Iranian Journal of

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Background & Objectives: Cancer has been traditionally regarded as a fatal disease it is a major public health problem in many countries throughout the world. In recent years, cancer morbidity and mortality has increased in our country and notably stomach cancer now ranks second or third among all cancers types with regard to morbidity.
Methods: Our study included all gastric cancer patients registered in the cancer registry of Fars province. The patients' survival status was followed using phone calls and death records from hospitals, other medical centers, and the city's cemetery. Data analysis involved the use of the nonparametric Kaplan-Meier and Cox proportional hazards models and was performed with the software package SPSS V.13.
Results: Of the 442 patients with gastric cancer, 303 cases (68.6 percents) were male, and the mean age of patients was 58.41 years (SD=14.46). In univariate analysis with the KM method, a statistically significant association was found between survival rates and the following factors: age at diagnosis (P<0.001), tumor grade (P=0.009), presence of metastases (P<0.001), and type of the initial treatment (P=<0.001). Factors without a significant relationship with the survival rate included sex, ethnicity, weight, BMI, tobacco use, history of cancer in close or distant relatives, place of residence, number of children, marital status, occupation, and income. In Cox regression, only age at diagnosis, tumor grade, and the presence of metastases showed a significant association with survival rates.
Conclusions: Our results imply that early detection of cancer at a lower age and in lower tumor grades could be important for increasing the patients' life expectancy.

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Background & Objectives: Although Cox regression is commonly used to detect relationships between patient survival and demographic/clinical variables, there are situations where parametric models can yield more accurate results. The objective of this study was to compare two survival regression methods, namely Cox regression and parametric models, in patients with gastric carcinoma registered at Taleghani Hospital, Tehran.
Methods: Using data from 746 patients who had received care at Taleghani Hospital from February 2003 through January 2007, we compared survival rates between different patient groups with both parametric methods and Cox regression models. The former group included Weibull, exponential and log-normal regression we used the Akaike Information Criterion (AIC) and standardized parameter estimates to compare the efficiency of various models. All the analyses were performed with the SAS software and the level of significance was set at P< 0.05.
Results: The results showed a significantly higher chance of survival in the following subgroups: those with age at diagnosis < 35 years, lower tumor size and those without metastases (P< 0.05). According to AIC, Cox and exponentials model are similar in multivariate analysis but in univariate analysis parametric models are more efficient than Cox, except in the case of tumor size. Log-normal appears to be the best model.
Conclusions: Cox and exponential models have similar performance in multivariate analysis. However, it seems that there is no single model that performs substantially better than others in univariate analysis. The data strongly supported the log-normal regression among parametric models it can give more precise results and can be used as an alternative for Cox in survival analysis of patients with gastric cancer.

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Background & Objectives: Today, the quality of life study has an important role in health care especially in chronic diseases, in clinical judgment and in medical resources supplying. Malignancies have a clinical and health importance in the world and Iran. Breast cancer has first order among women’s malignancies. Now, survival rate for this cancer is long. However Breast cancer has several complications that affected patient’s life. It is necessary that we studying the quality of life and related factors among this patients.
Methods: We conducted a cross-sectional study on 119 breast cancer patients that admitted and treated in chemotherapy ward of Namazi hospital in Shiraz.We used QLQ-C30 & QLQ-BR23 to assessment quality of life in these patients. We used univariate nonparametric tests and multiple linear regression model to identify associations between dependent variables and the quality of life and it’s different scales.All calculation performed by using SPSS.V.13.
Results: Mean age of patients was 48.27±11.42 with quality of life total score 64.92±24.28. Univariate analysis showed that occupation,duration of disease,grade of tumor,physical,emotional and cognitive functioning, also, symptoms such as fatigue,pain, nausea and vomiting , insomnia , constipation and financial difficulties, perspective were associated to quality of life. (P< 0.05). But in multivariate analysis, only occupation, menopause status, dyspnea , grade of tumor and financial difficulties perspective were related to quality of life (p<0.05).
Conclusions: With this finding, It is recommended that financial supports, also early detection are necessary for improvement of quality of life in these patients

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Dear Editor We read with interest the recent original article by Esmailnasab and his colleagues (1) discussing the issue of influencing factors on type 2 diabetes in Sanandajd. The authors are to be congratulated for conducting such an important topic both for healthcare providers and researchers. We have noticed that in that interesting paper the occupational status was classified unclearly into four categories as "housekeeper", "employee", "farmer and free job" and "unemployed" that the journals reviewers have been overlooked this easily. Since one of the main characteristic of occupation is making money, some groups such as "student" and "housekeeper" are excluded from this category. There are several international classifications for occupational status that can be used for national studies in Iran. These categorizations also called "social class" that considered to occupational exposure, amount of income and some other components. One of these classifications is presented by the International Labor Organization (ILO). A number of countries have localized this classification and many countries have used it without changes (2). The latest revised classification (ISCO) has been revealed 11 occupational groups (major group) provides the following (3): 1- Legislators, senior officials and managers, 2- Professionals, 3- Technicians and associate professionals, 4- Clerks, 5- Service workers and shop and market sales workers, 6- Skilled agricultural and fishery workers, 7- Craft and related trade workers, 8- Plant and machine operators and assemblers, 9- Elementary occupations, 11- Armed forces. It seems that with modification of such classifications, we could obtain a national standard categorization for occupation and then would be able to better understanding the role of occupation in development of disease and health problems.

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Background & Objectives: Chronic pain is one of main public and individual health problems and its epidemiological understanding needs reliable estimates of prevalence. The aim of this study was to investigate the epidemiology of chronic pain in all 368 neighborhoods of Tehran using small area estimation method.
Methods: The pain section from the second round of Urban HEART data from a selected individual of 23457 households in Tehran using a multistage randomized cluster sampling in 2011, were analyzed. In order to obtain reliable estimates for chronic pain prevalence at neighborhood level, a generalized linear mixed model and hierarchical Bayesian approach were used and the reliability of the estimates were evaluated.
Results: The average of estimated prevalence of chronic pain in neighborhoods of Tehran was 25.5% and a large heterogeneity was observed in its prevalence in neighborhoods of Tehran. Prevalence of chronic pain was significantly higher in married housewives, retirees and pensioners and was significantly associated with age, educational status, depression and anxiety (P<0.05). The reliability of Bayesian method was confirmed by evaluation methods in this analysis.
Conclusion: These results demonstrate prevailing amount of chronic pain at neighborhood-level in Tehran, which warrants careful attention to prevention, treatment, and rehabilitation by health care professionals.

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