[Components of clinical preventive services system in a specialized educational hospital: a qualitative approach]

Introduction: At first conference of health promotion in Ottawa in 1986, rearrangement of health providing services, especially hospitals, was introduced as a main strategy in health promotion. Health promoting hospitals project had been also proposed by the World Health Organization a decade before. According to the project, hospitals should have health promoting and disease preventing activities. In Iran, preventive services have not been defined as hospitals tasks and most efforts in hospitals are for medical treatment and rehabilitation. The purpose of this study was to recognize various components of clinical preventive services in Taleghani hospital in Tehran

Methods: In this qualitative study, 20 professionals and experts were interviewed using purposive sampling. Data were analyzed using content analysis

Results: Main themes extracted from the interviews consisted of: 1] challenges and barriers of clinical preventive services; 2] role of clinic of prevention in hospitals; 3] human recourses; 4] information recourses; 5] insurance system; 6] receiving and perusing patients; and 7] educating personnel

Conclusion: Providing preventive services is a perspective of future hospitals. Important necessities for implementation of these services in our country are description of the service packages, designing necessary structures, and training human recourses in this field

[Relationship of vitamin E consumption and preeclampsia/eclampsia in pregnant women]

Preeclampsia and eclampsia are threatening complications of pregnancy influencing the health of mothers and their fetus. So, prevention of these complications through providing mothers with natural diet vitamins during pregnancy is very important. The aim of this study was to examine relationship between consumption of diet rich in vitamin E and preeclapsia/ eclampsia in pregnant women. This was a case-control study. Data were collected through interview and filling up questionnaires. One hundred and fifty four women with age between 18-35 years were selected through continuous sampling method [75 women in case and 79 in control group]. Case and control groups were matched according to the gravida and vitamins supplement consumption. Finding indicated that there were statistically significant relationship between preeclampsia/ eclampsia and consumption of foods rich in vitamin E. This relationship was significant according to the number of servings and also amount of vitamin E received, for the number of serving for both nuts and unsaturated vegetable oil [P=0.000], mayonnaise cream [P=0.012], and for the amount of vitamin E received from diet [15mg[3]/day] [P=0.000]. Consumption of these diets in case group was less than control group. The consumption of saturated vegetable oil in case group were higher than control group [P=0.009]. As the results showed, there were direct relations between preeclampsia/ eclampsia and insufficient consumption of food full of vitamin E. Proper educational programs about nutrition during pregnancy, particularly during first trimester in the first pregnancy, is recommended. Prospective studies are suggested in order to confirm the existed findings

Comparative analysis of life quality in mothers after cesarean section and normal vaginal delivery

Statistics indicate that the rate of cesarean section increased in recent years. As complications of hospitalizations and surgery would affect the life quality, the current study was carried out to evaluate the life quality of mothers after normal vaginal delivery [NVD] and cesareane. This is an anterograde analytic study of cohort type. To fulfill the study, a specialized questionnaire was designed, and its validity and reliability was approved. The designed questionnaire accompanied with Edinburgh Postnatal Depression Scale [EPDS] and Short-Form-36 [SF-36] was filled by 50 women underwent NVD and 50 underwent cesarean, 6 to 8 and 12 to 14 weeks, postpartum. Finally, the data was analyzed using chi square, independent t, paired t, Wilcoxon and Mann-Whitney tests. Comparing the scores of the two groups 6-8 and 12-14 weeks postpartum indicated that both groups got higher marks in all fields in second step of the study. Anyhow, the improvement of NVD group was higher which was significant in some areas. Comparing the EPDS scores of the groups showed that the cesarean group was more prone to depressive disorders. The difference was significant 6-8 weeks postpartum. Also, the results of SF-36 questionnaire indicate that quality of life in NVD group was better in some aspects and similar with the cesarean group in other aspects. Findings demonstrated that women undergoing NVD experience better quality of life post partum, comparing those undergoing cesarean. So, to terminate the pregnancy, the NVD is better to be considered as the first choice

Comparison of two-month and four-month effect of vitamin E on cyclic Mastalgia

Cyclic mastalgia is a common cause of anxiety among women who visit health care centers. Due to some characters, the administration of proper drugs in treating of cyclic mastalgia is of prime importance. To compare the two-month and four-month effect of vitamin E on cyclic mastalgia in 20 years-old to premenopausal women. This was a double-blind randomized clinical trial performed on 150 women who visited three different clinics in Qazvin. The cases were divided into two study and control groups, each consisting of 75 women. Duration and intensity of pain was evaluated by visual analog scale [VAS] and breast pain chart. Daily vitamin E and placebo as chewing pills [200 IU] and for duration of 4 months were given to study and control groups, respectively. The cases were followed up for two and four months. Duration and intensity of pain and drug side-effect was evaluated afterward. The two-month and four-month administration of vitamin E and placebo caused a reduction in intensity of breast pain. But the four-month consumption of vitamin E in study group was more effective than in control group. The two-month and four-month intake of vitamin E and placebo caused a decrease in duration of breast pain. Again the four-month administration of vitamin E showed a greater effect in study group than in control group. It can be concluded that the administration of vitamin E for four months is an effective therapeutic protocol for cyclic mastalgia with no obvious side effects and could be considered as a suitable substitution for other types of treatment in case of cyclic mastalgia

[Comparing breast-feeding patterns in mothers with normal vaginal delivery [NVD] and cesarean section at teaching hospitals in Tehran, 2004]

Breast feeding is the best start in life of each child and breast milk is the most complete food in the first 4 to 6 months. However, one million children die of inadequate intake of breast milk each year. With respect to the importance of this milk in the health of mothers and children and high figures of Cesarean section in many countries, the effects of delivery type on breast feeding duration are unknown. This descriptive comparative study was conducted to compare breast-feeding patterns in two normal vaginal delivery [NVD] and Cesarean section groups. 140 pairs of mothers and newborn babies were selected in 2 groups. Initial sampling was started at 6 teaching hospitals in Tehran from March 2004 to May 2004. Data collection tools included 2 questionnaires and 1 observational checklist. Breast-feeding patterns were assessed according to definitions of WHO and such parameters as starting time of breast feeding. Mothers were followed up each month at their homes over the first 3 months after delivery. Qui-square, t-student, and Fisher statistical tests were used for data analysis. No significant difference was found between the 2 groups in terms of breast-feeding patterns, the first food of newborns and the frequency of breast feeding However, a significant difference was found in the mean starting time and frequency of breast feeding at the hospitals. It can be concluded that delivery type is not very significant in patterns of breast-feeding