pISSN: 1735-8949
eISSN: 1735-9392
Editor–in–Chief:
Fatemeh Davari Tanha, MD.
Vol 13, No 1 (March 2019)
Original Articles
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Objective: To investigate the trend of changes in Age-Specific Fertility Rate (ASFR), Total Fertility Rate
(TFR), and Cohort Fertility Rate (CFR) in rural areas of Fars province, southern Iran during 1988-2012.
Materials and methods: This cross-sectional study was conducted based on analyze fluctuations in
fertility. Information about the number of births and mothers aged 15-49 years was collected. By
calculating the ASFR, TFR, and CFR along with analyzing their patterns the trend of changes in fertility
rate would be revealed. Finally, modeling and time series forecast of ASFR based on age groups was
conducted using the SPSS software.
Results: The TFR was estimated to be 4.21, 2.1, 1.76, 1.65, and 1.78 per thousand in 1992, 1997,
2002, 2007, and 2012, respectively. Moreover, CFR was 2.01, 1.54, 1.05, 0.54, and 0.13 for those
born during 1972-1976, 1977-1981, 1982-1986, 1987-1990, and 1991-1995, respectively. Also the
time trend of ASFR based on age groups showed a negative slope.
Conclusion: The fertility followed a negative slope during 1992-2012, indicating their descending trend
during these years. TFR = 2.1 was a standard population replacement rate in the societies. Therefore,
continual decline of this rate during 1992-2012 could be a warning factor that requires planning for
reform and precise evaluation. -
Objective: To explore racial and ethnic variation in the effects of parental educational attainment on students’ grade point average (GPA) in the US. As suggested by the Minorities' Diminished Returns (MDR) theory, socioeconomic status (SES) systemically results in smaller outcomes for non-Whites compared to Whites. We still know very little about diminished trans-generational returns of SES resources such as parental educational attainment. For example, the differential impacts of parental educational attainment on school performance of youth from various racial and ethnic backgrounds are still unknown.
Materials and methods: The Population Assessment of Tobacco and Health (PATH 2013 - 2014) is a nationally representative survey in the US. The total sample was 10,701 youth (12-17 years old) were enrolled. The independent variable was parental educational attainment. The main outcome was GPA measured using self-report. Age, gender, and parental marital status were the covariates. Race and ethnicity were the effect modifiers. Linear regression models were used to analyze the data.
Results: Overall, higher parental educational attainment was associated with a higher GPA, independent of all possible confounders. Race and ethnicity, however, both showed significant interaction with parental educational attainment on students’ GPA, indicating smaller positive effects of parental educational attainment on students’ GPA for Hispanic and Black compared to non-Hispanic White youth.
Conclusion: The boosting effect of parental educational attainment on GPA is smaller for Black and Hispanic compared to White youth. To minimize diminished returns of parental educational attainment for Black and Hispanic families, there is a need for innovative public and social policies and programs that are not limited to equalizing SES but also address the structural barriers that disproportionately limit upward social mobility of racial and ethnic minority students and their families. The US society should reduce extra costs of upward social mobility for racial and ethnic minority families. As the underlying mechanisms are multifaceted, multi-level approach is needed to undo minorities’ diminished returns, so every individual can gain the same tangible outcome from their SES resources. -
Objective: To investigate the predictors of preeclampsia based on a 10-years case-control study.
Materials and methods: The present retrospective, case-control study was carried out in a referral Hospital in Hamadan, Iran, during 2005-2015. Using a hospital information system (HIS), all the available information on hospitalized preeclamptic patients during 10-years period was collected and all preeclamptic women were qualified for the study as the case group (729 subjects) and the same number of non-preeclamptic women were assigned to the control group. The required data were collected using the researcher-made questionnaire and analyzed using descriptive statistics, chi-square test, independent t-test and logistic regression.
Results: The results show that high age (OR = 1.04), low education (diploma compared to illiterate OR = 0.51 and middle school education compared to illiterate OR = 0.55), blood group O (AB: OR = 0.32; B: OR = 0.36; A: OR = 0.26) and fertilization during autumn (spring: OR = 0.41; summer: OR = 0.26; autumn: OR = 1.13) could raise the risk of preeclampsia.
Conclusion: High age, low education, blood group O and fertilization in cold seasons could be the risk factors of preeclampsia. Recognizing the risk factors of preeclampsia could help the determination of high risk cases and designing of effective interventions. -
Objective: The purpose of the present study was a survey of venous thromboembolism (VTE) prophylaxis in obstetrics patients in Iran.
Materials and methods: A national, multicenter, non-interventional, prospective study was performed on 1000 women at 11 different parts of Iran. Primary outcome was to assess the situation of VTE prophylaxis in pregnant and postpartum women and the secondary outcome was risk stratification in obstetrics patients and to evaluate the guideline adherence in physician’s practice of VTE prophylaxis.
Results: 1,036 women entered the final analysis. The three main VTE risk factors before hospitalization were BMI > 30 kg/m2, history of oral contraceptive (OCP) use, and the age over 35.VTE risk factors upon enrollment were detected in 780 (75.28%) patients. 219 women (28.07%) were deemed eligible for drug prophylaxis, however, only 37 women (17%) received it. A total of 113 (10.9%) patients received VTE prophylaxis, of which 76 (67.25%) women had no clear indications. Concordance between theory and practice was detected with a Cohen’s Kappa coefficient to be 0.74 (p < 0.001), which fell within “good agreement”. Multivariate analysis for association between VTE prophylaxis and VTE risk factors showed that history of VTE [OR = 9.06 (CI 95% 1.16 – 70.8) p = 0.036] was the most frequent risk factor for receiving VTE prophylaxis followed by obesity (BMI > 30 Kg/m2); [OR = 3.74 (CI 95% 1.79 – 5.69), p = <0.001], multiple pregnancy [OR= 2.81 (CI 95% 1.70 – 4.64), p = < 0.001] and age > 35 years; [OR =1.09 (CI 95% 0.82 – 1.21), p = 0.026]. Varicose Veins [OR= 0.22 (CI 95% 0.56 – 0.87), p = 0.031], PROM / PPROM [OR= 0.33 (CI 95% 0.12 – 0.91), p = 0.032] and history of using OCP [OR= 0.36 (CI 95% 0.24 – 0.53), p = < 0.001] were the most missed risk factors for receiving VTE prophylaxis respectively. Conclusion: History of VTE, obesity, multiple pregnancy and age > 35 years were the most frequent risk factors for receiving VTE prophylaxis and varicose veins, PROM / PPROM and history of using OCP were the most missed risk factors for receiving VTE prophylaxis. -
Objective: The aim of this study was to assess the sexual health knowledge among females seeking consultation in behavioral clinics or shelters with emphasis on sexual routs of HIV transmission.
Materials and methods: In this study 250 women who have attended behavioral clinics or shelters in Tehran were recruited and a standardized questionnaire which asked about demographics, sexual partner and knowledge about HIV/STDs was used.
Results: The median age of our cases was 40.82% and among them 16% were married but lived alone. Among the total 250 cases, 56% (140) were sexually active in the last 30 days, 19.2% (48) had a history of a one-night stand and 2.4% had more than 1 sexual partner. 212 cases answered questions about condom use, 60% (127) of them did not use condoms at all. For knowledge about signs and symptoms related to STDs, 63% believed that abdominal pain has no relation to STDs. Also 44%, 43%, 37%,and 40% believed that dyspareunia, dysuria, malodorous vaginal discharge and change in color of vaginal discharge, respectively had no relation to STDs and 13% of whom presented with these symptoms in the past 30 days had not seek medical evaluation.
Conclusion: It is a necessity to emphasize the use of condoms among the male population however in this study it was a challenge to do so because it goes against the government’s campaign of pro-natalism. Improving the knowledge of protected sex should start from the teenage years and at school to have maximum STD prevention planning. Most women in our study did not know about healthy sexual lifestyle and this shows the need of sexual health education before marriage or even at school. -
Objective: To investigate the effect of the Carumcarvi (BuniumpersicumBoiss) plant, a gas solvent, on resumption of bowel motility after caesarean section.
Materials and methods: A randomized controlled trial was done on a group of 98 women undergoing elective caesarean section under general anesthesia in a university hospital. Patients in the intervention group (Group A) drank 10 ml of a syrup containing 8 g of BuniumpersicumBoiss in 20 ml of syrup 6 to 7 hours after surgery. The control group (Group B) comprised 10 patients who drank 10 ml of placebo syrup 6 to 7 hours after surgery. Demographic characteristics, time to first hearing of normal intestinal sounds, time to first flatus, time to first bowel movement, and length of hospital stay were compared between the two groups.
Results: Compared with the control group, the intervention group had a significantly shorter mean time to hearing the first intestinal sounds (10.66 ± 2.38 vs. 19.54 ± 3.85 h), mean time to first flatus (13.91 ± 3.73 vs. 24.82 ± 5.83 h), mean time to first bowel movement (19.31 ± 4.63 vs. 30.70 ± 10.21 h), and mean length of hospitalization (31.70 ± 7.70 vs. 49.20 ± 10.16 h) (p < 0.05). No patients developed serious side effects associated with consumption of the syrup.
Conclusion: The use of a gas solvent such as BuniumpersicumBoiss after caesarean section can speed the resumption of postoperative bowel motility. -
Objective: The purpose of this study was to investigate the status of knowledge, attitude and practice of medical team about suitable " Healthcare personnel (HCP) attire".
Materials and methods: This is a descriptive study that was approved by the Research Ethics Committee of Tehran University of Medical Sciences, and evaluated knowledge, attitude and performance of physicians and nurses about "Health care personnel (HCP) attire" by a questionnaire. In order to create the questionnaire a panel of experts’ reviews was set and a questionnaire was made through Focus group discussion (FGD). The Variables included age, gender, work experience, type of employees' time, type of jobs, education level, type of employee.
Results: This study was conducted on 441 physicians and nurses who were working in Tehran University of Medical Sciences. The mean percent of KAP score was 72.6 ± 14.3. The score of the questionnaire in general was 14.91 ± 70.99 for knowledge, 73.5 ± 13.3 for attitude and 73.7 ± 17.1 for performance.
Conclusion: According to this survey, the questionnaire score in the general knowledge, attitude and performance about the "Healthcare personnel (HCP) attire" is low. -
Objective: The present study aims at evaluating the effects of psycho-education based on relaxation methods on Hyperemesis Gravidarum (HG).
Materials and methods: This is a quasi-experimental study, with pretest and posttest design, which was carried out on 100 pregnant women with complaints of nausea and vomiting who had referred to general health centers to receive pregnancy care. In accordance with the specified content, women in the intervention group received 3 sessions of psycho-education based on relaxation methods for a week. Four weeks after the end of education and before the 16th week of pregnancy, data were gathered from both the intervention and control groups using the Pregnancy-Unique Quantification of Vomiting and Nausea (PUQEN) scale. Data were analyzed with the aid of statistical tests.
Results: There was no significant difference between the average values of HG in the intervention group and the control group prior to the intervention. However, after receiving psycho-education, the average value of nausea and vomiting in pregnant women of the intervention group (5.11 ± 1.60) was significantly lower than that in the control group (6.00 ± 1.66) (p = 0.035).
Conclusion: The psycho-education based on relaxation methods of this study had a positive and significant effect on reducing the intensity of HG. It is helpful to integrate the educational content of this intervention in the caring programs of pregnant women with nausea and vomiting.
