Journal of School of Public Health and

Background and Aim: Coronary artery disease (CAD) and its complications at a low age are more serious and more progressive than at higher age. Because of this difference in the natural history of the disease as a function of age, this study was conducted to compare CAD risk factors between two age groups, namely people below and above 45 years old.

Materials and Methods: Two groups of 200 hospitalized CAD patients each, one below, and one above, 45 years old were selected by simple random sampling between 2005 and 2007. Two groups were similar with regard to dates and duration of hospitalization. The following data were collected from the patients' hospital files and analyzed using SPSS/Win: age, sex and marital status area of residence a history of smoking, diabetes, and hypertension a family history of early-onset cardiovascular disease (CVD) weight and height and lipid profile. The logistic regression test was used to compare the variables between the two groups.

Results: The following variables were found to be positively associated with CAD in the under-45 year group: smoking history (OR=2.54 p=0.009), a history of early-onset CVD (OR=3.15 p=0.009), low high- density lipoprotein cholesterol (HDLc) (OR=5.53 p<0.001), and high blood cholesterol (OR=3.96 p<0.006).

Conclusion: The most important coronary heart disease risk factors at a lower age are smoking, a history of early-onset CVD, low blood HDLc, and high total blood cholesterol.

Background and Aim: Diabetes mellitus is a widespread disease. Diabetes patients should be fully familiar with the different dimensions of this chronic disease and possess the skills required for self-management and self-care. They should realize that each patient is a different case. It is to be noted that promoting self-management behavior is an essential component of case management in type-2 diabetes mellitus. The objective of this study was to assess self-management behavior of type-2 diabetes patients in Isfahan, Iran and determine factors influencing it.  

Materials and Methods: This was a 6-month cross-sectional study conducted in 2011. The study population was type-2 diabetes patients consulting an outpatient diabetes center in Isfahan, Iran. The sample included a group of 350 patients selected by the continuous sampling method. The self-management behavior of the patients was assessed using a diabetes self-management instrument (DSMI), containing questions on 5 domains. The responses were rated on a 5-point Likert scale and SPSS software, version 11.5 was used for analyzing the collected data.

Results: The response rate was 88%. The majority of the patients were 50-60 years (55.52 ± 8.42) old and 54.3% of them demonstrated borderline metabolic control according to the World Health Organization criteria. Mean scores of self-integration, self-regulation, interaction with health professionals and other influential persons, self-monitoring blood glucose, and adherence to recommended regime were 33.67±6.36, 29.09±5.9, 27.08±4.81, 11.71±3.91 and 11.46±2.9, respectively. On the whole, the global diabetes self-management behavior seemed to be not quite desirable (the score was at an intermediate level). Further analysis of the data revealed that self-management behaviors (at 3 levels, namely, desirable, intermediate, and undesirable) had significant associations (p<0.001) with demographic (age, gender, marital status, education level) and health-related (duration of diabetes, diabetes-related diseases, diabetes complications, general health, type of treatment, family income, and serum HbA₁C level) variables. Self-management behavior had no association with disease history 

Conclusion: Empowerment of patients afflicted with diabetes and, more generally, non-communicable diseases, which are quite prevalent and on the increase, in the area of self-management at the individual and community level will be a vital step towards promotion of health of the population.

Background and Aim: Over 200 million pregnancies occur worldwide annually; one third are unwanted and half end up in abortion. This study aimed to determine the prevalence of unwanted pregnancies and induced abortions during women’s childbearing age over a period of 30 years (divided into 5-year intervals) in Tehran, Iran.

Materials and Methods: This cross-sectional study was conducted in 2014 on 518 married women 15 to 55 years old living in Tehran with a history of at least one pregnancy. A questionnaire containing two sets of questions on individual and demographic characteristics and women’s abortion history was used to collect the data for a period of 30 years (divided into 5-year intervals). The data collected were analyzed using SPSS 16 (the significance level was a p-value of <0.05).

Results: Of the 966 pregnancies among the 518 women studied, 665 (68.4%) were planned and 307 (31.6%) unwanted. There were 249 abortions, 108 (43.4%) of which were miscarriages, 41 cases (16.5%) for medical reasons, and 100 cases (40.2%) induced (deliberate).  The proportion of induced abortions in unwanted pregnancies increased from 0.0% in 1981-1986 to 41.7% in 2011-2014.

Conclusion: Based on the findings it can be concluded that due to changes in family planning program effectiveness and accessibility of contraception methods in Iran unwanted pregnancies and the subsequent abortions have become more common.