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Background and Aim: By creating an international emergency, the COVID-19 pandemic may have led to compromised reproductive health care, including family planning services, and thus increased unintended pregnancies and unsafe abortions. This study was conducted to compare methods of contraception, abortion, and unintended pregnancies in those served by the health centers of Babol city in Iran, both before and during the COVID-19 pandemic. Methods: A cross-sectional study was conducted including 425 participants registered to the health centers of Babol city, Mazandaran province, Iran. Using a multi-stage method, 6 urban health centers and 10 rural centers were selected for inclusion. Proportional allocation method was used for sampling those who met the inclusion criteria. A questionnaire was used to collect data in relation to individual characteristics and reproductive behaviors via 6 questions focused upon methods and preparation of contraception, number and type of abortions, and number and causes of unintended pregnancy from July to November 2021. The data were analyzed using SPSS software version 26. Significance level was considered to be p < 0.05 in all tests. Results: Most participants aged between 20 and 29 years old had a diploma level of education, were housewives and lived in the city. Prior to the pandemic, 32.0% used modern contraceptive methods and 31.6% used these during the pandemic. No change in the combination of contraceptive methods used was observed between these two periods. Approximately two-thirds used the withdrawal method in both periods. The majority of participants in both periods purchased their contraceptives from a pharmacy. Unintended pregnancy increased from 20.4% prior to the pandemic to 25.4% during the pandemic. Abortions increased from 19.1% prior to the pandemic to 20.9% during the pandemic, although these findings were not found to be statistically significant. Contraceptive methods had a statistically significant relationship with age, education, spouse's education, spouse's occupation, and place of residence. The number of unintended pregnancies had a significant relationship with age, the educational level of both participants and their spouses and socio-economic status, and the number of abortions had a statistically significant relationship with the age and education level of the spouse (p > 0.05). Conclusion: Despite there being no change in contraceptive methods compared to the pre-pandemic period, an increase in the number of unintended pregnancies, abortions and illegal abortions was observed. This may be indicative of an unmet need for family planning services during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The WHO model has laboratory-based and non-laboratory-based versions for 10-year risk prediction of cardiovascular diseases. Due to the fact that in some settings, there may not be the necessary facilities for risk assessment with a laboratory-based model, the present study aimed to determine the agreement between laboratory-based and non-laboratory-based WHO cardiovascular risk equations. Methods: In this cross-sectional study, we used the baseline data of 6796 individuals without a history of cardiovascular disease and stroke who participated in the Fasa cohort study. The risk factors of the laboratory-based model included age, sex, systolic blood pressure (SBP), diabetes, smoking and total cholesterol, while the non-laboratory-based model included age, sex, SBP, smoking and BMI. Kappa coefficients was used to determine the agreement between the grouped risk and Bland–Altman plots were used to determine the agreement between the scores of the two models. Sensitivity and specificity of non-laboratory-based model were measured at the high-risk threshold. Results: In the whole population, the agreement between the grouped risk of the two models was substantial (percent agreement = 79.0%, kappa = 0.68). The agreement was better in males than in females. A substantial agreement was observed in all males (percent agreement = 79.8%, kappa = 0.70) and males < 60 years old (percent agreement = 79.9%, kappa = 0.67). The agreement in males ≥ 60 years old was moderate (percent agreement = 79.7%, kappa = 0.59). The agreement among females was also substantial (percent agreement = 78.3%, kappa = 0.66). The agreement for females < 60 years old, (percent agreement = 78.8%, kappa = 0.61) was substantial and for females ≥ 60 years old, (percent agreement = 75.8%, kappa = 0.46) was moderate. According to Bland–Altman plots, the limit of agreement was (95%CI: -4.2% to 4.3%) for males and (95%CI: -4.1% to 4.6%) for females. The range of agreement was suitable for both males < 60 years (95%CI: -3.8% to 4.0%) and females < 60 years (95%CI: -3.6% to 3.9%). However, it was not suitable for males ≥ 60 years (95% CI: -5.8% to 5.5%) and females ≥ 60 years (95%CI: -5.7% to 7.4%). At the high-risk threshold of 20% in non-laboratory and laboratory-based models, the sensitivity of the non-laboratory-based model was 25.7%, 70.7%, 35.7%, and 35.4% for males < 60 years, males ≥ 60 years, females < 60 years, and females ≥ 60 years, respectively. At the high-risk threshold of 10% in non-laboratory-based and 20% in laboratory-based models, the non-laboratory model has high sensitivity of 100% for males ≥ 60 years, females < 60 years, females ≥ 60 years, and 91.4% for males < 60 years. Conclusion: A good agreement was observed between laboratory-based and non-laboratory-based versions of the WHO risk model. Also, at the risk threshold of 10% to detect high-risk individuals, the non-laboratory-based model has acceptable sensitivity for practical risk assessment and the screening programs in settings where resources are limited and people do not have access to laboratory tests. [ABSTRACT FROM AUTHOR]

Background: There are a few studies evaluating the predictive value of Framingham risk score (FRS) for cardiovascular disease (CVD) risk assessment in patients with metabolic syndrome in Iran. Because of the emerging high prevalence of CVD among Iranian population, it is important to predict its risk among populations with potential predictive tools. Therefore, the aim of the current study is to evaluate the FRS and its determinants in patients with metabolic syndrome.Methods: In the current cross-sectional study, 160 patients with metabolic syndrome diagnosed according to the National Cholesterol Education Adult Treatment Panel (ATP) III criteria were enrolled. The FRS was calculated using a computer program by a previously suggested algorithm.Results: Totally, 77.5, 16.3, and 6.3% of patients with metabolic syndrome were at low, intermediate, and high risk of CVD according to FRS categorization. The highest prevalence of all of metabolic syndrome components were in low CVD risk according to the FRS grouping (P < 0.05), while the lowest prevalence of these components was in high CVD risk group (P < 0.05). According to multiple logistic regression analysis, high systolic blood pressure (SBP) and fasting serum glucose (FSG) were potent determinants of intermediate and high risk CVD risk of FRS scoring compared with low risk group (P < 0.05).Conclusion: In the current study, significant associations between components of metabolic syndrome and different FRS categorization among patients with metabolic syndrome were identified. High SBP and FSG were associated with meaningfully increased risk of CVD compared with other parameters.Trial Registrations: The study is not a trial; the registration number is not applicable. [ABSTRACT FROM AUTHOR]