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

High prevalence of vitamin D deficiency and adverse pregnancy outcomes in Yazd, a central province of Iran

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 micro g/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

Predictors of adherence to type 2 diabetes medication

Background: Despite the effectiveness of drug therapy in diabetes management high rates of poor adherence persist

The purpose of this study was to determine the factors influencing the medication adherence and dietary regiment in type2 diabetic patients

Methods: This cross sectional study was conducted on 300 type2 diabetic patients referred to General Internal Medicine Clinic, Yazd Shohdaye Kargar Hospital, Yazd City, central Iran between September and December 2013. Each consented participant was interviewed by a trained study member using a questionnaire in three sections: Socio-demographic questions, self-reported Morisky medication adherence scale and Disease and medication beliefs Patient's questionnaire. Multivariable logistic regression model was developed to identify independent predictors of poor adherence. P<0.05 was considered statistically significant

Results: Patients had diabetes for an average of 8.87 [SD: 6.0] yr with a mean age of 58.22 [SD: 10.27] yr. Totally, 101[33.7%] of the patients reported poor adherence with their diabetes medication. In multivariate analyses, good familial support [OR=0.11; 0.03, 0.37], and tendency to consume sweets [OR=1.21; 1.05, 1.39], belief about medication [OR=0.02; 0.018, 0.07] and tendency to consume vegetables [OR=0.75; 0.65, 0.88] were considered as predictive factors for poor adherence

Conclusions: Familial support, belief about medication, tendency to consume sweets and vegetables are logical goals for educational interventions to modify diabetes self-management

burden of road traffic injuries in yazd province - Iran

Objectives: To estimate the Disabled-adjusted Life Years [DALYs] of Road Traffic Accidents in patients referred to hospitals in Yazd Province, central Iran

Methods: This cross-sectional study was conducted in Yazd province during 2010. To calculate the Years of Life Lost [YLL] due to premature death and to calculate the incidence of non-fatal injuries and Years Lost due to Disability [YLD], the data were collected from Yazd death registration system and hospital records

The causes of death and nature of non-fatal injuries were classified using International Classification of Diseases [ICD-10]

We estimated Disability Adjusted Life Years [DALYs] on the guidelines of the Global Burden of Disease Study [discount rate: 0.03, age weight: 0.04, constant age weight correction factor: 0.165]. Age and sex composition was taken from the National Statistical Center for the year 2010

Results: During 2009, 483 deaths were caused by traffic accidents in Yazd Province, 382 [79.09%] of which were males, and 101 [20.91%] were females

The mortality rates for males and females were 70.98 and 20.15 in 100,000, respectively. The years of life lost due to premature deaths were 15.84/1000 in men and 4.75/1,000 in women

Total YLLs caused by traffic accidents were 10,908 years. The injuries caused by traffic accidents were calculated as 15.21 and 3.73/1,000 in males and females, respectively. The total YLDs was calculated 1.51/1,000

The total burden of Road Traffic Injuries in Yazd province was 12478 years [DALYs], 87.41% of which was due to premature death, and 12.59% was related to disability. Also, 78.32% was lost in males. The age specific peak of burden was in 15-29 year

Conclusion: This study showed that traffic accidents in Yazd impose a high burden. It seems that it is one of the health sector priorities. It is recommended to revise laws on use of motorcycles, especially on helmet use for motorcyclists, enforce strict laws in residential areas, and review social determinant affecting the incidence of such accidents

Epidemiology and trend of cancer in Yazd, a central province of Iran, 2005-2009

Cancer incidence rate is increasing in the world particularly in developing countries. The awareness regarding cancer incidence and distribution helps policy makers and researchers to design comprehensive plan for controlling cancer. The aim of this study was to determine the incidence rate and trend of cancer in Yazd Province, centeral Iran. Data from Yazd cancer registry were derived from 2005 to 2009. Direct standardization through world standard population produced by the world health organization was used and Age- Standardized Incidence rate [ASR] was calculated. Data were analyzed using ASR, by EXCEL and SPSS software. The new cases of cancer were 4631 patients from 2005 to 2009. Mean age of these patients was 57.98 +/- 27.49 years and 53.5% were male. Female patients were approximately 5 years younger than males. The most frequent cancer was breast in women followed by skin, colorectal, hematologic system and stomach. The 5 most frequent cancers in men were skin, bladder, colorectal, stomach and prostate. The ASR in 2005 to 2009 was respectively 85.2, 86.1, 92.6, 102.2 and 104.7 per 100,000 populations. ASR of cancer is increasing rapidly in Yazd Province. It is necessary to have a comprehensive health policy for prevention and control of this problem

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

It is noted that oral contraceptive pills increase the risk of abnormal Pap smear but results have been inconsistent across the populations. 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. 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. 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]. 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