Showing 6 results for Effect
Arash Hossein-Nezhad, Bagher Larijani,
Volume 1, Issue 1 (7-2001)
Abstract
Background: Estimation of cost effectiveness and cost benefit are intrinsic to the design and evaluation of healthcare systems. The aim of most studies of gestational diabetes screening has been to modulate screening parameters to reduce the eligible population and therefore costs. We analysed the findings of a cross-sectional study of gestational diabetes mellitus carried out in Tehran to determine the screening method best suited to the socio-economic profile of our population.
Methods: 2416 pregnant women were universally screened in Tehran teaching hospitals. Each patient’s risk factors and laboratory results were recorded. The 50gGCT was used to screen and the 100gOGTT to confirm a diagnosis of GDM.
Results: Switching from the 130mg/dl to the 140mg/dl threshold, case-detection sensitivity declined by 12% (to 88%), with the per-pregnancy cost dropping from 30,410 to 25,641 Rials (from US$3.80 to 3.20) [-15.6%], and the cost per detected case from 644,488 to 619,500 Rials (from US$80.56 to 77.43) [-3.87%].
Conclusion: We recommend adoption of the universal screening approach in Iran for 4 reasons: (1) The high prevalence of gestational diabetes in the low-risk group (2) The poor level of healthcare provided in Iran compared with societies that have opted for the selective approach (3) The lower cost of screening and diagnostic tests in Iran compared with the aforementioned and (4) The high cost of treating the complications of diabetes.
Ozra Tabatabaei Malazy, Ramin Heshmat, Seyed Akhavan Hejazy Mogaddam Sa, Eghbal Taheri, Seddigheh Soheilykhah, Farzaneh Darvishzadeh, Bagher Larijani,
Volume 5, Issue 1 (8-2005)
Abstract
Background: Metformin is usually using for glycemic control in type 2 diabetes mellitus. The drug is the first line for obese patients without renal or liver failure. Different pharmaceutical types of Metformin are available. As a clinical trial, we compared effects of Aria Metformin (product of Aria pharmaceutical company, Iran) with Merck Metformin or Glucophage (product of Merck pharmaceutical company, France), in diabetic patients.
Methods: This double blind randomized clinical trial study performed with 60 non- pregnant diabetic patients, in order to comparison of therapeutic effects of combination therapy (Glibenclamide + Metformin "Aria or Merck") in a 12 weeks period. We evaluated FBS, BS 2hpp, HbA1c, lipid profile, liver function tests, weight, BMI and common or uncommon side effects.
Results: Not only each of two pharmaceutical types of Metformin had the same therapeutic effects for controlling of glycemia, lipid profile and weight, but also there were not difference between them in side effects. Distention was the most common side effects of two types products (33%). There is not significant difference between them in common side effects. 70% of patients were satisfied with each two kinds of Metformin.
Conclusion: It seems, in view of beneficial therapeutic effects of Aria Metformin, low rate of side effects, and finally low cost, Aria Metformin is a good choice.
Mohammad Asghari Jafarabadi, Akbar Soltani, Seyede Momeneh Mohammadi,
Volume 13, Issue 3 (3-2014)
Abstract
The P-Value cannot present a complete measure of association in medical studies considering the
association between categorical variables. In such situations, measures are required to reveal the
clinical importance of relation along with their statistical significance, as the effect size. This paper
aims to introduce the measures of associations for categorical variables and inferences about them in
these studies. Principles and method of calculating measures of associations and inference about them
including confidence interval and hypothesis testing were presented to assess the relationship between
qualitative variables for all types of medical studies taking into account relevant considerations.
Additionaly, the method of reporting of findings were introduced in the context of contingency tables.
To investigate the relationship between two binary qualitative variables, should be used the Odds
Ratio in cross-sectional or case-control studies, the relative risk in cohort studies, and prevalence ratio
in cross-sectional studies and risk difference in all type of studies along with their confidence intervals
and/or their significance tests considering the independent or related groups of studies. Additionally,
for bigger than 2 by 2 tables, the method of calculating of above mentioned measures considering a
reference category and other measures such as Phi, Crammers V, contingency and uncertainty
coefficients , Lambda, Gamma, Summers D, Kendals tau-b and tau-c would be recommended. In each
of these situations, based on research based examples, calculations of tests were performed and their
results were presented. To investigate the relationship between a set of risk factors and binary and
multi-category qualitative variables, the introduced analyses are recommended considering the
situation and purpose of the proposed study.
Mohammad Asghari Jafarabadi, Seyede Momene Mohammadi, Akba Soltani,
Volume 14, Issue 2 (1-2015)
Abstract
In medical studies, measures are required to reveal the effect of exposures and interventions and also the precision of measurements. This paper aimed to introduce the measures of effect and agreement and inferences about them in these studies. Principles and method of calculating measures of effect and agreement and inference about them were presented for all types of medical studies taking into account the relevant considerations. To assess the effect of risk factors on outcomes in case-control and cohort studies, and to determine the relevant effect, the attributable risk and fraction in the exposed group and population were used along with their confidence intervals. Also the relative risk reduction, absolute risk reduction and number needed to treat were applied as the measures of effect of intervention in the interventional studies especially in trails. The sensitivity, specificity and related measures along with their confidence intervals were computed for diagnostic accuracy and screening studies. In addition it is needed to evaluate the precision of measurements using standard error of measurements, ICC, Altman and Bland’s limits of agreement and Lin’s concordance correlation coefficient for quantitative variables and using kappa and weighted kappa for nominal and ordinal variables. In each of these situations the results of research based examples were presented along with the methods of their calculations.To assess the measures of effect and agreement, the mentioned analyses are recommended considering the situation and purpose of the study.
Tahereh Keramati, Farideh Razi, Mohammad Reza Mobinizadeh, Alireza Oliaei Manesh, Bagher Larijani,
Volume 15, Issue 1 (1-2016)
Abstract
Background: Diabetic patients need to be followed for glycemic index regularly and HbA1c test is one of the most important biochemical markers for patient monitoring. HbA1c should be standardized based on international standards, but using internationally accepted assays are expensive. This study aimed to evaluate cost effectiveness of different assays which are currently used in Iran.
Methods: In this economic evaluation study, five HbA1c assays (Pars Azmoon, NycoCard, DS5, Biosystems and CERA STAT 2000) have been evaluated for cost, sensitivity and specificity, true score and also incremental cost-effectiveness ratios. Tosoh G8 has been considered as reference method.
Results: Although none of the assays can be a good alternative for reference method, DS5 and pars azmoon had better cost effectiveness results compared to other assays.
Conclusion: The quality of HbA1c assays need to be improved by using real tariff or the establishment of referral labs.
Dr Parisa Saberi-Hasanabadi,
Volume 24, Issue 5 (12-2023)
Abstract
Background: Despite advances in diabetes-related treatments, the effects of the disease have not yet been adequately reversed or prevented in patients.
Methods: In this study, type 1 diabetes mice models was established using multiple low-dose alloxan, and the diabetic mice were treated with three doses of dimethyl fumarate (DMF) i.e low, medium, and high viz. 20, 40 and 80 mg/kg, respectively for a period of 21 days. Then, specific test were done to evaluate blood biochemical parameters, oxidative stress markers, inflammatory genes expression, and histopathological changes in the mice kidney and liver.
Findings: The obtained results showed remarkably improved anti-diabetic, hepato-renal-protective, and oxidative stress indexes of DMF in alloxan-induced diabetic mice (p< 0.001). Treated mice with DMF demonstrated a noteworthy decrease in blood glucose levels when compared with diabetic group (p< 0.001). On the contrary, the histological features of the treated mice with DMF improve as shown by normal size of glomerular capillaries along with decrease in less dilatation of ducts in comparison with diabetic mice. The real-time quantitative PCR results indicated that DMF injection decreased the alloxan-induced increase of significant elevations in mRNA levels of pro-inflammatory cytokines levels in both kidney and liver tissues. Meanwhile, mice treated with DMF showed an increase in Sirt1 and Nrf2 expression in comparison to diabetic group.
Conclusion: In conclusion, it can be concluded that DMF treatment provides hepato-renal protective effects on alloxan-induced diabetic mice model by attenuating ROS inflammatory pathways.
