Vol 5, No 1 (March 2011)

Original Articles

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    Objective: Evaluating the status of the ECO member countries in relation to HIV/AIDS (goal 6-a) which includes the main targets for global HIV/AIDS control.
    Materials and methods: In 2009, we have critically reviewed the countries' MDG reports and extracted the data on each MDG's indicator by year to explore the trend. In the next phase, the main stakeholders, from both governmental and international organizations in the country have been visited and interviewed (individually and in group) by the research team as part of the data validation process.
    Results: The most important issue in ECO countries is lack of accurate data about HIV/AIDS. From all countries four of them are facing concentrated epidemics in IDUs. ECO countries are categorized into three groups; countries in which HIV prevalence had remained less than 0.1 percent during 2001 to 2008 (Only country is within this group) , countries in which prevalence had reached 0.1 percent during 2001 to 2008 (5 countries are in this group) and countries in which prevalence had reached 0.2 percent or more during 2001 to 2008. Three countries  are in latter group. There is no valid data about people's awareness, condom usage during last sexual intercourse, and antiretroviral treatment. Existing data indicates inappropriateness of these indicators in all countries of the region.
    Conclusion: An efficient surveillance system in needed to illustrate an exact picture of HIV/AIDS in all countries. This study shows that though the epidemics has started lately in member countries compared with other parts of the world, no proper intervention has been adopted for controlling the epidemics yet. Moreover, in those countries which AIDS epidemics are concentrated among drug users, harm reduction activities are necessary to control the problem. Increasing the coverage of antiretroviral treatment and awareness of general and high risk population could help countries to achieve HIV/AIDS indicators.

  • XML | PDF | downloads: 482 | views: 366 | pages: 11-18

    Objective:The family physician program is one of the basic programs of the Fourth Plan on Economic, Social and Cultural Development in the health sector. This program more than five years old, is currently deployed in all villages and urban areas with populations less than 20,000 people in Iran. This study was conducted with the aim of measuring User's Satisfaction with Family Physician Program in Markazi Province in the fall of 2010. The main objective of this study was determining client satisfaction with family physician program in Markazi Province.
    Materials and methods: This study is descriptive - analytic and cross sectional, and was conducted at 40 medical centers with family physician services in the province. Demographic characteristics of individuals, personnel behavior, time spent in consultations, guidance and training, service costs, adequacy of services, ability and skills of personnel, access to medical facilities, adequacy of facilities and equipment, were the basis of a questionnaire and interview of registered patients or their relatives, was conducted.
    Results: 391 people were interviewed during the three months  The average age was 38.24±17.02 years, 66.5 percent of them were women and 81.3 percent of women were married. 34.52 percent of patients in the high or very high categories were satisfied with the whole performance of health centers. This High or very high level of satisfaction was about the performance of family physicians, midwives, laboratory and pharmacy, respectively 33.1, 37.1, 36.8 and 38.3.
    Conclusion: In general, the program has been successful in the province. Policymakers can achieve a higher level of satisfaction in the long term based on comments from service recipients and promoting the program and some program processes.

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    Objective: Tempo is the average waiting time to next birth for a woman. Role of fertility as the most important phenomenon determining population fluctuations due to the studies of it compared with other demographic phenomena be important and review the multifarious socioeconomic factors of it share  a large effective population studies. General purpose of this study is fitting the Cox model to determine factors that influence the birth of second child and too calculate the tempo in second to eight births on Bahram Abad rural women.
    Materials and methods: Population under study are all married women with 15-45 years old that live in Bahram Abad village's and have had at least two children. This study is a cross sectional study. In the present study birth of each child is considered as a disaster and because survival data generally have not symmetrical distribution then the Cox regression model  (Proportional hazard model) is used for effects of variables on survival and hazard.
    Results: In this research 228 mothers were studied and they have had 669 children. Mean number of children is 3and 42% of these children are girls and others are boys. Maximum tempo is from labor fifth to labor sixth (63.32) and the least is from the sixth to seventh of childbirth (57).
    Conclusion: In the final model from available variables only the age difference of parent had a positive impact on tempo.

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    Objective: IUD is a highly effective, safe, private, long-acting, and rapidly reversible method of contraception with few side effects. The aim of this study was to assess the continuation rate and cause of IUD discontinuation in Isfahan, Iran.
    Materials and methods: This historical Cohort study wascarried out on 12 randomly selected health centers of Isfahan province in 2007. 244 literate married reproductive aged women (15-49 years old) who had chosen IUD as a contraceptive method in 2002 enrolled the study by census sampling. After explaining the aim of study and taking informed consent, women completed the questionnaire for demographic characteristics, menstrual characteristics before and after IUD insertion and cause of IUD discontinuation. Data were analyzed by SPSS 11 software, descriptive statistics and Kaplan-Meier analysis.
    Results: Continuation rates at the end of 1, 2, 3, 4, 5 and 6 years were 100, 92, 87, 76, 66 and 65 per 100, respectively. Since 2001-2007, 60% (146) preserved and 40% (98) removed their IUD. 27.6% (27) discontinued IUD use due to occurring medical problems that the most common cause was infection (29.6%). 72.4% (71) had voluntary IUD removal and the most common cause was tendency to planned pregnancy (38%).
    Conclusion: These findings indicate that health care providers should give more emphasis to counseling programs for women desiring IUD insertion.

Case Reports

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    Osteogenesis imperfecta is a rare inherited Connective tissue disorder with an expression that varies from mild to severe disease affecting bone, Sclera and middle ear. Fertility is preserved, especially in those patients with type 1. We present hereby a pregnant woman with Osteogenesis imperfecta that had over 30 fractures in long bones and vertebrae. The object of this report was to determine choice of delivery method, maternal and neonatal Complications and prenatal diagnosis.