Risk factors for neonatal mortality among very low birth weight neonates

The objective of this study is to determine risk factors causing increase in very low birth way [VLBW] neonatal mortality. The medical files of all neonates weighing <1500 gram, born in Vali-e-Asr hospital [2001-2004] were studied. Two groups of neonates [living and dead] were compared up to the time of hospital discharge or death. A total of 317 neonates were enrolled. A meaningful relationship existed between occurrence of death and low gestational age [P=0.02], low birth weight, lower than 1000 gram [P=0.001], Apgar score <6 at 5[th] minutes [P=0.001], resuscitation at birth [P=0.001], respiratory distress syndrome [P=0.001] need for mechanical ventilation [P=0.001], neurological complications [P=0.001] and intraventricular hemorrhage [P=0.001]. Regression analysis indicated that each 250 gram weight increase up to 1250 gram had protective effect, and reduced mortality rate. The causes of death of those neonates weighting over 1250 gram should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 gram. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage

Economic burden of gastro-oesophageal reflux disease and dyspepsia: a community-based study

Gastro-oesophageal reflux disease [GERD] and dyspepsia are common digestive disorders that inflict serious harm, burden and economic consequences on individuals worldwide. The aim of this study was to estimate the direct and indirect economic burden of GERD and dyspepsia in the whole population of Tehran, the capital of Iran. The study was performed on a total of 18,180 adult subjects [age > 18 years] taken as a random sample in Tehran province, Iran [2006-2007]. A valid and reliable questionnaire was used to enquire about the symptoms of GERD, dyspepsia and the frequency of the utilization of health services including physician visits, hospitalisations and productivity loss due to GERD/dyspepsia symptoms in the preceding 6 months. GERD was found in 518 [41.9% males] patients and dyspepsia in 404 patients [38.9% males]. Further 1007 subjects had both GERD and dyspepsia. The total direct costs of disease per patient for GERD, dyspepsia and their overlap were PPP$97.70, PPP$108.10 and PPP$101.30, respectively [PPP, purchasing power parity dollars]. The total indirect cost of disease per patient was PPP$13.7, PPP$12.1 and PPP$32.7, for GERD, dyspepsia and their overlap, respectively. According to our results, hospitalisation and physician visits were the main cost of disease that could be minimized by revision of the insurance business in Iran