Analysis of survival data in thalassemia patients in Shiraz, Iran / 한국역학회지

OBJECTIVES: The survival rate of thalassemia patients has not been conclusively established, and the factors associated with survival remain unclear. This study aimed to determine the survival rate of thalassemia among patients in southern Iran and to identify the factors associated with mortality from thalassemia. METHODS: This retrospective cohort study was conducted based on a retrospective review of the medical records of 911 beta-thalassemia patients in 2014. Data analysis was conducted using the Kaplan-Meier method and Cox regression analysis. RESULTS: Overall, 212 patients (23.3%) died, and 26.8% had thalassemia intermedia. The 20-year, 40-year, and 60-year survival rates were 85%, 63%, and 54%, respectively. Both crude and adjusted analyses found that education, marital status, ferritin levels, and comorbidities were related to mortality. CONCLUSIONS: Sociodemographic and hematological factors were found to be significantly associated with the survival rate of thalassemia. Addressing these factors may help healthcare providers and physicians to provide the best possible care and to improve the survival rate.

Comparison of the effect of mono-stage and bi- stage acupressure at sp6 point on the severity of labor pain and the delivery outcome

One of the most painful experiences of women in life is labor. The use of non-drug methods for pain relief is on the increase. This study aimed to compare mono-stage and bi-stage acupressure at sp6 point on the severity of labor pain and the delivery outcome. This is a quasi-experimental single blind study from December 2010 to June 2011 in which 150 term pregnant women in labor pain were divided into 3 acupressure groups of mono-stage and bi-stage at sp6 point at 3-4 and 7-8 cm dilatation and control group. The intervention was carried out for a period of 20 minutes. Pain severity was evaluated before, immediately, 30 and 60 minutes after the intervention by Visual Analog Scale [VAS]. The pain severity after the intervention in 3-4 cm dilatation in the intervention group was'less than that of the control group [P=0.001] but the two groups of intervention did not differ from each other [P=0.94]. In 7-8 cm dilatation, the pain severity was reduced only in the bi-stage intervention group [P=0.001]. The duration of the 2nd stage and the rate of Cesarean section was lesser in the intervention groups [P=0.022]. Exerting pressure at sp6 point is effective in pain reduction, duration of labor and the rate of Cesarean section. Pain relief in bi-stage intervention was more than that of mono-stage. Therefore, it is used as an effective way to reduce maternal pain

[Comparison of the effects of one-step acupressure of spleen point 6 [SP-6] and gall bladder 21 [GB-21] on the duration and type of delivery in nulliparous women referred to hospitals in Shiraz University of Medical Sciences, Iran: a randomized clinical trial]

Sedatives constitute an important part of modern obstetric care. One of the under-investigation methods is the effect of acupressure on reduction of the duration of labor stages. This study was performed aiming at comparison of the effects of one-step acupressure of spleen point 6 [SP-6] and gall bladder 21 [GB-21] on the duration and type of delivery and Apgar of newborne in nulliparous women. This clinical trial study was performed on 150 nulliparous women. Women were randomly assigned to three groups, including gallbladder 21 acupressure, spleen point 6 acupressure, and control. In first two groups, pressure was performed at 3-4cm cervical dilatation for 20 minutes. In the control group, contact with no pressure was done on the acupressure points and with the same condition of the intervention group. The collected data was analyzed using paired t-test, independent t-test, and one-way variance analysis. In this study, the duration of the active stage of labor in the intervention group was less than control group [p<0.05], but no significant difference was observed in the two intervention groups [p>0.05]. Also, duration of the second stage of labor in the control group was more than two experimental groups, but the difference was not significant [p>0.05]. The three groups, had no significant difference in the fifth minute Apgar score [p>0.05]. The number of cesarean sections in the intervention groups were more than control group [p<0.05]. According to the results of this study, the acupressure in SP-6 and GB-21 points, in the one-step intervention was equally effective in reducing the duration of active stage of labor