Unintended pregnancies in Hamedan,Iran: Levels and determinants

The recent limitation in the provision of publicly funded family planning services in Iran has concerned stakeholders in reproductive health about the incidence of unintended pregnancies. This study used data from Hamedan Survey of Fertility (HSF), conducted in April–June 2015 among a representative sample of 3,000 married women aged 15–49 years living in the city of Hamedan (Iran), to estimate levels of unintended pregnancies and examine factors related to pregnancy intentions for the most recent birth, using multinomial logistic regression analyses. Results showed that 23 percent of pregnant women reported their pregnancy as unintended (17 percent mistimed and 6 percent unwanted). Moreover, unintended pregnancies in the five years preceding the survey were the result of failures of withdrawal (35 percent) and of modern contraceptive use (33 percent), along with contraceptive discontinuation (23 percent) and non-use (9 percent). Multivariate results indicated that the risk of unintended pregnancy was lower among women reporting modern contraceptive failures and lower among those reporting contraceptive discontinuation and non-use, compared with women experiencing withdrawal failures. The high incidence of unintended pregnancies among women experiencing contraceptive failures and discontinuation imply their high unmet need for contraceptive knowledge and counseling rather than for access to contraceptive methods.     

Effect of stone composition,color,size,impaction and location on the efficacy of pneumatic ureterolithotripsy

Objective： Assessment of the relationship between stone location, composition, color, size and impaction with success rate of pneumatic ureterolithotripsy. Methods： This study was performed on 440 patients who were candidate for pneumatic ureterolithotripsy admitted in an academic urology department from February 2004 to June 2006. Exclusion criteria included active urinary tract infection and pregnancy. Information such as stone composition, color, impaction, size, location and surface were recorded. Success rate was defined as stone fragmentation to 〈 2 mm. We used chi-square test and student t-test for statistical analysis. Results： The success rate of pneumatic ureterolithotripsy was 83.0 %. Mean stone size was 9.86 ± 3. 79 mm. The stone free rates in upper, middle and lower ureter were 66.7%, 100% and 90.7% respectively （P 〈 0. 000 1 ）. Stone free rate was 100 % and 69.35% in 〈 5 mm and 〉 5 mm stones respectively （P 〈 0.000 1 ）. Impaction did not correlate significandy with stone free rate （P=0.17）. The success rate was 100 % in phosphate and cystine stones. There was a significant statistical difference between success rate and stone composition （ P = 0. 026）. The most common fragmented stone color was gold （95.5% ）. Stone color correlated significantly with stone free rate （P 〈 0.0001 ）. Conclusion： In this series ureterolithotripsy, stone free rate had a significant correlation with stone color, size, composition and location, but it was independent of stone impaction.     

Effect of exposure to occupational noise and shift working on blood pressure in rubber manufacturing company workers

This study aimed to assess the relationship between shift working and occupational exposure to noise with blood pressure (BP). The study was carried out in a rubber manufacturing company in 2010. Demographic, medical and occupational information for carrying out the study were collected through direct interview. All 331 under study workers were divided into four groups according to work shift and noise exposure severity, from non-noise exposed day time workers (Group 1) to noise exposed shift workers (Group 4). Finally, systolic and diastolic blood pressure levels were compared among these four groups. The results of this study showed that there was a significant difference between average systolic and diastolic BP and hypertension (HTN) frequency in the four groups (p<0.05). The highest rate of HTN and mean systolic and diastolic BP were observed among shift workers who were exposed to noise higher than permissible limit (Group 4). Also the results of logistic regression analysis showed that there was a significant relationship between simultaneous exposures to noise more than the permitted limit and shift work with HTN (p<0.05). The results of our study showed that shift working and simultaneous exposure to noise have an additive effect on occurrence of HTN. It is recommended that during periodic physical examinations of noise exposed shift workers, assessment of the cardiovascular system and BP should be done as well as the auditory system.