brain Injury

Background: Nowadays, outcome prediction models using logistic regression (LR) and artificial neural network (ANN) analysis have been developed in many areas of healthcare research. Objectives: In this study, we have compared the performance of multivariable LR and ANN models, in prediction of psychological symptoms six months after mild traumatic brain injury. Methods: In a prospective cohort study, information of 100 mild traumatic brain injury patients, during a six months period between 2014 and 2016 were included. Data were divided into two training (n = 50) and testing (n = 50) groups, randomly. 300 ANNs and LRs were studied in the first group and then the predicted values were compared in the second group using the two final models. The receiver operating characteristic (ROC) curve and accuracy rate were used to compare these models. Results: The results showed that accuracy rate for the neural network model was 90.65, while it was 75.96 for the LR model. Conclusions: The ANN models appeared to be more powerful in predicting psychological symptoms versus the LR models

Epidemiological aspects of suicide lead to death in Iranian population during 2004-2008; A retrospective study

Suicide is raised in many countries around the world as one of the major problems in medical and social advocacy. The increasing incidence of suicide in the community is sensible and irreparable damage to the body of a society's human resources. Therefore the present study aimed to explore the epidemiological aspects of suicide leads to death in Iranian population during 2004-2008. In a retrospective study a census sampling method was used. All records formed of suicide death in Ilam province during 2004 to 2008 in the Office of the State Coroner were evaluated. Data was collected by a checklist including age, gender, marital status, educational level, occupation, number of families, suicide instrument location of attempted to suicide, place of death and season. SPSS software Package 14 was used to analyze the data of this project. Mean± SD, median and percentages were used to describe the data. The average percentage of suicide lead to death in Ilam province was 18.7 per 100.000 person's .Women and men have a suicide rate roughly equal (50.8 and 49.2). There was a significant relationship between month (P= 0.02), season (P= 0.03), the number of families (P= 0.001) and percentage of suicide lead to death. Self-burning was the most common method used by suicide lead to death. This study showed that suicide remains a serious problem and an increase occurred in suicide in Ilam province in comparison with previous years

Risk factors of pelvic organ prolapse in Iranian women: a cross-sectional study

Background and aims: Pelvic organ prolapse (POP) is a common condition which affects on a large proportion of women. The objective of this study was to determine the risk factors of POP in Iranian women. Methods: This cross-sectional study was carried out to examine the role of demographic, anthropometric and clinical characteristics in POP disease in a sample of 365 females in Ilam, Iran. Examinations were performed according to Pelvic Organ Prolapse Quantification (POPQ) technique in dorsal lithotomic position. Then, the sample divided into two groups as with and without prolapse. Then, unilabiate and multivariate analyses were performed. Results: Totally, 365 women participated in this study. The prevalence of POP was 80.8. Univariate logistic regression analysis showed a significant differences between groups with and without POP based on age, maximum birth weight, BMI, pregnancy, delivery mode, delivery operative and delivery position. But after multivariate analysis, the most significant factors identified as risk factors for POP were age (OR= 1.12, 95 CI= 1.02-1.23, P= 0.02), normal vaginal delivery (NVD; OR= 6.18, 95 CI= 1.43-26.75, P= 0.01) and episiotomy (OR= 30, 95 CI= 5.69-158.11, P= 0.000). Conclusion: Findings of the study showed that several risk factors could collaborate in creating of POP. However; body mass index and number of pregnancies are modifiable factors. So, maternal care providers should educate women for maintaining the ideal weight and decreasing the number of pregnancy in order to prevent POP

Suicide Attempts in Ilam Province, West of Iran, 2010-2014: A Time Trend Study

Background: Suicide has become an increasingly widespread form of morbidity in the developing countries. There has been an increasing trend in morbidity and mortality due to suicide in Iran over the past few decades. This study surveyed attempts and completed suicide over a 5-year period. Methods: Through a cross-sectional study, overall identified suicides by systematic registration suicide data (SRSD) in Ilam Province, western Iran from 21 March 2010 to 11 December 2014 were enrolled. Multiple logistic regression analysis was used for measuring the association between the risk factors of interest and suicide. The statistical software package was Stata 11.2. Results: A Suicide attempts have slightly increased in Ilam during 2010-2014, during which, 6,818 attempted suicides occurred of which 546 were completed. The odds of completed suicide was higher among older age groups than younger ones so that the crude OR estimates of completed suicide among people aged 50 to 59 yr against people aged <20 yr was (OR=6.99; 95 CI: 3.02, 11.07). The crude and adjusted odds ratio (OR) estimates of completed suicide in males against females were (OR=3.22; 95 CI: 2.58, 3.93) and (OR=3.66; 95 CI: 3.03, 4.11), respectively. Significant excess risk also appeared with academic against illiterate attempters (OR= 2.31; 95 CI: 1.35, 3.95). Results showed no increasing trend in the suicide method. Some methods such as self-immolation had decreasing trend over time, although it was not statistically significant (P= 0.089). Conclusions: We observed the variety of suicide risk factors that calls for more diversity in preventative programs. Distribution of suicide methods is diverse across the period of the study

Marshall syndrome in children referred to specialist clinic of Imam Khomeini Hospital of Ilam, Iran, 2012

Periodic fever syndrome is a self-inflammatory disease. Since the disease is benign and self-limiting, the present study aimed to achieve a model to detect and differentiate it from other infectious diseases .In this study all children residing in Ilam who were suspected of Marshall Syndrome were examined. We chose a sample comprising children referred to Imam Hospital clinic of Ilam in 2012. Inclusion criteria consisted of more than three periods of fever without a source of infection, fever periods shorter than 5 days and repeated at intervals of about one month. The collected data were analyzed using SPSS software 16. We used both of descriptive and inferential statistics, Kolmogrov smirnov, Chi-square. Significance level of P ≤ 0.05 was considered. The average of patients' age was 4.9 ± 1.8 months and their gender perception was 85.7 male and 14.3 female. In this study the average age of symptoms emergence was 48.33 ± 23.25 month. The average of fever periods in surveyed patients was 4.09 ± 0.88 days (minimum 3 days & maximum 5 days) and the intervals between fever periods was 40.23 ± 16.84 in average. The applied treatments in this study were Prednisolone and Ttonsillectomy. There was significant relationship between age and the symptoms (P<0.007). By having a true perception of Marshall Syndrome using diagnosis criteria, we could prevent uncontrolled prescription of antibiotics and their possible side effects, and it is a positive step towards reducing healthcare costs

Smoking status in Iranian male adolescents: A cross-sectional study and a meta-analysis

The present study aimed to estimate the prevalence of smoking status and its associated factors in Iranian adolescents and a meta-analysis of recent cross-sectional studies in order to estimate the corresponding prevalence for all Iranian adolescents. In a cross-sectional study, 1064 male high school students in Zanjan city (northwest of Iran) were recruited. A self-administered questionnaire was used for smoking status and associated factors. Through the meta-analysis, all relevant published studies were reviewed. Almost one-third of adolescents (34.2, n =354) have experienced smoking either experimentally (23.4, n=242), or regularly (10.8, n=112). Multivariate analysis showed that older age (OR = 1.20; 95 CI: 1.05-1.37), risky behaviors (OR=1.83; 1.25-2.68), Tramadol medication (OR = 2.19; 1.54-3.11), low self-esteem (OR 1.07; 1.03-1.11), positive attitude toward smoking (OR= 1.15; 1.09-1.21), positive thinking about smoking (OR= 1.07; 1.01-1.14) and having smoker friends (OR= 1.94; 1.36-2.77) were significantly associated with cigarette smoking in adolescents. Meta-analysis results showed that 7 of Iranian adolescents are regular smokers and 27 are experimenters. Increasing prevalence of smoking in Iranian adolescents is a major concern for public health. Controlling risky behaviors and increasing health education are recommended. (C) 2013 Elsevier Ltd. All rights reserved