Aa Haghdoost,
Volume 5, Issue 1 (6-2009)
Abstract
Sample size estimation is one of the crucial issues in the research methodology in medical sciences. It is an important issue for not only researchers but also readers of medical papers their frequent questions show how much they need to simple but accurate information.
This paper presents the basic concepts of sample size calculation, and simplifies complicated issues using concrete examples to clarify the concept of sample size estimation for none-professional readers in statistics. The paper starts with explaining the basic concepts of sample size calculation such as effect size, confidence interval and confidence coefficient, statistical errors, and assumptions in sample size calculation. Then, it presents the common formulae in the sample size calculation to estimate a mean, a proportion, to compare two means and to compare two proportions.
M Osooli, Aa Haghdoost, Sh Yarahmadi, Mh Foruzanfar, M Dini, K Holakouie Naieni,
Volume 5, Issue 1 (6-2009)
Abstract
Background and Objectives: The aim of this study was to assess the geographical distribution of Congenital Hypothyroidism (CH) in Iran using Geographic Information System
Methods: The incidence of Congenital Hypothyroidism in each city and province calculated based on national CH screening program and then the map of its distribution was depicted. The spatial distribution of CH was assessed in each city by employing binominal test and Hotspot Analysis. The map of distribution of CH was drawn by ArcGIS version 9.2 software.
Results: The national incidence of CH (including both transient and permanent types) has been estimated 2.2/1000 in screened new borne babies. The distribution of CH seems more or less equally around the country and its spatial variation was not statistically significant. We did not find any specific CH Hot Spot in Iran.
Conclusions: We did not find any particular explanation for high incidence of CH is Iran geographically therefore other explanations for such a high risk in screened neonates should be investigated including the non-environmental factors and factors related to quality of screening program in Iran.
M Babakhani,
Volume 5, Issue 1 (6-2009)
Abstract
ackground & Objectives: In fact, economic growth, income inequality and health are integrated issues. Economic growth along with increasing income lead to individuals' health promotion and public health and has a positive impact on it, but if there is inappropriate policy to redistribute of these resources, it would have reverse effects. The purpose of this study was to examine the relationship between economic growth and ecological income inequality indices with health in Iran from 1978 to 2006.
Methods: An ecological study was designed and relevant data were gathered from the statistics center of Iran and Iran Central Bank.
Results: The correlation between Gini coefficient and health indices was statistically significant (P<0.01). The association between economic growth and mortality rate of children under five years index (P<0.01) and with life expectancy (P<0.05) were statistically significant as well.
Conclusions: Economic development and decreasing income inequality should be considered as important determinant factors to have better health in Iranian society.
J Poorolajal, P Tajik, B Yazdizadeh, M Sehat, Ar Salehi, M Rezaei, K Holakouie Naieni,
Volume 5, Issue 1 (6-2009)
Abstract
Background & Objectives: Observational studies are not often reported in detail and clear enough, so that assessment of the strengths and weaknesses of these studies is not straightforward. To improve the reporting of observational studies, a checklist of items called ‘Strengthening the Reporting of Observational Studies in Epidemiology’ (STROBE) was developed by some experts in October 2007. The aim of this study was to assess the quality of reporting of observational studies before STROBE statement.
Methods: We included randomly sixty cohort studies published in six important international journals until October 2007. Then, we used STROBE checklist to assess the strengths and weaknesses of these included studies.
Results: On average, more than 81% (95% CI: 77%-87%) of included studies pointed to 43 items of aim of this study. The most reported (100%) items were "scientific background" and "rationale for the investigation" and the less reported (30%) item was “flow chart”.
Conclusions: Although, the quality of reported cohort studies’ results was acceptable, the type of study, journal and date of publication could influence on the quality of observational studies.
Aa Ramezani, M Miri, M Hanafi, H Zangooi,
Volume 5, Issue 1 (6-2009)
Abstract
Background & Objectives: vaccination is one of the most important index for disease prevention program. Therefore this study conducted to assess the coverage of vaccination program to identify the delay or disruption of program in 2005 year.
Methods: Health profiles (vaccination card) of children between 15-26 months assessed. We did interview with their mothers as well. This survey was conducted in rural and urban area in southern Khorasan province in Iran during 2005.
Results: The coverage of children and mother's vaccination were 96.7% and 71.1% respectively. The study findings showed that inadequate information about the arrangement of dosage, distance to health centre and feeling the necessity of vaccination were most factors for incomplete converge of vaccination program.
Conclusions: Based on study findings educational program to increase mothers awareness is recommended.
H Eftekhar, K Mohammad, Ss Tavafian, K Mirkarimi, A Ramezanzadeh,
Volume 5, Issue 1 (6-2009)
Abstract
Background and objectives: Although in many developed and developing countries, self care is the most important part of primary care, in Iran it has not been supported as well as its values. The aim of this study was to assess the views of general people living in south of Tehran about self care.
Methods: This was a population based study in which 1200 individuals aged 15 years and over were interviewed using cluster sampling. A structured interview questionnaire which including 5 sections on regarding demographic characteristics, views on general health, views on self care knowledge, interest and practice, views on barrier and enabler factors for self care, and views on sources of information was used. Content validity and cronbach’s alpha coefficient was used for its validity and reliability. Data were analyzed through spss version 11.
Results: The mean age of participants was 27.9 ± 5.2 years. Six hundred and fifty eight respondents (55%) stated they were not knowledgeable on self care, 986 (82%) and 1035 (86%), were interested and self rated themselves active regarding healthy life style, respectively. In practice, only fifty three participants (4%) were actually active in eating ≥7 glasses of water daily, 31 (3%) stated they ate more than five portions of fruits daily and 51(4%) did physical activity more than 3 hours weekly.
Conclusions: The findings of this study have highlighted the significant role of information in doing self care activities.
Gh Hassanshahi, M Kazemi Arababadi, Er Zarandi, M Moradi, R Vazirinegad, H Yousefi Darehdor, Se Pourhosseini, Sma Sajadi, M Arasteh,
Volume 5, Issue 1 (6-2009)
Abstract
Background and objectives: People with thalessemia and chronic renal failure on maintenance hemodialysis are prone to blood-born infections, especially hepatitis C due to the long-term transfusion. Recently, hepatitis C has been one of the main health concerns in these patients. The aim of this study was to determine the prevalence of hepatitis C and its risk factors in these groups of patients in Kerman province of Iran.
Methods: HCV RNA in blood sample of 384 patients (203 hemodialysis cases and 181 thalassemia cases) was evaluated.
Results: One hundred thirty (130) out of 384 were infected by HCV. Infected male was predominant (83%).
Conclusions: It seems that the frequency of hepatitis C infection in Kerman is higher than the other provinces of Iran. Therefore more attention should be paid to screen of blood before transfusing for these group of patients.
A Alipour, N Habibian, Shr Tabatabaee,
Volume 5, Issue 1 (6-2009)
Abstract
Background and objectives: Iranian family physician care program as a new program has begun since 2005 to deliver a better service particularly in primary health care. The objective this survey was to evaluate the impact of this program on family planning in Sari city between 2003-2007.
Methods: This survey was conducted among all women 15-49 years who married. Required data were collected from health files. The pattern of time trend evaluated and relevant indices compared before and after the family physician program.
Results: The application of condom, hormone injection, vasectomy and total modern contraceptives increased but employing the methods of tubectomy, IUD, OCP, Norplant and traditional method were descending. This variability for condom, tubectomy and traditional methods were statistically significant (p<0.05). However for other methods were not statistically significant (p>0.05). Difference of contraceptive using rates in pre and post of the application of program for condom, hormone injection, tubectomy and OCP were statistically significant (p<0.05) and for others were not statistically significant (p>0.05).
Conclusions: It seems relatively success of family physician program on family planning in Mazandaran province however more human resource should be allocated to family planning.
H Soori,
Volume 5, Issue 2 (9-2009)
Abstract
Translated by Hamid Soori with permission from the BMJ Publishing Group and in coordination with International Journal of Epidemiology.
R Nosratabadi , E Saneimoghadam , M Arababadi, S Khosravi , Gh Hassanshahi , R Vazirinegad ,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Anaphylactic reaction is one of the most important transfusion anaphylactic reactions in medicine. During transfusion if Individuals with IgA deficiency take blood which containing IgA, they would suffer from severe allergic reaction. Since there is a little known about this in different ethnic groups in Iran we have decided to evaluate this issue in Sistan & Baluchestan province in Iran.
Methods: During one year, blood samples were collected from 3837 volunteer blood donors. Then the serum samples were tested for IgA titer by nephlometry and SRID techniques.
Results: According to our results only, one donor (0.026%) was found to have IgA less than 5mg/dl and 34(0.9%) cases had IgA: 5-30 mg/dl while 3798(99%) had IgA more than 30mg/dl.
Conclusions: With regards to very low prevalence of IgA deficiency in blood donors in Southeast part of Iran, it seems that anaphylactic reactions most likely be due to other factors in the individuals that receive blood products.
F Farivar, R Heshmat, B Azemati, Sh Abbaszadeh Ahranjani, Aa Keshtkar, R Sheykholeslam, A Nadim,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Lack of nutritional knowledge is one of the most important reasons of nutritional problems worldwide and consequently, improper practice which can lead to several complications such as: malnutrition and non-contagious diseases. This study has been designed to investigate the knowledge, attitude and practices of the urban households regarding practical principals of nutrition in Boushehr, Golestan, and Sistan & Balouchestan provinces in 2004.
Methods: Evaluation of knowledge, attitude and practice of urban households towards practical principals of nutrition in mentioned provinces was carried out by this cross sectional study. The sampling method at the level of the households in each province was the single-stage cluster sampling with equal size clusters. The necessary data were gathered with a structured questionnaire and via the interviews between the questioners and the eligible people in each household.
Results: A total of 1154 individuals were participated in this survey. Approximately seventy percent of individuals were aware about having basic four food groups and 45% of them were also aware of role of food group in human body. Majority of people had acceptable attitudes toward nutrition. Based on standard criteria consumption of meat was rare and consumption of fish was in medium level, legumes in high level, fruits and vegetables, milk & dairy products were in acceptable level. Consumption of carbonated beverages, junk foods and sugar were in high level.
Conclusion: The findings of this study imply a need for effective implementation of nutritional community interventions by health policy makers in Iranian health systems.
S Pirouzpanah , Fa Taleban, Ar Abadi , M Atri , P Mehdipour,
Volume 5, Issue 2 (9-2009)
Abstract
Background & Objectives: The repression of retinoic acid receptor-β2 (RARβ2) expression is a concerning aspect of breast cancer, which is often induced by hypermethylation at promoter of the gene. We aimed to explore the correlation of plasma folate, vitamin B12 and total homocysteine (tHcy) levels with hypermethylation status of RARβ2 gene among Iranian breast cancer patients.
Methods: The hypermethylation status was investigated in 137 specimens tissues from primary breast cancer patients aged 28-85 years thorough methylation-specific PCR.
Results: Hypermethylation at RARβ2 gene was observed in 36.5 %. The hypermthylated RARβ2 associated with younger age at diagnosis and negative family history of breast cancer. The plasma level of folate was found lower in cases aged ≥48 years with hypermethylated RARβ2 gene (P<0.05). In contrast the level of tHcy was shown higher in cases aged <48 y (P<0.05). The risk of hypermethylation at RARβ2 gene increased with low plasma levels of folate (OR=0.21, 95%CI: 0.05-0.88) and vitamin B12 (OR=0.04, 95%CI: 0.01-0.92) and high plasma level of tHcy (OR=7.55, 95%CI: 1.07-25.7) in cases older than 48y.
Conclusions: Low plasma levels of folate, Vitamin B12 and high plasma level of total homocysteine could have important roles as prognostic factors in hypermethylation status of RARβ2 gene in breast cancer.
Shr Tabatabaee, O Fazalzadeh,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Publication of scientific articles nowadays is one of the important indexes of knowledge production. This index plays a key role for ranking in academia. The aim of this study was to assess the how academic staff in Shiraz Medical Sciences University considered the principle of scientific writing.
Methods: In a cross-sectional study 200 published papers among 1104 paper registered to vice chancellor of research from 2002 to 2007 were selected with systematic random sampling method.
Results: Among 200 papers, 190 (95%) had corresponding author from faculty members. Twenty three percents (23%) of papers were in basic sciences field and 72% were in clinical field. In 19 (9.5%) of papers either an epidemiologists-biostatistician or social medicine specialists were coauthor. Forty five (22.5%) of published papers, consisted of descriptive studies and the rest were analytic studies. Maximum faults in descriptive studies were the missing of time interval stating (26%). In case-control studies, 59% of papers had not stated diagnosis criteria and disease definitions. In cohort studies and clinical trials, 90% and 85% of papers had not expressed the number of missed patients during study, respectively.
Conclusions: With regards to findings of this study, scientific writing and research methodology short course as continuing development professional for academic staff should be emphasized in academic institutes in Iran.
Keywords: Scientific writing, Journals, Shiraz,Iran
A Kabirzadeh, A Zamani Kiasari , Mr Habbibi , B Mohseni Saravi , M Khademlo, T Hakimi Moghadam ,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Making an accurate clinical diagnosis can be a great challenge with pediatricians. We aimed to compare the initial diagnosis and final diagnosis for hospitalized children in one teaching hospital in Iran.
Methods: In this cross-sectional study, patients’ clinical files were used. The relationship between variables was assessed by ANOVA and X2 statistical tests. The agreement rate between final and primary diagnosis was evaluated by Kappa coefficient.
Results: A total of 1310 patients’ hospital files were reviewed. There were 1244 (94.9%) cases with complete agreement, 12 (0.9%) with relatively agreement and 54 (4.2%) cases without agreement. The overall Kappa coefficient for primary and final diagnosis was 0.88.
Conclusions: The agreement rate between primary and secondary diagnosis in this teaching hospital was high. This might be due to academic atmosphere in teaching children hospital
L Manavifar, H Nemati Karimooy , A Nejat Shokuhi , A Sheerdel , M Shakeri , M Mahjoob ,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Incidence of neurocognitive and psychologic disorders in elderly seems to become high There are numerous factors affecting neurocognitive functions like vascular factors, Vitamin B12 and folate and homocysteine levels. The aim of this study was to assess the relation between neurocognitive- psychologic markers and homocystein (Hcy), V.B12 (Cobalamin) and folate in serum.
Methods: Two hundred eighty elderly people admitted to Emam Reza Teaching Hospital in Mashahd, Iran. neurocognitive-psychologic disorders was diagnosed by a trained physician. Serum cobalamin, folate and homocystein measured by RIAand ELIZA methods, respectively.
Results: Based on Hcy>15 µmol/l level, cut off point <330 pg/ml for serum cobalamin and <6.5 ng/ml for folate deficiency defined as deficiency. The correlation between cobalamin and folate was statistically significant (p=0.000). Hemocystein correlated inversely to cobalamin (p=0.001) and folate (p=0.044). There were no statistical significant between Cobalamin, Folate and Hcv>15µmol/l and neurocognitive & psychologic markers unless Deep Tendon reflex test (P=0.04). All patients with dementia had hyperhemocysteinemia.
Conclusions: Despite the plausible biochemical mechanism, further diagnostic studies, based on clinical, neuropsychological, laboratory features will be necessary to better understand this fascinating biochemical challenge.
N Shams Alizadeh , Ar Delavari , A Sheirdel, B Mohsenpour , E Ghaderi,
Volume 5, Issue 2 (9-2009)
Abstract
Background and Objectives: Measuring the quality of life is one of the important indicators in evaluating health. The chronic disease is a one of the main cause of reduction in quality of life. The aim of this study was to assess the quality of life and its influential factors in 15-64 years old people in Kurdistan province, Iran.
Methods: In this cross-sectional study EUROHIS-QOL 8-item questionnaire was employed. Data was analyzed by SPSS statistical package.
Results: After adjusting the possible confounders, the mean score of quality of life was less in smoker 1.41 score versus non-smoker, in women 1.52 score versus men, in hypertension patients 1.41 score versus non-hypertension. The mean score of quality of life was reduced 0.05 per each year.
Conclusions: It is recommended to implement some interventions to manage properly current chronic diseases in order to increase the quality of life. It also seems that EUROHIS-QOL (8-item) is a suitable tool to measure the QOL in Iranian culture.
A Akbarzadeh Bagheban, A Beaji, Y Mehrabi, H Saadat,
Volume 5, Issue 3 (12-2009)
Abstract
Background and objective: Numerous studies have reported beneficial effects of smoking cessation in terms of decreased cardiovascular mortality in patients with coronary heart disease. This paper aimed to determine a valid estimate for the relative risk of mortality in subjects who quit smoking compared to those continued smoking.
Methods: All relevant prospective cohort studies of chronic heart disease published during 1975 to 2008 were considered. Studies with at least two years follow-up were eligible for analysis. The qualities of studies were assessed independently by two reviewers. In addition, to obtain a precise estimate, we used the sample size and the follow-up duration of each study as the covariates in the Bayesian meta-analysis model. The Winbugs and Boa softwares were utilized for fitting the Bayesian meta-analysis model.
Results: The estimate of relative risk of mortality for those who quit smoking compared to those continued smoking was 0.64 (95%CI: 0.57-0.70). We also did not find any significant relationship between the estimate of risk reduction and the described covariates.
Conclusions: Using this Bayesian meta-analysis, a 36% reduction in relative risk of mortality was found for those who quit smoking compared to those continued smoking, after eliminating the effects of study sample size and follow-up duration.
R Hokmabadi, H Soori, Mj Jafari,
Volume 5, Issue 3 (12-2009)
Abstract
Background & Objective: Road traffic injuries (RTIs) are the leading cause of burden of disease in Iran. Determination of road safety situation as a complex issue can reduce injury and death rates on roads. This study aimed to determine the effective indicators of road safety and introduce approaches to combine different indicators for implementation index to assess the road safety situation of Iran.
Methods: In this analytical and comparative study eleven indicators which have been categorized in nine dimensions were employed. Indicators normalized with maximum and minimum measures and three approaches were used to calculate the index. In order to put index into practice, data collected from eleven Association of Southeast Asian Nations (ASEAN) countries. Comparison was performed by al-Haji index which has been development for ASEAN countries in 2007.
Results: The findings indicated that weighted index results based on previous experience are similar to al-Haji index and correlations between them are statistically significant (r=0.997). This study showed a remarkable difference between some selected countries. Singapore and Brunei have the best index records, Malaysia, Thailand, Philippines have the medium index records, Iran (with score 36.81), Indonesia, Myanmar, Cambodia, Vietnam and Laos have the least index records.
Conclusions: Findings of study indicate that Iran needs implementation composed index of risk factors to prevent RTIs and to assess better performance on road safety. The road safety in our country is still far from the desired condition therefore, more attention is necessary to be done to reduce injury and mortality rates in Iran.
S Athari Nik Azm, Mr Vafa, I Nourmohammadi, A Bidari, A Hoshyarrad, Sh Jazayeri, F Hoseini, M Fasihi Radmandi,
Volume 5, Issue 3 (12-2009)
Abstract
Background & Objectives: oxygen free radicals have been implicated as mediators of tissue damage in RA patients. This study was aimed to find the effects of vitamin A, C and zinc supplementations on oxidant–antioxidant, inflammatory and clinical indices in inactive RA patients.
Methods: We designed a randomized controlled trial. Forty nine (49) patients were randomly allocated in two groups group I received their conventional treatment plus 300 mg vitamin C, 5 mg Zinc daily and 25000 IU vitamin A every other day for 12 weeks, group II received their conventional treatment only for the same duration. Disease activity (using the rheumatoid arthritis disease activity index (RADAI) score), biochemical indices [malondialdehyde (MDA), total antioxidant capacity (TAC)] and inflammatory markers [erythrocyte sedimentation rate (ESR), c-reactive protein (CRP)] was evaluated before and after 12 weeks.
Results: Serum concentration of MDA and RADAI score (P<0.0001) and ESR (P=0.033) were significantly decreased and TAC levels (P<0.0001) were significantly increased in the first group in comparison to second group after 12 weeks. However, there were no statistically significant differences in serum CRP concentration of two groups (P>0.05).
Conclusions: This study indicates that adding antioxidants as supplementations with conventional medications in inactive RA patients plays an important role in improving oxidative stress and decreasing disease activity and inflammatory status.
S Dabiran, M Daneshvar Fard, Z Hatmi,
Volume 5, Issue 3 (12-2009)
Abstract
Background & Objective: A growing body of literature suggests that healthy and well-nourished women can safely participate in most forms of physical activity during pregnancy. The objective of this study was to determine the performance of pregnant women about exercise during pregnancy in Tehran.
Methods: we performed an analytical cross-sectional study on 400 pregnant women referred to prenatal care units in Imam Khomeini hospital. Information was obtained through a questionnaire designed to measure practice. Data analysis was performed by the Spss v 13.5 software package. We calculated means and standard deviation for practice in terms of independent variable and applied ANOVA test and regression model for detection of association between variables.
Results: The mean of practice scale was (14.23+/- 1.76). We observed significant association between performance of pregnant women regarding exercise and their occupation, education status and education status of their husbands (P<0.001).Education status of husbands had a significant predictive effect in regression model (p<0.001).
Conclusions: It seems that the majority of pregnant women, who exercise during pregnancy, do not follow the principles correctly therefore their performance is not adequate almost in all domains.
