Smoking frequency and modeling the underlying predicting factors of tobacco smoking among high school students in Yazd city, 2012

زمینه و هدف: با توجه به اهمیت مصرف سیگار به عنوان یک ریسک فاکتور مهم و قابل پیشگیری و به خصوص اهمیت شیوع بالای مصرف آن در دوران نوجوانی، این مطالعه با هدف شناخت عوامل زمینه ای گرایش به استعمال سیگار در نوجوانان دبیرستانی شهر یزد انجام شده است. روش بررسی: در این مطالعه توصیفی-تحلیلی، 450 نفر از دانش آموزان دبیرستانی شهر یزد به روش تصادفی خوشه ای انتخاب شدند. اطلاعات به کمک پرسشنامه محقق ساخته ای که بر اساس پرسشنامه ی جهانی GYTS طراحی شده بود، جمع آوری و با استفاده از آنالیز رگرسیون لوجستیک مورد تجزیه و تحلیل نهایی قرار گرفت. یافته ها: بر اساس نتایج حاصل از این مطالعه در مجموع 108 نفر (5/23 درصد) سیگار مصرف می کردند. میانگین سن شروع مصرف سیگار در آن ها 3/3±9/12 سال بود. در میان متغیرهای مورد بررسی جنس مذکر، پدر سیگاری، شرکت در جمع افراد سیگاری، پایبندی به نماز و رضایت متوسط از محیط خانه به عنوان فاکتورهای پیشگویی کننده مصرف سیگار مشخص گردیدند. نتیجه گیری: نتایج به دست آمده می تواند تعیین کننده برنامه های مداخله ای خاص و متناسب با گروه هدف پر خطرتر باشد. این می توانند در شفاف سازی جمعیت هدف دارای اولویت بالاتر جهت برنامه های مداخله ای در آینده کمک کننده باشد

Comparison of pregnancy outcome in intrauterine insemination-candidate women with and without endometrial scratch injury: An RCT

Background: Endometrial scratch injury is considered controversial in increasing the success rate of assisted reproductive technology. Objective: To compare the pregnancy outcomes in women undergoing intrauterine insemination with and without an endometrial scratch. Materials and Methods: In this randomized clinical trial, 150 women referred to the Fatemieh Hospital, Hamadan, Iran who were candidates for IUI between December 2017 and December 2018 were randomly assigned into two groups (n = 75/each) with or without an endometrial scratch (as case and control groups, respectively). Women in both groups were in proper and identical protocol for IUI. Chemical and clinical pregnancies, abortion, and live birth rate, also pregnancy complications were compared between the groups. Results: Chemical and clinical pregnancy rates were higher in the case than the control group (p = 0.25, p = 0.54, respectively). In the case group, the abortion and multiple gestation rates were 14.3% and 4.3%, respectively, while it was 5% in the control group (p = 0.60, p = 0.54 respectively). The endometrium thickness on day 21 was higher in the case group than the control (p = 0.01). Conclusion: Endometrial scratching in intrauterine insemination women is not associated with an increase in both clinical and clinical pregnancy rates, however, studies with a larger sample size are recommended to evaluate this intervention. Key words: Pregnancy infertility, Women, Endometrial injury, Pregnancy, Intrauterine insemination

Comparison of the pregnancy outcomes between the medical and surgical treatments in tubal ectopi pregnancy

Background: Various treatments have been proposed to treat ectopic pregnancy, but their impact on future pregnancies is still the subject of controversy. Objective: The aim of this study is to compare the medical and surgical treatment methods and their impact on the subsequent fertility results and complications in women with a history of ectopic pregnancy. Materials and Methods: In this analytical, cross-sectional study, 370 women with the history of ectopic pregnancy, (treared with single dose of methotrexate or salpingectomy by laparotomy), that referred to Al-Zahra Hospital, Rasht, Guilan between 2009 to 2013 were enrolled. 147 women responded to the phone call. The age, the number of women that needed to drug for pregnancy, fertility rate and the fertility outcomes were studied. Result: 147 women responded to the call and between them, 114 women tried to get pregnant again after the ectopic pregnancy treatment. They were agreed to the participate in the study. The mean age of the patients was 28.56±5.63 yr. The fertility rates in the medical and the surgical groups were 56.6 and 47.61, respectively (p=0.141). There were no significant differences in the poor consequences of pregnancy among the two groups; ectopic pregnancy (p=0.605), miscarriage (p=0.605), and prematuredelivery (p=0.648). 15.1 in the medicinal group and two patients 12.5 in the surgical group had received fertility treatment in order to get pregnant (p=0.135). There was no significant difference in two groups. Conclusion: It seems that surgical treatment depending on the underlying variables of each patient, can be used such as medical treatment, without worrying about its effect on fertility. © 2018, Research and Clinical Center for Infertitlity. All rights reserved

High Prevalence of Vitamin D Deficiency and Adverse Pregnancy Outcomes in Yazd, a Central Province of Iran

Abstract Background: There is a growing concern about the high prevalence of vitamin D deficiency and its relationship with variety of diseases worldwide. The objective of this study was to determine the prevalence of vitamin D deficiency and its relationship with pregnancy adverse effects in Yazd. Methods: This was a cross sectional study conducted among 200 nulliparous women from October 2013 to April 2014. Data containing socio-demographic and personal details, vitamin D level, pregnancy complications and growth situation of newborns were collected and analyzed using Mann-Whitney, Kruskal-Wallis and Pearson's correlation coefficient by SPSS. p<0.05 was considered statistically significant. Results: The mean serum 1, 25 (OH) 2 D 3 concentration was 20.3±10.8 µg/l. Totally, 78% of the women had less than sufficient levels. Mean of vitamin D was significantly higher in natural or elective cesarean in comparison with abortion and emergency cesarean (p=0.040). Risk of abortion was 3.1(1.39-6.8) and higher in severely deficient group in comparison to women with vitamin D deficiency (p=0.017) and mean of vitamin D group was significantly lower in women who had oligohydramnios or polyhydramnios complication (p=0.045). Conclusion: The study findings revealed that vitamin D deficiency is prevalent in pregnant women and it is significantly associated with elevated risk for abortion, and oligohydramnios or polyhydramnios. Probably, a targeted screening strategy can be suggested to detect and treat women at high risk of vitamin D deficiency in early pregnancy as a simple way to reduce the risk of these adverse pregnancy outcomes in Yazd

Comparison of the pregnancy outcomes between the medical and surgical treatments in tubal ectopi pregnancy

Background: Various treatments have been proposed to treat ectopic pregnancy, but their impact on future pregnancies is still the subject of controversy. Objective: The aim of this study is to compare the medical and surgical treatment methods and their impact on the subsequent fertility results and complications in women with a history of ectopic pregnancy. Materials and Methods: In this analytical, cross-sectional study, 370 women with the history of ectopic pregnancy, (treared with single dose of methotrexate or salpingectomy by laparotomy), that referred to Al-Zahra Hospital, Rasht, Guilan between 2009 to 2013 were enrolled. 147 women responded to the phone call. The age, the number of women that needed to drug for pregnancy, fertility rate and the fertility outcomes were studied. Result: 147 women responded to the call and between them, 114 women tried to get pregnant again after the ectopic pregnancy treatment. They were agreed to the participate in the study. The mean age of the patients was 28.56±5.63 yr. The fertility rates in the medical and the surgical groups were 56.6 and 47.61, respectively (p=0.141). There were no significant differences in the poor consequences of pregnancy among the two groups; ectopic pregnancy (p=0.605), miscarriage (p=0.605), and prematuredelivery (p=0.648). 15.1 in the medicinal group and two patients 12.5 in the surgical group had received fertility treatment in order to get pregnant (p=0.135). There was no significant difference in two groups. Conclusion: It seems that surgical treatment depending on the underlying variables of each patient, can be used such as medical treatment, without worrying about its effect on fertility. © 2018, Research and Clinical Center for Infertitlity. All rights reserved

Observance Rate of the Rights of Patients by Providers Care and its Necessity from View of Patients in Shahid Sadooghi Hospital in Yazd 2012

Introduction:Efficient health system needs active participation and good relationship between health care providers and health care recipient. The fundamental reason for the importance attached to patient’s rights and the corresponding increase in legislation is that respecting patient’s rights is an essential part of providing good health care. Existence of patient rights prism doesn't mean its observance. The purpose of this study is to determine the observance rate of patient’s rights and its necessity from patient`s point whom hospitalized in Shahid Sadooghi hospital of Yazd. Methods:This study has been done as a cross sectional descriptive survey in three months (December 2012, junuary and febriary2013) in Shahid Sadughi hospital of Yazd city. The study group that selected randomly consisted of 200 patients who hospitalized in study period. Data were collected during face to face interviews using a standard questionnaire. This questionnaire was based on patient right prism and its validity and reliability has been obtained in previous studies. Data analyzed by SPSS18. Results:Results showed that observance rate of patient’s rights and its necessity from patient`s point was 63.2% and 76.85% respectively with a significant relationship (R=0.49, P=0.000). There was a significantly relationship between patient`s education, their residency and age of them with observance and necessity of their rights. Urban residency, high education and more age was related to better opinion. Also there is significantly relationship between observance of patient`s rights and its necessity at all and in subscales with their satisfaction of hospital (P=0.000). Conclusion:According to observance rate of patients' rights and its necessity for patient satisfaction and their health promotion. A strategy for increasing of observance is increasing in patients’ awareness of patient’s rights pris

Frequency of Accidental and Symptomatic Thrombo-embolic Events in Patients with Gastrointestinal Cancer

Background and Objective: One of the complications that can cause significant death and disability in cancer patients is thromboembolic events. Since gastrointestinal cancers are among the most common cancers in the world and Iran, and there is little information about thromboembolic events associated with gastrointestinal cancers in Iran, this study was conducted to determine the frequency of asymptomatic and symptomatic thromboembolic events in patients with gastrointestinal cancer. Materials and Methods: In this cross-sectional study, the files of patients with gastrointestinal cancer in Shahid Beheshti Hospital and Imam Khomeini Clinic in Hamadan city, Iran, during 2017-2021 were examined. Results: In this study, 630 patients with gastrointestinal cancer were examined, and a total of 59 (9.4%) cases of thromboembolism were recorded. Most thromboses occurred in patients with stomach cancer (P>0.05). The relative frequencies of thrombosis in patients using and not using anticoagulants were 7.6% and 13.2%, respectively (P<0.05). Conclusion: The occurrence of thrombosis in Iran is less than that in western societies and it is not related to the location of cancer, age, and gender. In the case of taking oral anticoagulants, the risk of thrombosis decreases. Most thromboembolic events occur during the first 6 months after cancer diagnosis and the first 3 months after the start of chemotherapy

Secondary Prevention by Enhancing Adherence in Diabetic Patients

Objectives: Adherence to prescribed medications is a key dimensionof healthcare quality. Poor medication adherence might be a significantbarrier to achievement of positive clinical outcomes. This study aimedto compare the adherence to oral hypoglycemic agents in patients withtype 2 diabetes by using two methods of completing diary checklist andcollecting drug shells.Methods: This randomized clinical trial was conducted in IsfahanDiabetes Institute. A number of 100 type 2-diabetic patients were selectedthrough systematic sampling method and then were randomlyallocated to two groups of equal number. Each group was invited toattend our 12-week educational program. We asked one group to completediary checklist about how they took their drugs during the studyperiod. The other group was asked to collect the shells of oral hypoglycemicagents after taking in a pocket. Medication adherence ratiowas calculated for both groups.Results: Overall, 87 patients completed the study, of which 30 cases(34.5%) were in the check list group and 57 (65.5%) in the referencegroup. In the check list group, the adherence ratio was good in 96.7%and moderate in 3.3%, with no case of poor adherence. In the referencegroup, the corresponding figures were 55.2%, %6.9 and 37.9%,respectively (p<0.05 between groups).Conclusions: Although the adherence ratio was greater than 80% inboth groups, it was significantly higher in the check list group. Therefore,we suggest that by increasing adherence to prescribed medications,diary checklist can be an effective method of secondary preventionof chronic diseases, as diabetes mellitus

Does oral contraceptive pill increase the risk of abnormal Pap smear?

Background: It is noted that oral contraceptive pills increase the risk of abnormal Pap smear but results have been inconsistent across the populations. Objective: This study aimed to evaluate the association between oral contraceptive pill (OCP) consumption and abnormal Pap smear in women who referred to Shahid Sadoughi and Madar hospitals in Yazd. Materials and Methods: A cross sectional descriptive study was carried out and a database of all Pap smear reports from 2009-2011 at Cytopathology Department of Shahid Sadoughi and Madar hospitals in Yazd, Iran was reviewed. A total number of 1286 women with history of OCP consumption were selected as the case group and 1218 women applying other contraceptive methods were selected as control group for evaluation. Both case and control groups were matched by age, parity and socioeconomic status. All of the women in this study maintained a single partner as their husband and none of them were considered as smokers. The duration of OCP use was at least 5 years. Results: Abnormal Pap smear results were observed in 0.4% of cases and 0.2% of controls. There was no significant association between OCP consumption and abnormal Pap smear (p=0.727). Conclusion: Our findings did not show any specific association between OCP consumption and abnormal Pap smear results. In addition, the number of abnormal Pap smears in women who consumed OCP was lower than that of western countries. More prospective studies are required

Relation between low birth weight with attention deficit and hyper activity disorder in children

Background and Objective: Low birth weight (LBW) is one of the most important problems in the world. Many morbidity are more prevalent in LBW included in attention deficit and hyper activity disorder (ADHD). This study was done to find the Relation between low birth weight with attention deficit and hyper activity disorder in children. Methods: This historical cohort study was done on 226 rural children in Yazd province, central area of Iran. ADHD symptoms were evaluated in LBW and NBW using DSM-IV criteria. Results: Frequency of ADHD was 22.8% in LBW and 12.5% in NBW (P<0.05). The mean of family members was 4.7±0.6 and 4.2±0.8 in child with ADHD versus child without ADHD (P<0.05). Odd's ratio for ADHD was 3.1 in patient with more than one sister or brother (95% CI: 1.2-7.9, P<0.001), and 5.7 in patients with positive familial history (95% CI: 2.6-12.4, P<0.001). Conclusion: Relationship between ADHD and LBW was statistically significant. Positive familial history for ADHD and over-crowded family were social factors related with ADHD. LBW is one of the risk factors for ADHD and can be considered in children health program ADHD was frequent in child with low birth weight than child with normal birth weight