حسین کریم

The advance in technology has improved the quality and timely access to laboratory services, besides increased costs. Approximately, 70% of clinical decisions are made based on laboratory results. For cost management in the health system, the role of the number of requested tests is unclear in health quality. Therefore, this study aimed to investigate the number of laboratory tests in medical prescriptions in the Alborz province of Iran.

In a descriptive-analytic study, the number of requested laboratory tests was extracted from medical prescriptions issued to the Social Security Organisation and the Iranian Health Insurance in the province of Alborz between 2011 and 2016. The data were analyzed by Excel.

The results showed that between 2011 and 2016, the number of laboratory tests issued to the two main health insurance schemes of Iran, with the highest population coverage, was increasing. In 2011 and 2016, the average number of tests requested per person was 3.4 and 5.6, respectively.

The requests for laboratory tests or irrational administrations may increase for various reasons, including lack of knowledge, laziness, fear, greed, and induced demand. It is suggested that standard guidelines be developed using the results of this study and similar studies for requesting laboratory tests by doctors.
 

Total fertility rate has fallen below the replacement level in several provinces of the Islamic Republic of Iran, including Kermanshah. The aim of this study was to investigate fertility trends, in 5-year birth cohorts in Kermanshah. In this survey, using multi stage random sampling, fertility trend of married women born in 1956-95 were assessed in eight birth cohorts. Linear regression with least squares method was used to evaluate the relationship between marriage age and child number. The number of children born by women before the age of 35, has decreased from 4.05 to 2.41 among women born in 1956-60 and 1971-75 respectively. There was an inverse relationship between age at marriage and the number of children in women of up to 40 years old (r= -0.5; P<0.02). According to the findings on this research, it is predicted that the speed of fertility slope reduction will be decreased.

Coronary artery and carotid stenosis risk factors are frequently common in these two problems. The present study was aimed to determine the relationships between carotid arthroscleroses and coronary artery stenosis in candidates for cardiovascular angiography. In a cross sectional study، 218 candidates for cardiovascular angiography، visiting Imam Ali hospital of Kermanshah، were divided into two groups of case (158 subjects) and control (60 subjects) and were investigated by angiography and Doppler echo. Data were analyzed by Chi-square test (χ2) and multiple logistic regressions. Totally، 47 subjects (21. 6%) had carotid stenosis with >50% plaque. The frequencies of this value in the case and control groups were 37 (23. 4%) and 10 (16. 7%) cases، respectively، indicating no significant difference between groups (P=0. 27). There was a significant association between coronary artery and carotid stenosis، and female gender (P=0. 008). However، no significant correlation was observed between smoking and history of hypertension in terms of age (P<0. 05). There was no significant association between coronary artery and carotid stenosis occurrence. However، among independent risk factors، only females had an effective role in their co-occurrence. Therefore، considering the females with coronary artery or carotid stenosis and conducting preventive measures are recommended to prevent co-occurrence of these two problems.

Coronary disease is the most common cause of death in the world. Because of common risk factors، atherosclerotic stenosis of coronary and carotid arteries occurs together. This study evaluated the prevalence of carotid stenosis in diabetic candidates for angiography

In a cross-sectional study، 152 diabetic candidates for angiography referred to cardiology clinic of Shariati Hospital in 2011 went under angiography and Doppler echocardiography. Data were analyzed employing chi-square and ordinal regression.

Results indicated a negative correlation between carotid stenosis and coronary disease (P=0. 017) which means without coronary disease، there was 1. 7 times less risk for carotid stenosis. Age، duration of diabetes، side of carotid stenosis، and plaque size showed no effects on these variables، while female gender (P=0. 03)، no history of variables like smoking (P=0. 026)، hypertension (P<0. 001)، cerebral vessels disease (p=0. 003)، and family history of coronary disease (P=0. 01) showed significant effect on relation between coronary disease and carotid stenosis.

In diabetic patients with female gender، with history of smoking، hypertension، cerebral vessels disease and family history of coronary disease، carotid stenosis and coronary disease have co-incidence without relation to these factors. It appears that diabetes independently causes involvement in both carotid and coronary arteries.