ABSTRACT
A key challenge for equality evaluation and monitoring, mainly in developing countries, is assessing socioeconomic status [SES] of individuals. This difficulty along with low technical competency, have resulted in many health information collected in these countries which are devoid of suitable SES indices. However, simplifying data collection requirements for estimating economic parameters seems to guarantee their wide adoption by survey and health information system [HIS] designers, resulting in immediate production of equity-oriented policy-relevant information. The goal of this study is obtaining adequate number of variables, which their combination can provide a valid assessment of SES in Iranian population. The data source was Living Standards Measurement Study of Iran [2006]. Data of 27,000 households on the ownership of 33 household assets was used for this analysis. Households of this study were divided into 5 groups in terms of SES status using principle component analysis. Then selection was made among the 33 variables so that a combination with minimum necessary number for obtaining SES status is reached. Agreement of the new combination [including minimum number of variables] with full variable combination [including all 33 variables] was assessed using weighted kappa. A minimum set of six variables including having kitchen, bathroom, vacuum cleaner, washing machine, freezer and personal computer could successfully discriminate SES of the population. Comparing this 6 item-index with the whole 33 item-index revealed that 65% of households were in the same quintiles, with a weighted kappa statistics of 0.76. For households in different quintiles, movement was generally limited to one quintile, with just 2% of households moving two or more quintiles. The proposed simple index is completely applicable in current Iran's society. It can be used in different survey and studies. The development is quite simple and can be done on a yearly basis using the updated National level data. Having such standardized simplified and up to date SES indices and incorporating them into all health data sources can potentially ease the measurement and monitoring of equity of health services and indices
ABSTRACT
Maternal mortality [MM] is an avoidable death and there is national, international and political commitment to reduce it. The objective of this study is to examine the relation of MM to socioeconomic factors and its inequality in Iran's provinces at an ecologic level. The overall MM from each province was considered for 3 years from 2004 to 2006. The five independent variables whose relations were studied included the literacy rate among men and women in each province, mean annual household income per capita, Gini coefficients in each province, and Human Development Index [HDI]. The correlation of Maternal Mortality Ratio [MMR] to the above five variables was evaluated through Pearson's correlation coefficient [simple and weighted for each province's population] and linear regression-by considering MMR as the dependent variable and the Gini coefficient, HDI, and difference in literacy rate among men and women as the independent variables. The mean MMR in the years 2004-2006 was 24.7 in 100,000 live births. The correlation coefficients between MMR and literacy rate among women, literacy rate among men, the mean annual household income per capita, Gini coefficient and HDI were 0.82, 0.90, ?0.61, 0.52 and ?0.77, respectively. Based on multivariate regression, MMR was significantly associated with HDI [standardized B=?0.93] and difference in literacy rate among men and women [standardized B=?0.47]. However, MMR was not significantly associated with the Gini coefficient. This study shows the association between socioeconomic variables and their inequalities with MMR in Iran's provinces at an ecologic level. In addition to the other direct interventions performed to reduce MM, it seems essential to especially focus on more distal factors influencing MMR
ABSTRACT
Most clinical laboratories directly measure serum triglyceride, total cholesterol, and high- density lipoprotein cholesterol. They indirectly calculate low-density lipoprotein cholesterol value using the Friedewald equation. Although high serum triglyceride [>400 mg/dL or 4.52 mmol/L] devaluates low- density lipoprotein cholesterol calculation by using this formula, effects of low serum triglyceride [<100 mg/dL or 1.13 mmol/L] on its accuracy is less defined. Two hundred thirty serum samples were assayed during a one-year period. In 115 samples, the triglyceride level was below 100 mg/dL and in 115 samples from age- and sex-matched patients the triglyceride level was 150 - 350 mg/dL [1.69 - 3.95 mmol/L]. In both groups total cholesterol was above 250 mg/dL [6.46 mmol/L]. On each sample, total cholesterol, high-density lipoprotein cholesterol, and triglyceride were directly measured in duplicate and low-density lipoprotein cholesterol measured directly and calculated with Friedewald equation as well. Statistical analysis showed that when triglyceride is <100 mg/dL, calculated low- density lipoprotein cholesterol is significantly overestimated [average :12.17 mg/dL or 0.31 mmol/L], where as when triglyceride is between 150 and 300 mg/dL no significant difference between calculated and measured low-density lipoprotein cholesterol is observed. In patients with low serum triglyceride and undesirably high total cholesterol levels, Friedewald equation may overestimate low-density lipoprotein cholesterol concentration and it should be either directly assayed or be calculated by a modified Friedewald equation. Using linear regression modeling, we propose a modified equation
Subject(s)
Humans , Male , Female , Triglycerides/blood , Cholesterol, HDL/blood , Cholesterol/bloodABSTRACT
To compare the effectiveness of 5 different modalities, and determine the usefulness of recently proposed extensor grip test [EGT] in predicting the response to treatment. In a randomized controlled clinical trial, 92 of 98 tennis elbow patients in Sina Hospital Tehran, Iran between 2006 and 2007 fulfilled the trial entry criteria. Among these patients 56 [60.9%] had positive EGT result. The stratified EGT result, were randomly allocated to 5 treatment groups: brace, physiotherapy, brace plus physiotherapy, injection, and injection plus physiotherapy. Patients with a positive EGT result had better response to treatments. Among them, injection plus physiotherapy was the most successful, then brace plus physiotherapy, physiotherapy, and brace injection was the worst treatment modality. Response to treatment was comparable in all groups between EGT positive and negative patients except bracing, in which positive EGT was correlated with a dramatic response to treatment. In all patients, injection plus physiotherapy and then brace plus physiotherapy is recommended, but in EGT negatives, bracing seems to be of no use. Injection alone is not recommended in either group