Life and health satisfaction in the adult population of Iran / 한국역학회지

OBJECTIVES: Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran. METHODS: We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables. RESULTS: On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent. CONCLUSIONS: The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction.

Analyzing Gensini score as a semi-continuous outcome

Background: Investigators frequently encounter continuous outcomes with plenty of values clumped at zero called semi-continuous outcomes. The Gensini score, one of the most widely used scoring systems for expressing coronary angiographic results, is of this type. The aim of this study was to apply two statistical approaches based on the categorization and original scale of the Gensini score to simultaneously assess the association between covariates and the presence and severity of coronary artery disease [CAD]

Methods: We considered the data on 1594 individuals admitted to Tehran Heart Center with CAD symptoms from July 2004 to February 2008. The participants' baseline demographic and clinical characteristics were collected, and their coronary angiographic results were expressed through the Gensini score. The generalized ordinal threshold and two-part models were applied for the statistical analyses

Results: Totally, 320 [20.1%] individuals had a Gensini score of zero. The results of neither the two-part model nor the generalized ordinal threshold model showed a significant association between Factor V Leiden and the occurrence of CAD. However, based on the two-part model, Factor V Leiden was associated with the severity of CAD, such that the Gensini score increased by moving from a wild genotype to a heterozygote [beta = 0.44; 95% CI: 0.20-0.69 in logarithm scale] or a homozygote mutant [beta = 0.70; 95% CI: 0.28- 1.12 in logarithm scale]. The proportional odds assumption was not met in our data [= 54.26; p value < 0.001]; however, a trend toward severe CAD was also observed at each category of the Gensini score using the generalized ordinal threshold model

Conclusion: We conclude that besides loss of information by sorting a semi-continuous outcome, violation from the proportional odds assumption complicates the final decision, especially for clinicians. Therefore, more straightforward models such as the two-part model should receive more attention while analyzing such outcomes

Models predicting success of infertility treatment: a systematic review

Background: Infertile couples are faced with problems that affect their marital life. Infertility treatment is expensive and time consuming and occasionally isn't simply possible. Prediction models for infertility treatment have been proposed and prediction of treatment success is a new field in infertility treatment. Because prediction of treatment success is a new need for infertile couples, this paper reviewed previous studies for catching a general concept in applicability of the models

Methods: This study was conducted as a systematic review at Avicenna Research Institute in 2015. Six data bases were searched based on WHO definitions and MESH key words. Papers about prediction models in infertility were evaluated

Results: Eighty one papers were eligible for the study. Papers covered years after 1986 and studies were designed retrospectively and prospectively. IVF prediction models have more shares in papers. Most common predictors were age, duration of infertility, ovarian and tubal problems

Conclusion: Prediction model can be clinically applied if the model can be statistically evaluated and has a good validation for treatment success. To achieve better results, the physician and the couples' needs estimation for treatment success rate were based on history, the examination and clinical tests. Models must be checked for theoretical approach and appropriate validation. The privileges for applying the prediction models are the decrease in the cost and time, avoiding painful treatment of patients, assessment of treatment approach for physicians and decision making for health managers. The selection of the approach for designing and using these models is inevitable

Modified natural cycle frozen-thawed embryo transfer in patients with repeated implantation failure: an observational study

Background: Natural endometrium in Frozen-thawed Embryo Transfer [FET] may have some benefits upon implantation in patients with Repeated Implantation Failure [RIF]. It might be due to possible differences between natural and stimulated endometrial growth factors and cytokins secretions

Objective: The objective of this study was to compare the pregnancy rate of FET on modified natural cycle versus hormone replacement therapy [HRT] cycle endometrium in patients with RIF

Materials and Methods: In this observational study the pregnancy rate of patients with RIF undergoing day 3 FET in natural cycle endometrium [group 1, n=56], were compared with another group of patients with RIF in whom frozen-thawed day 3 embryos were transferred on HRT cycle [group 2, n=52]

Results: The pregnancy rate in group 1 was 41.07%, compared with the pregnancy rate of group 2; 36.5% [p=0.63]. The abortion rate was not significantly different among the groups

Conclusion: It can be concluded that FET in a modified natural cycle is comparable with HRT cycle in patients with RIF

Multi-state survival analysis in renal transplantation recipients

Renal transplantation is a therapy for end-stage renal disease. During the study of recipients' survival after renal transplantation, there are some events as intermediate events that not only affect the recipients' survival but also events which are affected by various factors. The aim of this study was to handle these intermediate events in order to identify factors that affect recipients' survival by using multi-state models. This retrospective cohort study included 405 renal transplant patients from Afzalipour Hospital, Kerman, Iran, from 2004 to 2010. The survival time of these recipients was determined after transplantation and the effect of various factors on the death hazard with and without renal allograft failure and hazard of renal allograft failure was studied by using multistate models. During 4.06 years [median] of follow-up; 28 [6.9%] recipients died and allograft failure occurred in 51 [12.6%] recipients. Based on the results of multi-state model, receiving a living kidney transplantation decreased the hazard of renal allograft failure [HR=0.38; 95% CI: 0.17- 0.87], pre-transplant hypertension [HR=2.94; 95% CI: 1.54- 5.63] and serum creatinine levels >1.6 upon discharge from the hospital [HR=7.38; 95% CI: 3.87- 7.08] increased the hazard of renal allograft failure. Receiving living kidney transplantation decreased the hazard of death directly [HR=0.18; 95% CI: 0.04- 0.93]. It was concluded that the effect of donor type, pre-transplant hypertension and having serum creatinine >1.6 upon discharge from the hospital was significant on hazard of renal allograft failure. The only variable that had a direct significant effect on hazard of death was donor type

Genetic profile variation in vaccine strains and clinical isolates of bordetella pertussis recovered from Iranian patients

Re-emergence of pertussis has been reported in Iran despite a high rate of vaccination coverage. Low efficacy of the vaccine might be due to the genetic divergence between Clinical versus vaccine strains. In the current study, the genetic profiles of Clinical isolates and vaccine strains of Bordetella pertussis [B. pertussis] were assessed by using Pulsed Field Gel Electrophoresis [PFGE]. Following phenotypic and molecular identification of isolates, XbaIdigested genomic DNA of 5 Clinical isolates, 2 vaccine strains and a Tohama I strain were analyzed by PFGE along with B. parapertussis as a control. Seven distinct PFGE profiles were found among all examined isolates/strains. In 5 Clinical isolates, 4 profiles were identified whereas the vaccine strains displayed 2 distinct profiles. The reference strain, Tohama I had a distinct profile. Vaccine and Clinical profiles had low similarity, with relatedness of approximately 40%. The genetic profiles of B. pertussis were different between circulating isolates and vaccine strains used in the national vaccination programs. Since new genetic profiles of B. pertussis can be disseminated periodically, the profiles of isolates circulating in the population should be monitored over the course of the re-emergence

Factors affecting the survival of patients with gastric cancer undergone surgery at Iran cancer institute: univariate and multivariate analyses

Gastric cancer is the most prevalent cancer among men and the third most prevalent cancer among women in Iran. Its most important reason for death is its belated diagnosis at the advanced stages of the disease. Various factors can be effective on the survival of these patients after surgery, which are the major concern in this study. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995 to 1999 were analyzed. The Survival Time of patients was determined after surgery and the effect of individual and demographic; clinical and diagnostic; and treatment and post-surgical factors on patients' survival was studied. For data analysis, Kaplan- Meier, Log-Rank test and Proportional Hazards Model were used. The median of survival time was 16.33 months. The one-year, three-year, and five-year survival rates were, 0.66, 0.31, and 0.21. Based on univariate analysis results of age[P<0.001], metastases[P=0.012], disease stage[P=0.016], and number of renewed treatments[P<0.001], as well as multivariate analysis which was used to investigate the simultaneous effect of influencing variables on patients' survival showed that age[61-70:HR=1.40,>70:HR=2.08], marital status[HR=0.39], number of renewed treatments[1:HR=0.54,2:HR=0.30,3:HR=0.22], relapse[HR=1.51], type of gastrectomy [Subtotal: HR=1.12, Distal:HR=0.49, Partial:HR=0.94, Proximal:HR=0.52], liver metastases [HR=1.79], distance metastases[HR=1.84], and disease stage[II:HR=1.28,III:HR=2.12,IV:HR=1.90] variables had a significant effect on patients' survival. Patients who call on doctors in early stages of disease will have a higher survival rate due to early diagnosis whereas disease progression will increase the risk and will decrease the survival. Identifying factors affecting patients' survival and improving diagnostic methods can prevent disease progression and increase survival rate

Factors affecting survival of patients with oesophageal cancer: a study using inverse Gaussian frailty models

<p><b>INTRODUCTION</b>Oesophageal cancer is one of the most common causes of cancer mortality in developing countries, including Iran. This study aimed to assess factors affecting survival of patients with oesophageal cancer using parametric analysis with frailty models.</p><p><b>METHODS</b>Data on 359 patients with oesophageal cancer was collected from the Babol Cancer Registry for the period 1990-1991. By 2006, the patients had been followed up for a period of 15 years. Hazard ratio was used to interpret the risk of death. To explore factors affecting the survival of patients, log-normal and log-logistic models with frailty were examined. The Akaike Information Criterion (AIC) was used for selecting the best model(s). Cox regression was not suitable for this patient group, as the proportionality assumption of the Cox model was not satisfied by our data (p = 0.007).</p><p><b>RESULTS</b>Multivariate analysis according to parametric models showed that family history of cancer might increase the risk of death from cancer significantly. Based on AIC scores, the log-logistic model with inverse Gaussian frailty seemed more appropriate for our data set, and we propose that the model might prove to be a useful statistical model for the survival analysis of patients with oesophageal cancer. The results suggested that gender and family history of cancer were significant predictors of death from cancer.</p><p><b>CONCLUSION</b>Early preventative care for patients with a family history of cancer may be important to decrease the risk of death in patients with oesophageal cancer. Male gender may be associated with a lower risk of death.</p>

Analysis of familial aggregation in total, against-the-rule, with-the-rule, and oblique astigmatism by conditional and marginal models in the Tehran eye study

The purpose was to determine the familial aggregation of the total, against-the-rule [ATR], with-the-rule [WTR], and oblique astigmatism by conditional and marginal models in the Tehran Eye Study. Total, ATR, WTR, and oblique astigmatism were studied in 3806 participants older than 5 years from August 2002 to December 2002 in the Tehran Eye Study. Astigmatism was defined as a cylinder worse than or equal to -0.5 D. WTR astigmatism was defined as 0 +/- 19[degree sign], ATR astigmatism was defined as 90 +/- 19[degree sign], and oblique when the axes were 20-70[degree sign] and 110-160[degree sign]. The familial aggregation was investigated with a conditional model [quadratic exponential] and marginal model [alternating logistic regression] after controlling for confounders. Using the conditional model, the conditional familial aggregation odds ratios [OR] [95% confidence interval] for the total, WTR, ATRs, and oblique astigmatism were 1.49 [1.43-1.72], 1.91 [1.65-2.20], 2.00 [1.70-2.30], and 1.86 [1.37-2.54], respectively. In the marginal model, the marginal OR of the parent-offspring and sib-sib in the total astigmatism were 1.35 [1.13-1.63] and 1.54 [1.13-2.11], respectively; WTR 1.53 [1.06-2.20] and 1.94 [1.21-3.13] and; ATR 2.13 [1.01-4.50] and 2.23 [1.52-3.30]. The model was statistically significant in sib-sib relationship only for oblique astigmatism with OR of 3.00 [1.25-7.20]. The results indicate familial aggregation of astigmatism in the population in Tehran adjusted for age, gender, cataract, duration of education, and body mass index, so that the addition of a new family member affected with astigmatism, as well as having a sibling or parents with astigmatism, significantly increases the odds of exposure to the disease for all four phenotypes. This aggregation can be due to genetic and/or environmental factors. Dividing astigmatism into three phenotypes increased the odds ratios

[Evaluation of consumed bread in hospitals affiliated to Tehran University of Medical Sciences]

Objective: To evaluate bread consumption in the hospitals and health centers [South, Shahr-e-rey, Eslamshahr] that are under covering of Tehran University of medical control

Methods: In a descriptive study, Usability of breads in hospitals and health networks covered by Tehran University of medical sciences, randomly were investigated. Our tests were Colorimetric, alkalinity and the amount of salt. All samples were selected from bread bakeries producing breads Barbari and Lavash or hospitals in the areas at least once a term study, and at every turn three specimens of bread [overall 615 No] in the sealed packages were collected

Results: This study showed that 46% and 41% of Barbari bread samples respectively [south of Tehran, Shahr- e - rey and Islamshahr] had mean test colorimetric positive and high alkalinity [PH>6], 8% High salt[salt>2%] and overall 45% of Barbari bread samples and 80% of their rumal was unusable. And respectively 55% and 55% of Lavash bread samples had mean test colorimetric positive and high alkalinity and 32% had High salt and overall 65% of Lavash bread samples in that three mentioned areas were unusable and finally the result shows that 64% of Tehran university hospitals Lavash bread samples also were unusable

Conclusion: In this study, respectively 59 and 64 percent of bread consumed in the three regions and hospitals for their high alkalinity were unusable and contained high salt and soda so their consumption is Harmful for everybody specially for patients that must limit their Na intake, so preventing from taking soda has special importance and Pervasive action for controlling of bread alkalinity must be done

Combination of thrombophilic gene polymorphisms as a cause of increased the risk of recurrent pregnancy loss

Recurrent pregnancy loss is [RPL] a heterogeneous condition. While the role of acquired thrombophilia has been accepted as an etiology for RPL, the contribution of specific inherited thrombophilic gene polymorphisms to the disorder has been remained controversial. One hundred women with a history of two or more consecutive abortions and 100 women with at least two live births and no miscarriages were included in the study and evaluated for the presence of 11 thrombophilic gene polymorphisms [Factor V LEIDEN, Factor V 4070 A/G, Factor V 5279 A/G, Factor XIII 103 G/T, Factor XIII 614 A/T, Factor XIII 1694 C/T, PAI-1-675 4G/5G, ITGB3 1565 T/C, ?-Fibrinogen-455G/A, MTHFR 677 C/T, MTHFR 1298 A/C] using PCR-RFLP technique. The data were statistically analyzed using Mann-Whitney test and logistic regression model. There was no relation between factor XIII 103G/T gene polymorphism with increased risk of RPL. However, the other 10 gene polymorphisms were found to be associated with increased/decreased risk of RPL. Multiple logistic regression model for analyzing the simultaneous effects of these polymorphisms on the risk of RPL showed that six of these 11 polymorphisms [Factor V 1691G/A, Factor V 5279A/G, Factor XIII 614A/T, ?-Fibrinogen-455G/A, ITGB3 1565T/C, and MTHFR 1298A/C] were associated with RPL. It is possible to calculate the risk of abortion in a patient with RPL by determining only six of the 10 polymorphisms that are individually associated with RPL

[Comparing anxiety, depression and sexual life satisfaction in two groups of fertile and infertile women in Tehran]

Infertility is a major painful emotional distress that is manifested in the form of psychological disorders such as anxiety, depression and reduction of normal sexual function in affected couples. The purpose of this study was to compare anxiety, depression and life satisfaction between fertile and infertile women admitted to Vali-e-Asr Infertility Clinic in Tehran in 2009. This descriptive study included 60 participants, being composed of 30 infertile and 30 fertile women. The demographic data including marital status, infertility duration, age and occupation were recorded. Zung's self-rating Anxiety Scale and Beck Depression Inventory [BDI] were used for evaluating anxiety and depression, respectively. The Evaluation and Nurturing Relationship Issues, Communication and Happiness [ENRICH] questionnaire was also used for evaluating the participants' life satisfaction. Anxiety and depression were significantly higher in infertile compared to fertile women [p < 0.05] but life satisfaction was not much different in the two groups. In both groups, anxiety and depression did not relate with age or infertility duration but life satisfaction grew more in infertile women than fertile women by age and marriage duration. In the two groups, anxiety, depression and sex satisfaction did not relate with education but infertility duration was affected by sexual satisfaction despite having no significant relationship with anxiety or depression. Moreover, depression and sexual dissatisfaction in infertile housekeeper women was more prevalent than infertile employed women but anxiety had no relationship with their occupational status. Infertile women need psychiatric care. Considering the results of this study, suggestions addressing the improvement of psychological health of infertile women through supportive measures seem to be of value

Comparison of the results of Cox proportional hazards model and parametric models in the study of length of stay in a tertiary teaching hospital in Tehran, Iran

Survival analysis is a set of methods used for analysis of the data which exist until the occurrence of an event. This study aimed to compare the results of the use of the semi-parametric Cox model with parametric models to determine the factors influencing the length of stay of patients in the inpatient units of Women Hospital in Tehran, Iran. In this historical cohort study all 3421 charts of the patients admitted to Obstetrics, Surgery and Oncology units in 2008 were reviewed and the required patient data such as medical insurance coverage types, admission months, days and times, inpatient units, final diagnoses, the number of diagnostic tests, admission types were collected. The patient length of stay in hospital 'leading to recovery' was considered as a survival variable. To compare the semi-parametric Cox model and parametric [including exponential, Weibull, Gompertz, log-normal, log-logistic and gamma] models and find the best model fitted to studied data, Akaike's Information Criterion [AIC] and Cox-Snell residual were used. P<0.05 was considered as statistically significant. AIC and Cox-Snell residual graph showed that the gamma model had the lowest AIC [4288.598] and the closest graph to the bisector. The results of the gamma model showed that factors affecting the patient length of stay were admission day, inpatient unit, related physician specialty, emergent admission, final diagnosis and the number of laboratory tests, radiographies and sonographies [P<0.05]. The results showed that the gamma model provided a better fit to the studied data than the Cox proportional hazards model. Therefore, it is better for researchers of healthcare field to consider this model in their researches about the patient length of stay [LOS] if the assumption of proportional hazards is not fulfilled

Urogenital chlamydia trachomatis infection among prisoner men

Chlamydia trachomatis [C.trachomatis] is one of the most common curable STDs. Little information is available on its incidence among prisoner men. This study aimed to investigate the frequency of urogenital infection with C.trachomatis among imprisoned men as a high risk group. In this cross-sectional study, 130 imprisoned men aged 16-49 years in one of Tehran prisons were randomly selected. After completing informed consent, each volunteer dedicated a urine sampler and a completed questionnaire. DNA extraction and PCR assay were performed in Avicenna Research Institute. Among the 130 prisoner men, only 3 [2.3%] had positive PCR test results. Mean age of participants was 28.00 +/- 4.58 and the mean age at first sexual contact was 20.33 +/- 3.51. All had at least elementary education while 66.7% were unmarried and 33.3% were unemployed and had less than 1000000 Rails per month. Moreover, 33.3% were homeless and others living in rental houses. Furthermore, 66.6% had more than 4 sexual partners. There was no difference in condom use and none of them mentioned urinary discharge or dysuria. Additionally, 66.6% were IVDU and had more than 3 prison admissions. There was no report of HIV, HCV or HBV infection among them. The low incidence of C.trachomatis in this study showed that screening of asymptomatic men by PCR is not cost-effective and in order to obtain more epidemiological information, low-cost techniques such as serological methods can be recommended. Moreover, studies with broader distribution and higher sample size should be performed to determine real prevalence of chlamydia infection and make a definite decision about screening

Comparing serum basal and follicular fluid levels of anti-Mullerian hormone as a predictor of in vitro fertilization outcomes in patients with and without polycystic ovary syndrome

The prediction of in vitro fertilization [IVF] outcomes by anti-Mllerian hormone [AMH] measurement is getting increasing attention from clinicians. This study compares the relationship between serum or intrafollicular AMH levels and IVF outcomes in women with and without polycystic ovary syndrome [PCOS]. This prospective study was carried out in two university-based fertility clinics. Serum samples were collected on cycle day 3 and follicular fluid [FF] was collected on the day of oocyte retrieval from 26 women with PCOS and 42 normo-ovulatory controls. AMH levels were measured in the samples using immunoenzymatic assay. The relationship between serum or FF AMH levels and IVF outcomes, including number of oocytes retrieved, oocyte maturation rate, fertilization rate, implantation rate, high quality grade embryo rate, and bio-chemical and clinical pregnancy rates were further assessed. Median serum basal AMH and FF AMH levels were significantly higher in the PCOS group as compared to controls, the values being 14.2 ng/mL vs. 3.2 ng/mL [P<0.001] and 8.2 ng/g protein vs. 4.7 ng/g protein [P,.01], respectively. In both groups, serum basal AMH levels showed a positive correlation with number of positive relationship between serum basal AMH levels and percentage of matured oocytes [r=0.331; P=0.32] and implantation rate [r=0.305; P=.05]. Serum basal, and not intrafollicular, AMH levels may be a good predictive factor for quantitative and qualitative IVF outcomes in normo-ovulatory, but not in PCOS patients

C-reactive protein level and pregnancy rate in patients undergoing IVF/ICSI

C-reactive protein [CRP] can be increased after hormonal stimulations. The changes of CRP might affect the success of in-vitro fertilization [IVF]. The aim of this study was to determine the possible relationship between the serum CRP level and outcome of controlled ovarian stimulation, and pregnancy rate in patients undergoing IVF or intra cytoplasmic sperm injection [ICSI]. This prospective cross sectional study was performed in Avicenna Infertility Clinic on 70 consecutive infertile patients [Jan 2008-Aug 2009] who were candidate for IVF/ICSI, using standard long GnRH agonist protocol. Blood was drawn 4 times during the cycle, on first day of stimulation, the day of HCG injection, the day of ovum pick up, and the day of embryo transfer. In 82.2% of cases, the serum CRP level was higher in day of HCG injection than first day of stimulation and also the day of ovum pick up the day of HCG injection. The ratio of CRP level in the day of transfer to the day of ovum pick up, was significantly higher [ratio >/= 1.23] in patients who became pregnant after ICSI [p=0001]. All patients with less than this Ratio have not been pregnant. Controlled ovarian hyper stimulation and puncture of ovaries can potentiate systemic stimulation. Increasing serum CRP level in day of embryo transfer rather than ovum pick up can predict the success in patients undergoing IVF/ICSI

Comparative molecular and microbiologic diagnosis of vaginal colonization by group B streptococcus in pregnant women during labor

Rapid tests for detection of Streptococcus agalactiae or Group B Streptococci [CGS] at the onset of labor are needed to permit early intrapartum antibiotic prophylaxis. This study aimed to evaluate the PCR assays targeting the 16S ribosomal RNA gene [16S rDNA] for detection of the GBS in comparison with a specific culture method. Two swabs were used to obtain vaginal specimens from the 330 pregnant women attended delivery room at Hedayat hospital, Tehran, Iran. One swab was analyzed by direct plating onto selective GBS agar medium [ISLAM] and the other swab was used for a PCR assay, which amplified the 16S rDNA of S.agalactiae. Comparative study between the selective culture and the PCR assay was done among the 330 tested women. The GBS colonization rate based on the culture results was 20.6% [68/330]. Both culture and PCR methods were positive for 56 and negative for 253 women. The culture method was positive and PCR was negative in 12 women. The culture was negative and the PCR positive for 9 women. Sensitivity of the PCR assay was 82.3% and specificity was 96.5%. The positive predictive value was 86.15% and negative predictive value was 95.4%. ISLAM diagnostic procedure and PCR are rapid and reliable analyzing methods, which might be useful for accurate diagnosis of GBS colonization in pregnant women at the time of delivery

Preventing mother-to-child transmission of HIV/AIDS: do Iranian pregnant mothers know about it?

Nowadays, HIV is mostly spreading in Asian countries. One of the important routes for HIV transmission in these countries is the vertical route which infects 35% to 45% of newborns. Mother's education, drug prophylaxis and Cesarean section, accompanied by banning breastfeeding will decrease this rate to 2%. Therefore, mothers' knowledge about Prevention of Mother to Child Transmission [PMTCT] has a great role in HIV/AIDS prevention. This study was designed to evaluate knowledge of pregnant women about HIV, its vertical transmission and prevention in Tehran, Iran. This cross-sectional study was conducted on 1577 pregnant women aged 15-46 years who were attending prenatal care clinics in Tehran, Iran. The research material was a questionnaire which was completed daily by trained midwives. The data were statistically analyzed by ANOVA, independent sample t-test, Pearson correlation and linear regression with a significance level of p = 0.05. About 16.5% of the participants had good knowledge about HIV/AIDS and 54.1% about its transmission routes but awareness about its prevention was only 5.7%. Fifty-seven percent of the participant had not been tested for HIV earlier and 20.2% were not willing to undergo such tests. About 86.2% of the participants had no idea about the availability of drug prophylaxis in Iran for PMTCT. The fact that 28.2% of the participants were not willing to undergo HIV testing reflects negative attitude about HIV infection. Although the overall awareness about the infection and its transmission was good but knowledge about its prevention especially by PMTCT and its availability in Iran was low. Educational programs through mass media or prenatal care programs by focusing on HIV/AIDS prevention maybe useful

predictive model for the diagnosis of preeclampsia

Preeclampsia is one of the three main causes of death in pregnant women. The medical condition is identified by hypertension and proteinuria with serious effects on the health of mother and the fetus. There seems to be no precise methods to diagnose preeclampsia at its onset. This study was done to evaluate the simultaneous measurement of some variables thought to be responsible in the pathogenesis of preeclampsia for predicting or screening those at risk. In this study, 466 primiparas were selected randomly among the bulk of pregnant women who attended Maryam Hospital for prenatal care in Tehran, Iran during 2007-2008. The subjects had no history of chronic health conditions and regularly took Iron supplements. The predictive variables included age, job, education, income, number of pervious marriages, BMI during the first trimester of pregnancy, age at the time of recruitment for the study, changes in hematocrit concentration at the beginning and the 24[th] to 28[th] weeks of pregnancy, blood pressure and roll-over test during 28[th] to 32[nd] week of gestation but the onset of preeclampsia was considered as a dependent variable. For analyzing the overall effects of the mentioned variables on prediction of the disease, multivariate logistic regression analysis was employed and ROC curves were used for determining a suitable cut-off point for determining the sensitivity and specificity of the model. The prevalence of preeclampsia was 6.4% [95% CI: 4.2-8.6]. Variables such as as positive roll-over test, fulfillment of university education, marriage more than once, high blood pressure during the 24[th]-28[th] weeks of gestation, being a housekeeper, satisfaction with income, positive roll over test at a late stage of gestation and increase in BMI raised the risk of preeclampsia 8.61, 7.98, 2.65, 1.84, 1.56, 1.28, 1.21 and 1.11 times respectively. The proposed logistic regression model had a sensitivity of 83% and a specificity of 76% regarding the inclusion of all the mentioned variables. Regarding the serious complications and negative effects of preeclampsia on both the mother and the fetus and the high sensitivity of this logistic regression model and imposition of no costs on the person for the measurement of the variables this model seems to be suitable for the screening of preeclampsia

[Reproductive health and educational needs among pre-marriage couples]

To investigate pre-marriage educational needs of couples to plan support services. In a cross-sectional study, a self administered questionnaire was used to collect data from 2117 participants in pre-marriage consulling sessions in Isfahan city. The questionnaire included educational needs in different subjects of reproductive health field, spousal relationships and Islamic rules and rights. The educational priorities in different fields are as follows: women cancers and safe sex in reproductive health, communication techniques and ways to solve problems with the spouse in the spousal relationships and legal rights related to sex and the advices of Islam about spousal relationships in the field of Islamic rules and rights respectively. The average age of women and men were 22.8 +/- 4.2 years, 26.2 +/- 4.3, respectively. Significant association was observed in the field of reproductive health between the educational needs and women's job [P=0.022], men's job [P=0.009], women's age [P=0.033] and the level of education [P=0.001], in the field of spousal relationships between the educational needs and women's job [P<0.001], men's job [P=0.043], age of both women and men [P=0.001], and in the Islamic rules and rights field, between the educational needs and women's job [P<0.001], age of both women and men [P=0.44] and the level of education [P=0.007]. In men with higher educational level, demands for learning increase however in women it reduce. By increasing the age, needs for education in both sexes reduce. Employed women had lower needs for education compared to other groups and employed men had more needs. There was no significant difference between rural and urban residents