Journal of School of Public Health and

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To determine the level of knowledge and to assess attitudes and lifestyles in patients with unstable angina. A descriptive study was conducted among CCU patients in Mashad hospitals. 180 subjects were chosen by sequential admission. They filled an 82-item questionnaire covering demographic variables (4 items) - knowledge (5 items) –attitude (56 items) – lifestyle (17 items). Findings indicate that the global level of knowledge is sufficient on issues such as cardiac risk factors, current treatments, and treatment compliance. The same patients showed very low knowledge of pain-inducing behaviors. Meanwhile, attitude scores turned out to be relatively low in some areas including perceived threat of disease (severity and susceptibility) and internal health Locus of Control. Health care professionals (physicians, nurses,..) tended to ignore the need for proper education of cardiac patients. There is a strong need to promote patient education in order to enhance knowledge and bring about a change in attitudes.

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Background and Aim: We studied 1800 pregnant women receiving routine prenatal care in the urban and rural health centers of Shahr-e-Rey in south of Tehran, for a comparative assessment of 5-minute neonatal Apgar Scores in wanted versus unwanted pregnancies.

Material and Methods: The subjects were studied in 2 groups, each comprising 900 pregnant women. Group A consisted of mothers with wanted pregnancy and group B of mothers with unwanted pregnancy. Inclusion criteria were gestational age less than 28 weeks at the time of entering the study. The two groups were followed through their prenatal care to the time of delivery. For each neonate, we extracted the 5-minute Apgar score from the birth certificate.

For a more precise assessment, the impact of conditions affecting the Apgar score of newborns (such as normal vaginal delivery vs. caesarean section, premature birth, low birth weight, congenital anomalies, and birth place (hospital and health center, or house) was assessed by logistic regression.

Results: We found 15 cases (0.4%) of low 5-minute Apgar score (under 8) among newborns of wanted pregnancies and 4 such cases (1.1%) among those of unwanted pregnancies. The difference between the 2 groups was significant (P= 0.011). After applying the logistic regression model to adjust for other factors, unwanted pregnancies still had a significant association with low Apgar scores (increasing the risk 3-fold).The attributable risk for low 5-minute Apgar score in unwanted pregnancies was 0.54 (CI_.95 = 0.132 to 0.813).

Conclusion: The estimated attributable risk means that with 95% confidence, between 13.2% and 81.3% of the low Apgar scores could have been prevented by eliminating unwanted pregnancy. As there have been no similar studies in Iran, more research with larger samples must be performed to assess these results more precisely.

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Background and Aim: Hearing impairment is one of the most common congenital defects. Unfortunately there have been no studies so far on the prevalence of various degrees of neonatal hearing, loss in Iran. As accurate determination of prevalence is crucial in estimating disease burden and planning subsequent interventions, we carried out this study to determine the prevalence of neonatal hearing impairment.

Materials and Methods: In this study, we assessed the prevalence of hearing loss among the newborns in province capitals and also looked at the role of some putative risk suggested by the Joint committee on Infant Hearing (JCIH). In this research, 76500 newborns who had undergone audiologist-administered screening tests were assessed by a special questionnaire designed specifically for this study.

Results: After trapshooting the overall prevalence of hearing loss was estimated and then cases were classified as moderate (40 - 65 db HL), severe (65 - 90 db HL), or profound (>90 db HL) hearing loss. Among the newborns examined, a total of 362 were diagnosed with hearing loss and hence the overall prevalence was estimated at 4.7 per thousand 168 cases had moderate (2.2 × 10 -3), 114 cases had severe (1.5 × 10 -3) and 80 cases had profound (1.1 × 10 -3) hearing loss.The prevalence rate ranges from 2-3 × 10 -3 (in Hamedan and Mazandaran) to 7-8 × 10 -3 (in Yazd and Chaharmahal-Bakhtiari). In newborns with a family history of sensory-neural hearing loss the prevalence was 16 × 10 -3, compared to 18 × 10 -3 in those requiring blood transfusions, 15 × 10 -3 in newborns with a history of admission to neonatal intensive care units, 17 × 10 -3 in those with craniofacial anomalies, and 19 × 10 -3 in newborns with birth weights below 1500 grams. The sample included 39376 boys and 37124 girls 193 boys (5 × 10 -3) and 169 girls (4.6 × 10 -3) were affected. The stratified prevalence in males (193) was 477 × 10 -3 for intermediate, 311 × 10 -3 for severe and 202 × 10 -3 for profound deafness. The rates in the female population were 437 × 10 -3 for intermediate, 320 × 10 -3 for severe and 273 × 10 -3 for profound hearing loss.

Conclusion: The results confirm the need for extensive neonatal screening programs, and the significant difference in prevalence between high-risk groups and the normal population provides justification for continuous audiologic screening in this group of newborns.

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Background and Aim: Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia for non-medical reasons.The World Health Organization has estimated that 100 to 140 million girls and women worldwide are currently living with the adverse consequences of FGM. Two of the major incentives for FGM are traditions and social pressure, and the practice is mostly carried out by traditional circumcisers. Not only FGM has no health benefits for girls and women, but it has immediate and long-term complications. The objective of this study was to determine the prevalence of female genital mutilation and factors associated with it among women consulting health centers in Ravansar City, Iran

Materials and Methods: A cross-sectional study was conducted on 348 women consulting 5 health centers in Ravansar City, Iran. Data were collected using a structured questionnaire and SPSS.16 was used for data analysis.

Results: The prevalence of FGM was 55.7% and the mean age of the women undergoing FGM was 9.2±14.2 years. The prevalence increased with age. Almost in all cases the operation had been performed by traditional local circumcisers. The data also showed that 96.2% of the mothers and 87.6% of the sisters of the subjects had also been mutilated. There were statistically significant associations between FGM and several independent variables as follows: the mutilated women's age (0.001) and education level (p<0.001) their mothers' education level (p=0.006) and their awareness of, and attitude towards, mutilation (p<0.001).

Conclusion: FGM is prevalent among Ravansar women. Religious leaders and health personnel should attempt to discourage FGM. Promoting public awareness of FGM and its undesirable consequences is essential. Research shows that if a community itself decides to abandon FGM, the practice can be eliminated rapidly.

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Background and Aim: Cervical cancer is the second most common cancer in women with incidence of more than 500000 cases per year. It is preventable because of its long pre-cancerous period, suitable screening programs and effective treatments. Since the social and cultural barriers alongside the lack of knowledge are deterrents to participation in screening programs, the current study was performed to assess the effect of educational intervention through the Health Belief Model on knowledge and attitude of teachers about pap smear, considering their role in making people aware. Materials and Methods: This was a controlled before-after interventional study conducted on 72 individuals selected through simple sampling, assigned to two groups. Data collection tool was a questionnaire used and compared before training and one month after that. Training methods (intervention) included lectures with questions and answers. Data were analyzed with SPSS, version 11.5. Results: 47.2% of intervention and 45.8% of control group were 40 to 50 years old and majority of them (47.2% and 50% respectively) had undergraduate educational level and 86.1% were married. Respectively, 67.2% and 74.2% have experience of being examined via Pap smear, while the knowledge of women in both groups was moderate about the disease. Study results revealed significant differences in knowledge, attitude and Health Belief Model constructs within intervention group (before and after training) as well as between groups (p<0.05). Conclusion: Using Pap smear test among the participants was lower compared with healthy people aims targeted by 2010. Therefore, necessity of education and knowledge promotions are obvious.