RESUMEN
@#Caesarean section without medical indication imposes many problems to families, personnel and medical equipment causing some side effects to pregnant woman and foetus, compared to natural childbirth. The present study aimed to evaluate the interventions in reducing caesarean section in the world. This study was a systematic review using Embase, PubMed, Scopus, Web of Science, Science Direct, Magiran and SID databases and grey literature. All studies conducted during 2000–2018 were reviewed and finally the studies with inclusion and exclusion criteria were selected. A total of 19 studies were selected among 5,559 studies. The interventions conducted for reducing caesarean section included training the specialists and women by using Six Sigma method, changing the guidelines, reviewing the definition of natural childbirth various stages, encouraging the natural childbirth and expanding painless childbirth. All interventions were divided into educational strategy and managerial strategy. The interventions can be implemented to change the behaviour of physicians and attitude of pregnant women in order to reduce caesarean section. In this regard, the authorities are recommended to make more efforts.
RESUMEN
The aim of this study was to assess and compare the diagnostic accuracy of Helicobacter pylori stool antigen [HpSA] test with three other invasive and non-invasive diagnostic methods. A total of Fifty-two dyspeptic patients were included. None of the patients had previous eradication therapy for Helicobacter pylori. Endoscopic biopsy samples were obtained for histology examination and Rapid Urease Test [RUT]. Urea Breath Test [UBT] and HpSA were also performed. Patients were considered Helicobacter pylori positive when 2 of 3 tests [histology examination, RUT and UBT] were positive [gold standard]. Diagnostic accuracy of HpSA was assessed performing a Receiver Operating Curve [ROC] analysis. Twenty-three Were men and 29 Were women, with a mean age of 42.3 years of the Patients. The prevalence of Helicobacter pylori infection was 67.3%. ROC curve analysis was showed a significant area under curve of 94.6% [p=0.0001]. Cut-off value was estimated to be 0.1. The sensitivity, specificity, positive and negative predictive values of HpSA wa 91.4%, 94.1%, 97% and 84%, respectively. HpSA level significantly increased with increasing in bacterial load. HpSA was proved to be a highly accurate, simple and non-invasive test for the diagnosis of Helicobater pylori infection before treatment in dyspeptic patients