Predictive value of plasma haematocrit level in early diagnosis of pre-eclampsia

While pre-eclampsia is the most common complication of pregnancy, a definitive screening test for early diagnosis is still elusive. In this study, haematocrit value was assessed as a screening test for pre-eclampsia in 660 women at 24-28 weeks of pregnancy attending a hospital in Tehran, Islamic Republic of Iran. Mean haematocrit values were significantly higher in pre-eclamptic than non-pre-eclamptic women; 37.7% [SD 2.0%] and 35.9% [SD 1.7%] respectively. The receiver operating characteristics curve showed that the most appropriate cut-off point for the haematocrit test in this sample of women was 38%; at this value the sensitivity was 58.6% and specificity was 88.9%; positive and negative predictive values were 33.7% and 95.7% respectively. The haematocrit, done as a routine screening test for anaemia at 24-28 weeks of pregnancy, may also be useful as a screening test for early diagnosis of pre-eclampsia

[Survival analysis of the patients with acute myocardial infarction by use of penalized splines]

Cardiovascular diseases are one of the most common causes of death and also major health problems in the world. The classical methods such as Cox regression are used in most medical studies on survival distribution, while this model assumes a linear relationship between log hazard ratio and risk factors which is not useful in many cases. The present study was performed to use the method of penalized splines to analyze the survival rate of the patients who had acute myocardial infraction. This research was a prospective descriptive-analytical study of longitudinal type which included 650 patients with acute myocardial infarction. Patients were followed for one year from the moment of diagnosis of MI, for survival analysis. The collected data were recorded in a check-list for every patient. Two different multivariate methods, proportional hazard regression and Cox model with penalized splines were used. Data analysis was carried out using R version 2.12 software and significant levels were considered 0.05. The mortality rate of the patients in a period of one year was 10.3% [67patients]. History of smoking, hypertension, diabetes, hyperlipidemia, arrhythmia and heart block were detected in 48%, 33.4%, 17.7%, 15.3%, 30% and 10.3% of the patient respectively. Based on Cox model with penalized splines the factors affecting survival rate were age, ejection fraction and use of streptokinase. Knowledge of the survival rate and factors affecting survival in the patients with acute MI can be used to provide the patients with valuable services, and to take measures to control and reduce mortality rate which can lead to increased life expectancy of these patients

Self-efficacy: does it predict the effectiveness of contraceptive use in Iranian women?

This study explored the relative effects of self-efficacy on oral contraceptive use among a sample of 352 Iranian married women aged 18-49 years. In structured interviews 5 variables based on the Steps to Behaviour Change model [knowledge, approval, intention, practice and advocacy] were assessed and correlated with measures of family planning self-efficacy and general self-efficacy. The results indicated that the 2 independent measures, when taken together, were more effective in predicting behavioural intentions for effective use of oral contraceptives, with family planning self-efficacy making the strongest contribution. It is suggested that self-efficacy intervention techniques will benefit oral contraceptive users in preventing unintended pregnancies

Comparative analysis of life quality in mothers after cesarean section and normal vaginal delivery

Statistics indicate that the rate of cesarean section increased in recent years. As complications of hospitalizations and surgery would affect the life quality, the current study was carried out to evaluate the life quality of mothers after normal vaginal delivery [NVD] and cesareane. This is an anterograde analytic study of cohort type. To fulfill the study, a specialized questionnaire was designed, and its validity and reliability was approved. The designed questionnaire accompanied with Edinburgh Postnatal Depression Scale [EPDS] and Short-Form-36 [SF-36] was filled by 50 women underwent NVD and 50 underwent cesarean, 6 to 8 and 12 to 14 weeks, postpartum. Finally, the data was analyzed using chi square, independent t, paired t, Wilcoxon and Mann-Whitney tests. Comparing the scores of the two groups 6-8 and 12-14 weeks postpartum indicated that both groups got higher marks in all fields in second step of the study. Anyhow, the improvement of NVD group was higher which was significant in some areas. Comparing the EPDS scores of the groups showed that the cesarean group was more prone to depressive disorders. The difference was significant 6-8 weeks postpartum. Also, the results of SF-36 questionnaire indicate that quality of life in NVD group was better in some aspects and similar with the cesarean group in other aspects. Findings demonstrated that women undergoing NVD experience better quality of life post partum, comparing those undergoing cesarean. So, to terminate the pregnancy, the NVD is better to be considered as the first choice