[Affecting factors the choice of delivery and attitude of pregnant women admitted to the civil hospitals, the Social Security Organization in 2013]

Background: Cesarean delivery is usually limited to cases where it is not possible through normal path, or is associated with serious risks for the fetus and mother, therefore it is expected, Caesarean section should be used in limited and specific cases and the rate of it does not exceed certain limits. Unfortunately, nowadays reported cesarean section rate is more than acceptable in the country. Lack of awareness of the complications of cesarean and negative attitude toward normal vaginal delivery was of the causes of the increased tendency of pregnant women to have cesarean. The aim of this study was to investigate the factors affecting on selection of the methods of delivery and attitude of pregnant women admitted to the civil hospitals Social Security Organization in 2013.

Materials and Methods: This research was descriptive–analytical and cross–sectional. In this study of 2521 pregnant women in 67 civil hospitals Social Security Organization across the country had referred in the summer of 2013, using simple random sampling were examined. For data collection, a questionnaire including demographic characteristics, the questions about reasons for selection of cesarean, and attitude measurement toward vaginal delivery and cesareanwas prepared by voting of midwives and obstetricians and then, after final approval by test-ratest method, completed through interviews withpergenant mothers. For the data analysis were used of SPSS 22 software and chi-square and T-tests.

Results: The mean age mothers were 27.64 +/- 0.21 and also 57% of them had a higher education diploma. The cesarean rate was 50.7% in women in the study. 57% of women tend to be more moderate cesarean [p<0.001]. Their main reasons for choosing cesarean were analgesia operating procedures, the lack of harm to the fetus, preventing tearing and deformed genitalia, do not require frequent examinations and suggestion of doctor or midwife. Significant statistically association was between current birth mothers with maternal age, spouse's age, age at marriage, level of Education, job, income, previous delivery, parity, stillbirth, infertility and miscarriage and a family history of cesarean section [p<0.001]. There was significant relationship between level of knowledge and attitude toward cesarean delivery [p<0.001]. But there was no found significant association between the attitude of the normal vaginal delivery with mother's level of knowledge [p=0.31].

Conclusion: According to the survey results and the relationship between attitudes to caesarean and selection, it is essential to deal with the excessive increase in cesarean and achieve an acceptable limit this type of delivery [cesarean section], Necessary actions should be performed to raise the awareness of women about the benefits of normal vaginal delivery and disadvantages of cesarean section.

[To determine the prognostic factors in esophageal cancer using log-logistic regression model in Iran]

Each year almost 400,000 people are diagnosed with oesophageal cancer worldwide. Wide variation in incidence has been reported both between countries and in different ethnic groups and populations within a country. The area with the highest reported incidence for oesophageal cancer is the so-called Asian 'oesophageal cancer belt', which stretches from eastern Turkey through north-eastern Iran, northern Afghanistan and southern Russia to northern China. In the high risk area of Gonbad in Iran, world age-standardised rates are more than 200 per 100,000 and the male/female ratio is reported as 0.8:1.0.This study aimed to assess the risk factors and demographic factors influencing survival of patients with esophageal cancer in north of Iran using weibull and log-logistic regression models. Demographic and clinical data of 359 patients with confirmed diagnosis of esophageal cancer from Babol Cancer registry utilized for our model. parametric and weibull models were employed to analyze the data. The Akaike information criterion [AIC] was also considered as a criterion to select the best model[s]. All p values as 0.05 were considered as statistically significant. The sample study consisted of 62.7% men and 37.3% women. Estimated survival rates in 1, 3, and 5 years following diagnosis were 23%, 15%, and 13% respectively. According to AIC criterion, the hazard rate of non-monotonic and rejection proportional hazards assumption [p<0.05], log-logistic model was more efficient than weibull model. Family history of having cancer in patients showed a significant difference in both models. It is concluded that early detection of people with a family history of cancer can be effective as an important factor in reducing the risk of death in patients with esophageal cancer