Addressing the changing sources of health information in Iran

Following the entrance of new technologies in health information era, this study aimed to assess changes in health information sources of Iranian people during past decade. Totally 3000 people were asked about their main sources of health information. They were selected as two community-based samples of 1500 people of more than 18-years-old in two different periods of time in August 2002 and August 2010 from the same locations in Tehran, the capital of Iran. Data analyzed based on age group, sex, educational level and household income in two different periods of time using Chi-square. Odds ratios associated with each basic characteristic were calculated using logistic regression. Most common sources of health information in 2002 were radio and television [17.7%], caregivers [14.9%] and internet [14.2%] and in 2010 were radio and television [19.3%], internet [19.3%] and caregivers [15.8%] [P < 0.001]. In 2010, young adults female used television and radio and male used internet as the main source of health information [P = 0.003]. In moderate educational level women got their health information from radio and television and caregivers; while men used radio and television and internet as main source of health information [P = 0.005].Highly educated women and men mainly got their health information from internet and radio and television [P > 0.05]. Although during 8 years of study radio and television remained as main source of health information but there is an increasing tendency to use internet especially in men. Policymakers should revise their broadcasting strategies based on people demand

Effect of Iranian Ministry of Health protocols on cesarean section rate: a quasi-experimental study

High Cesarean section rate is a major health problem in developing countries. This study was established to evaluate the effectiveness of Iranian Ministry of Health and Medical Education protocols on Cesarean section rate trend. Through a non-concurrent controlled quasi-experimental study, Cesarean section rate in Shohada-e-Tajrish and Taleghani hospitals in Tehran was compared during 2008-2009. Intervention group included 578 participants hospitalized because of premature rupture of membranes, prolonged pregnancy, pre-eclampsia, intra-uterine growth retardation, vaginal bleeding and premature labor in first and second trimester underwent interventions based on MOHME new protocol. On the other hand 594 cases as control group were selected during the same time before the intervention and underwent routine treatments. Descriptive statics, t-test, chi square and univariate analysis were used when appropriate. Basic characteristics in two groups had no statistically significant difference. Cesarean section applied for 360 [67.8%] women in case group and on the other hand, 270 [48.8%] Cesarean sections were done for control group [P<0.001]. There was 19% difference between intervention and control groups. Complication of pregnancies had increased by 6% in intervention group [P<0.001]. Mortality rate in the study was zero in both groups. Applying clinical practice guidelines does not guarantee decreasing Cesarean section rate. Providing appropriate service may increase the ability of service providers to find more indications for Cesarean section

Factors associated with delay in thrombolytic therapy in patients with ST-elevation myocardial infarction

Treatment delay in the management of ST-elevation myocardial infarction conversely correlates with prognosis and survival of the patients. This study aimed to investigate factors associated with delay in the thrombolytic therapy of these patients in Tehran. Between 2007 and 2010, the interval between the self-reported time of the onset of symptoms and initiation of the thrombolytic agent in 513 patients with a diagnosis of acute ST-elevation myocardial infarction was recorded. Medical history and socio-demographic characteristics of the patients treated within two hours after the onset of symptoms and patients treated after two hours from the onset of symptoms were compared, and the odds ratios were calculated using logistic regression. The mean age of the patients was 61.2 [SD = 11.1] years, and 76% of the patients were male. The median time between the onset of symptoms and treatment was 158 [SD = 30.4] minutes. Mean for decision time was 61 [SD = 19], which was responsible for 83% of the entire treatment delay. The mean transportation time was 34 [SD = 12] minutes, and the median door-to-needle time was 44 minutes. Odds ratio for history of diabetes mellitus was 1.90 [95% CI: 1.26-2.87], for hypertension was 1.55 [95% CI: 1.08-2.23], and for prior coronary heart disease was 1.47 [95% CI: 1.17-1.84]. The most important factor associated with delay in treatment was decision time. Improving emergency medical services dispatch time, obtaining pre-hospital electrocardiograms for early diagnosis, and pre-hospital initiation of thrombolytic therapy may reduce the delay time