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Ajoodani Z.,Islamic Azad University at Karaj | Ahari S.B.,Iranian Social Security Organization | Nasrollahi S.,Islamic Azad University at Karaj
Biosciences Biotechnology Research Asia

Cervical cytology is widely used for primary screening of cervical cancer. Once the Pap smear is reported as unsatisfactory for evaluation, the cervical intraepithelial lesions cannot be certainly diagnosed, which leads to false negative results. We investigated the frequency of unsatisfactory smears and their reasons. This prospective descriptive analytical study was conducted from June 2011 to September 2013, on women having Pap smear in Gynecology Clinic of Alborz Hospital in Karaj, Iran. The tests were done conventionally by cervical brush and then adequacy of specimens was assessed based on Bethesda system 2001 by one pathologist. Of 1557 cervical cytology specimens, the frequency of satisfactory and unsatisfactory smears were 445 (92.8%) and 112 (7.2%), respectively. The reasons for unsatisfactory smear included obscured by inflammation in 48 (42.9%) cases, obscured by blood in 42 (37.5%), insufficient cellularityin 11(9.8%), and poor fixation in 11 (9.8%). The results of this study showed that sampling by trained personnel, persistent supervision and use of appropriate equipment can reduce unsatisfactory Pap smears. Source

Haghighat S.,Shahid Beheshti University of Medical Sciences | Haghighat S.,Breast Cancer Research Center | Akbari M.E.,Shahid Beheshti University | Ghaffari S.,Iranian Social Security Organization | Yavari P.,Shahid Beheshti University of Medical Sciences
Asian Pacific Journal of Cancer Prevention

Introduction: Breast cancer is the most common cancer in women. Improvements of early diagnosis modalities have led to longer survival rates. This study aimed to determine the 5, 10 and 15 year mortality rates of breast cancer patients compared to the normal female population. Materials and Methods: The follow up data of a cohort of 615 breast cancer patients referred to Iranian Breast Cancer Research Center (BCRC) from 1986 to 1996 was considered as reference breast cancer dataset. The dataset was divided into 5 year age groups and the 5, 10 and 15 year probability of death for each group was estimated. The annual mortality rate of Iranian women was obtained from the Death Registry system. Standardized mortality ratios (SMRs) of breast cancer patients were calculated using the ratio of the mortality rate in breast cancer patients over the general female population. Results: The mean age of breast cancer patients at diagnosis time was 45.9 (±10.5) years ranging from 24-74. A total of 73, 32 and 2 deaths were recorded at 5, 10 and 15 years, respectively, after diagnosis. The SMRs for breast cancer patients at 5, 10 and 15 year intervals after diagnosis were 6.74 (95% CI, 5.5- 8.2), 6.55 (95%CI, 5-8.1) and 1.26 (95%CI, 0.65-2.9), respectively. Conclusion: Results showed that the observed mortality rate of breast cancer patients after 15 years from diagnosis was very similar to expected rates in general female population. This finding would be useful for clinicians and health policy makers to adopt a beneficial strategy to improve breast cancer survival. Further follow-up time with larger sample size and a pooled analysis of survival rates of different centres may shed more light on mortality patterns of breast cancer. Source

Haghighat S.,Breast Cancer Research Center | Haghighat S.,Shahid Beheshti University of Medical Sciences | Akbari M.E.,Shahid Beheshti University of Medical Sciences | Yavari P.,Shahid Beheshti University of Medical Sciences | And 2 more authors.
Iranian Journal of Cancer Prevention

Background: Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease. Objectives: We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer. Patients and Methods: This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs. Results: The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively. Conclusions: Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making. © 2016, Iranian Journal of Cancer Prevention. Source

Mirdamadi A.,Islamic Azad University at Najafabad | Dashtkar S.,Islamic Azad University at Najafabad | Kaji M.,Iranian Social Security Organization | Pazhang F.,Iranian Social Security Organization | And 2 more authors.
ARYA Atherosclerosis

BACKGROUND: Venous thromboembolism (VTE) and deep vein thrombophlebitis (DVT) is a serious problem with high mortality and morbidity rates. This study was conducted to compare efficacy and safety results of the two types of VTEpreventing in patients underwent total knee arthroplasty (TKA).METHODS: Having considered exclusion criteria, 90 patients of 136 ones were registered in the study. Our patients of TKA were split randomly in two groups. Totally, 45 patients received enoxaparin, 40 mg 12 h before surgery and treated by 40 mg daily up to 15 days. The second group (45 patients) were treated by dabigatran 150 mg 4 h after surgery and 225 mg daily up to 15 days. Efficacy was evaluated by Doppler sonography after 15 days for the presence of DVT and safety was determined by 3 months follow-up for all-cause mortality and any major or minor bleedings.RESULTS: Two groups were similar in baseline characteristics. The efficacy outcome events occurred in 2.2% (2 of 90) of the patients (1 symptomatic VTE in dabigatran and 1 in the enoxaparin group) without significant statistical difference between groups (P = 0.64). In terms of safety, 3 patients (6.6%) in dabigatran and 2 patients (4.4%) in enoxaparin group had major bleeding (P = 0.66) and 8 patients (17.7%) in dabigatran and 7 patients (15.7%) in enoxaparin group had non-major bleeding event (P = 0.81). There were no death, pulmonary emboli, and cardiac events during follow-up.CONCLUSION:Three months follow-up did not show statistical difference in efficacy and safety between dabigatran and enoxaparin. Future studies with mentioning to later outcomes for checking safety are warranted. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved. Source

Mojtaba R.-B.,Institute of Applied Scientific Education of Jahad e Agriculture | Hamidreza S.,Iranian Social Security Organization | Rohollah Z.,Iranian Social Security Organization
Biosciences Biotechnology Research Asia

Business Process Reengineering (BPR) in the management literature is defined as a fundamental rethinking and a radical and new design of process to achieve significant improvements in the benchmark measures such as price, quality, service and speed. This study examines the relationships between structural characteristics (complexity, formalization and centralization), and human resources management (recruitment, maintenance and improvement) on the BPR implementation in the Social Security Organization (SSO) to check the possible impacts of the special features of SSO and cultural challenges of the organization on the BPR process. This was a descriptive-survey study conducted on the managers and supervisors of 16 headquarters and health and insurance units of the SSO, selected using Morgan Table and relative stratified random sampling methods. Standardized questionnaires were distributed among 210 members and 132 were collected. The descriptive analyses of the variables and the relationship between the variables and the BPR implementation were assessed. The data analyses using structural equation modeling showed a significant relationship between the structural features of SSO, human resources management and implementation of the BPR. Additionally, there was a significant relationship among the complexity variables, formalization, centralization (elements of organizational structure), recruitment, keeping and development of human resources (human resource management elements) and BPR implementation of SSO. It is recommended to study the effects of the governmental organizations on the BPR implementation to determine the priorities. In addition, further studies to evaluate the impacts of the occupational levels of managers and supervisors involving in the BPR implementation are recommended. © 2015, Oriental Scientific Publishing Company. All rights reserved. Source

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