1
|
Tabrizi M, Behravan M, Seyyed Tabaei SJ, Lasjerdi Z, Pourhoseingholi MA, Mohammad Rahimi H, Mirjalali H, Haghighi A. Assemblage characterization of Giardia duodenalis in South Khorasan province, eastern Iran, using HRM real-time PCR method. Mol Biol Rep 2024; 51:127. [PMID: 38236550 DOI: 10.1007/s11033-023-09001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/06/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Giardia duodenalis is a common parasitic protozoan causing gastrointestinal illness in humans worldwide. The genetic diversity of G. duodenalis is reflected through the identification of different assemblages. In this study, we aimed to determine the assemblages of G. duodenalis in eastern Iran using nested-PCR and high-resolution melting (HRM) real-time PCR methods. METHODS A total of 58 positive G. duodenalis, which were isolated from 1800 subjects, referred to medical center laboratories in South Khorasan province, eastern Iran, from April 2020 to March 2022, were included in this study. DNA was extracted and HRM real-time PCR was performed for assemblage characterization. RESULTS HRM real-time PCR successfully characterized all samples. Accordingly, out of 58 positive samples, 53 (91.36%) and 5 (8.62%) were identified as assemblage A and B, respectively. CONCLUSIONS Our findings showed that HRM real-time PCR was able to characterize the assemblages of G. duodenalis. In addition, our results suggest high prevalence of assemblage A in eastern region of Iran.
Collapse
Affiliation(s)
- Moloud Tabrizi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoodreza Behravan
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seyyed Javad Seyyed Tabaei
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Lasjerdi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Mohammad Rahimi
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Mirjalali
- Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Haghighi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Mohammadi G, Azizmohammad Looha M, Pourhoseingholi MA, Rezaei Tavirani M, Sohrabi S, Zareie Shab Khaneh A, Piri H, Alaei M, Parvani N, Vakilzadeh I, javadi S, Moradian Haft Cheshmeh Z, Razzaghi Z, Mahmoud Robati R, Zamanian Azodi M, Zarean Shahraki S, Talebi R, Charati Yazdani J, Motlagh ME, Khodakarim S, Hadavi M. Classification and Diagnostic Prediction of Colorectal Cancer Mortality Based on Machine Learning Algorithms: A Multicenter National Study. Asian Pac J Cancer Prev 2024; 25:333-342. [PMID: 38285801 PMCID: PMC10911721 DOI: 10.31557/apjcp.2024.25.1.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths. This study aimed to predict survival outcomes of CRC patients using machine learning (ML) methods. MATERIAL AND METHODS A retrospective analysis included 1853 CRC patients admitted to three prominent tertiary hospitals in Iran from October 2006 to July 2019. Six ML methods, namely logistic regression (LR), Naïve Bayes (NB), Support Vector Machine (SVM), Neural Network (NN), Decision Tree (DT), and Light Gradient Boosting Machine (LGBM), were developed with 10-fold cross-validation. Feature selection employed the Random Forest method based on mean decrease GINI criteria. Model performance was assessed using Area Under the Curve (AUC). RESULTS Time from diagnosis, age, tumor size, metastatic status, lymph node involvement, and treatment type emerged as crucial predictors of survival based on mean decrease GINI. The NB (AUC = 0.70, 95% Confidence Interval [CI] 0.65-0.75) and LGBM (AUC = 0.70, 95% CI 0.65-0.75) models achieved the highest predictive AUC values for CRC patient survival. CONCLUSIONS This study highlights the significance of variables including time from diagnosis, age, tumor size, metastatic status, lymph node involvement, and treatment type in predicting CRC survival. The NB model exhibited optimal efficacy in mortality prediction, maintaining a balanced sensitivity and specificity. Policy recommendations encompass early diagnosis and treatment initiation for CRC patients, improved data collection through digital health records and standardized protocols, support for predictive analytics integration in clinical decisions, and the inclusion of identified prognostic variables in treatment guidelines to enhance patient outcomes.
Collapse
Affiliation(s)
- Gohar Mohammadi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Azizmohammad Looha
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Samaneh Sohrabi
- Vice Chancellor in Administration and Resources Development Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Amirali Zareie Shab Khaneh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hassan Piri
- Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Alaei
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Naser Parvani
- Vice Chancellor in Administration and Resources Development Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Iman Vakilzadeh
- Vice Chancellor in Administration and Resources Development Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sara javadi
- Vice Chancellor for Research & Technology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Zahra Razzaghi
- Laser Application in Medical Sciences Research Center. Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Mahmoud Robati
- Department of Dermatology, Director of Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mona Zamanian Azodi
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Saba Zarean Shahraki
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Raheleh Talebi
- Department of Mathematics at Architecture and Computer Engineering, University of Applied Sciences (unit 10), Tehran, Iran.
| | | | - Mohammad Esmaeil Motlagh
- Department of Pediatrics, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Soheila Khodakarim
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Melika Hadavi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Taheri E, Bostick RM, Hatami B, Pourhoseingholi MA, Asadzadeh Aghdaei H, Moslem A, Mousavi Jarrahi A, Zali MR. Dietary and Lifestyle Inflammation Scores Are Inversely Associated with Metabolic-Associated Fatty Liver Disease among Iranian Adults: A Nested Case-Control Study. J Nutr 2022; 152:559-567. [PMID: 34791370 DOI: 10.1093/jn/nxab391] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/13/2021] [Accepted: 11/13/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Diet and lifestyle may affect risk for metabolic-associated fatty liver disease (MAFLD) by chronically elevating systemic inflammation. OBJECTIVES In this study we investigated the separate and joint associations of dietary and lifestyle inflammation scores (DIS and LIS, respectively) with MAFLD risk. METHODS For this nested case-control study we identified and recruited 968 patients with MAFLD (defined as having a fatty liver index ≥60 plus ≥1 of the following conditions: overweight or obese, type II diabetes mellitus, evidence of metabolic dysregulation) and 964 controls from among 35-70-y-old men and women in the baseline phase of the Sabzevar Persian Cohort Study. We collected demographic, lifestyle, anthropometric, biochemical, and dietary intake information (via a validated FFQ) from which we calculated a circulating inflammation biomarker-weighted, predominantly whole foods and beverages-based, 19-component DIS and a 3-component LIS. We estimated DIS- and LIS-MAFLD associations using multivariable unconditional logistic regression. We also calculated equal-weight DIS and LIS to capture all potential mechanisms (inflammation plus other mechanisms) for associations of diet and lifestyle with MAFLD risk. RESULTS Among those in the highest relative to the lowest DIS and LIS tertiles, the multivariable-adjusted ORs and their 95% CIs were OR: 1.84; 95% CI: 1.61, 2.07; Ptrend < 0.001, and OR: 1.96; 95% CI: 1.69, 2.21; Ptrend < 0.001, respectively. For those in the highest relative to the lowest joint DIS and LIS tertile, the values were OR: 2.56; 95% CI: 2.19, 2.93; Pinteraction < 0.001. The findings were similar by sex. The third tertile values for the equal-weight DIS- and LIS-MAFLD associations were OR: 1.87; 95% CI: 1.41, 2.34; and OR: 2.16; 95% CI: 1.85, 2.46, respectively. CONCLUSIONS Our results suggest that higher balances of pro- relative to anti-inflammatory dietary and lifestyle exposures, separately and especially jointly, may be associated with higher MAFLD risk among adults. Also, inflammation may be the primary mechanism through which diet affects MAFLD risk.
Collapse
Affiliation(s)
- Ehsaneh Taheri
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Roberd M Bostick
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Behzad Hatami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Alireza Moslem
- Cellular and Molecular Research Center, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Alireza Mousavi Jarrahi
- Department of Community Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| |
Collapse
|
4
|
Ashtari S, Vahedian-Azimi A, Shojaee S, Pourhoseingholi MA, Jafari R, Bashar FR, Zali MR. Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study. Radiologia (Engl Ed) 2021; 63:314-323. [PMID: 34246422 PMCID: PMC8064840 DOI: 10.1016/j.rxeng.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/01/2021] [Indexed: 01/08/2023]
Abstract
Introduction and objectives The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. Materials and methods Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients’ clinical outcomes; non-critical group (n = 194), critical group (n = 65), and death group (n = 104). The detailed of CT findings were collected from patients’ medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. Results Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P < 0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. Conclusion CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.
Collapse
Affiliation(s)
- S Ashtari
- Centro de Investigación de Epidemiología Básica y Molecular de los Trastornos Gastrointestinales, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teheran, Iran
| | - A Vahedian-Azimi
- Centro de investigación de traumatismos, Facultad de Enfermería, Universidad de Ciencias Médicas de Baqiyatallah, Teheran, Iran
| | - S Shojaee
- Centro de Investigación de Epidemiología Básica y Molecular de los Trastornos Gastrointestinales, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teheran, Iran
| | - M A Pourhoseingholi
- Centro de Investigación de Gastroenterología y Enfermedades Hepáticas, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teheran, Iran.
| | - R Jafari
- Departamento de Radiología, Centro de Investigación Sanitaria, Instituto de Estilo de Vida, Universidad de Ciencias Médicas Baqiyatallah, Teheran, Iran
| | - F R Bashar
- Departamento de Anestesia y Cuidados Críticos, Universidad de Ciencias Médicas de Hamadán, Hamadán, Iran
| | - M R Zali
- Centro de Investigación de Gastroenterología y Enfermedades Hepáticas, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teheran, Iran
| |
Collapse
|
5
|
Ashtari S, Vahedian-Azimi A, Shojaee S, Pourhoseingholi MA, Jafari R, Bashar FR, Zali MR. Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study. Radiologia 2021; 63:314-323. [PMID: 35370315 PMCID: PMC7955942 DOI: 10.1016/j.rx.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/01/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION AND OBJECTIVES The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. MATERIALS AND METHODS Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. RESULTS Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. CONCLUSION CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.
Collapse
Affiliation(s)
- S Ashtari
- Centro de Investigación de Epidemiología Básica y Molecular de los Trastornos Gastrointestinales, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teherán, Irán
| | - A Vahedian-Azimi
- Centro de investigación de traumatismos, Facultad de Enfermería, Universidad de Ciencias Médicas de Baqiyatallah, Teherán, Irán
| | - S Shojaee
- Centro de Investigación de Epidemiología Básica y Molecular de los Trastornos Gastrointestinales, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teherán, Irán
| | - M A Pourhoseingholi
- Centro de Investigación de Gastroenterología y Enfermedades Hepáticas, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teherán, Irán.
| | - R Jafari
- Departamento de Radiología, Centro de Investigación Sanitaria, Instituto de Estilo de Vida, Universidad de Ciencias Médicas Baqiyatallah, Teherán, Irán
| | - F R Bashar
- Departamento de Anestesia y Cuidados Críticos, Universidad de Ciencias Médicas de Hamadán, Hamadán, Irán
| | - M R Zali
- Centro de Investigación de Gastroenterología y Enfermedades Hepáticas, Instituto de Investigación de Gastroenterología y Enfermedades Hepáticas, Universidad de Ciencias Médicas Shahid Beheshti, Teherán, Irán
| |
Collapse
|
6
|
Taheri E, Moslem A, Mousavi-Jarrahi A, Hatami B, Pourhoseingholi MA, Asadzadeh Aghdaei H, Zali MR. Predictors of metabolic-associated fatty liver disease (MAFLD) in adults: a population-based study in Northeastern Iran. Gastroenterol Hepatol Bed Bench 2021; 14:S102-S111. [PMID: 35154609 PMCID: PMC8817755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022]
Abstract
AIM This study aimed to identify the risk factors of metabolic (dysfunction)-associated fatty liver disease (MAFLD) among adults in northeastern Iran. BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and hepatic manifestation of metabolic syndrome that threatens global public health. Recently, MAFLD has been proposed as a new terminology updated from NAFLD and diagnosed based on modified criteria. METHODS A nested case-control study was performed on the participants of the first phase of the Persian Sabzevar Cohort Study (PSCS), a survey that was conducted in northeastern Iran and enrolled 4,242 participants aged 35-70 years. In total, 968 MAFLD cases and 964 controls adjusted for age and sex were recruited. Data including demographic, lifestyle, anthropometric, biochemical, sleep pattern, and dietary intake information was collected. RESULTS The mean (SD [standard deviation]) age of participants was 49.2 (8.8) years, and 39.9% of the participants were males. The prevalence of MAFLD was 22.8% (95% CI [confidence interval] 19.2 - 26.3%). Increased body mass index (BMI) (OR [odds ratios] 5.51, 95% CI 2.73 - 11.10), waist circumference (WC) (OR 1.85, 95% CI 1.44 - 2.38), blood concentrations of triglycerides (TG) (OR 1.10, 95% CI 1.06 - 1.15), total cholesterol (TC) (OR 1.02, 95% CI 1.003 - 1.04), and alanine aminotransferase (AST) (OR 1.10, 95% CI 1.05 - 1.16) were significantly associated with an increased risk of the MAFLD (p-value <0.05). Furthermore, the odds of MAFLD risk was 43% higher in subjects who slept ≤ 5 hrs/day than those with ≥ 7 hrs per day of sleep (OR 1.43; 95% CI 1.07 - 1.92, p-value = 0.01). CONCLUSION In this study, it was found that MAFLD was best predicted by BMI, WC, and serum levels of TG, total cholesterol, and AST. Sleeping ≤ 5hrs/day compared to ≥ 7hrs/day was associated with an increased risk of MAFLD.
Collapse
Affiliation(s)
- Ehsaneh Taheri
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Alireza Moslem
- Cellular and Molecular Research Center, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Alireza Mousavi-Jarrahi
- Department of Community Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Behzad Hatami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| |
Collapse
|
7
|
Kariman N, Hashemi SSB, Ghanbari S, Pourhoseingholi MA, Alimoradi Z, Fakari FR. The effect of an educational intervention based on the theory of planned behavior on childbearing intentions in women: A quasi-experimental study. J Educ Health Promot 2020; 9:96. [PMID: 32509904 PMCID: PMC7271907 DOI: 10.4103/jehp.jehp_2_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/15/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Childbearing is an important biological and social event in the life of most women. It is a voluntary behavior that can be affected by many factors. Behavioral theories are a potential path way to study and influence childbearing behavior. The present study was conducted to determine the effect of an educational intervention based on the theory of planned behavior (TPB) on childbearing intentions in women presenting to premarital counseling centers in Tehran. MATERIALS AND METHODS This randomized controlled quasi-experimental study was conducted on 150 women aged 20-35 years presenting to premarital counseling centers. The participating women were randomly divided into an intervention (n = 75) and a control (n = 75) group using randomized sampling in Excel. The intervention group received two 90-min sessions of training. The effect of training was assessed 6 weeks after the intervention using the researcher-made questionnaire based on the components of the TPB. The questionnaires included subjects' demographic details, knowledge (11 items), attitude (13 items), subjective norms (10 items), perceived behavioral control (8 items), and behavioral intention (4 items). Data were analyzed by SPSS software (version 22) and independent t-test, Chi-square, Mann-Whitney U-test, and Wilcoxon test. P <0.05 was considered statistically significant. RESULTS There were significant differences between the intervention and control group after the intervention in the Mean ± SD scores of knowledge (6.73 ± 2.63 vs. 4.73 ± 2.85, P = 0.001), attitude (48.23 ± 7.19 vs. 40.13 ± 5.80, P = 0.001), perceived behavioral control (33.19 ± 5.28 vs. 23.59 ± 3.47, P = 0.001), and behavioral intention (13.84 ± 2.95 vs. 11.77 ± 2.12, P = 0.027). CONCLUSION The findings showed that an education based on the TPB increased women's childbearing intentions by affecting their knowledge, attitude, perceived behavioral control, and intention. It is therefore essential to implement better public policies, create a more conducive educational setting for women of different age groups, and build a social support system.
Collapse
Affiliation(s)
- Nourossadat Kariman
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyedeh Sara Baki Hashemi
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahla Ghanbari
- Department of Health Education and Promotion, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Department of Health System Research, Research Institute for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zainab Alimoradi
- Department of Midwifery, School of Nursing and Midwifery, Qazvin University of Medical Science, Qazvin, Iran
| | - Farzaneh Rashidi Fakari
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Mokhayeri Y, Riahi SM, Rahimzadeh S, Pourhoseingholi MA, Hashemi-Nazari SS. Metabolic syndrome prevalence in the Iranian adult's general population and its trend: A systematic review and meta-analysis of observational studies. Diabetes Metab Syndr 2018; 12:441-453. [PMID: 29292185 DOI: 10.1016/j.dsx.2017.12.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 12/21/2017] [Indexed: 12/20/2022]
Abstract
AIMS Metabolic syndrome (MetS) is one of the most important predictors of CVD. Determining the trend of MetS, represents the trend of its components and consequently could forecast the incidence of related diseases particularly CVD. The main object of this study is describing the trend of MetS prevalence in both male and female. MATERIALS AND METHODS Original research studies from March 21, 2005 to March 20, 2015 that were published in English database and Persian databases were included in the systematic review. The random effect model was used to estimate the pooled prevalence of MetS. Subgroup analyses, to portray the trend of MetS, conducted based on implementation year. RESULTS The total sample sizes for males using the criteria of ATP III and IDF were 30012 and 35064, and for female were 14572 and 16292. The pooled estimation of MetS prevalence in total, male, and female population according to ATP III was 28%, 23%, and 33%; for IDF definitions was 28%, 22%, and 33%. Moreover, according to meta-regression for ATP III the most important source of heterogeneity was mean age. CONCLUSION The findings revealed the trend of MetS prevalence is declining although steady in the last 10 years.
Collapse
Affiliation(s)
- Yaser Mokhayeri
- Department of Epidemiology, School of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Seyed Mohammad Riahi
- Department of Epidemiology, School of Public Health, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Health, Birjand University of Medical Sciences, Birjand, Iran.
| | - Shadi Rahimzadeh
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Saeed Hashemi-Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Hatami B, Kashfi SMH, Abbasinazari M, Nazemalhosseini Mojarad E, Pourhoseingholi MA, Zali MR, Mohammad Alizadeh AH. Epinephrine in the Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis: A Preliminary Study. Case Rep Gastroenterol 2018; 12:125-136. [PMID: 29805355 PMCID: PMC5968254 DOI: 10.1159/000479494] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/10/2017] [Indexed: 01/01/2023] Open
Abstract
Background Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). The incidence of post-ERCP pancreatitis (PEP) ranges between 15 and 20% among patients at high risk of developing PEP. The efficacy of indomethacin administration in the prevention of PEP is rather debatable. In the present randomized trial study, we evaluated whether or not the combination of indomethacin and epinephrine in comparison to the single administration of indomethacin differs in the pathogenesis and prevention of post-ERCP pancreatitis. Patients and Methods One hundred and ninety-two patients were randomized in a double-blinded manner into 3 groups: the epinephrine group (group A), the indomethacin group (group B), and the combined epinephrine and indomethacin group (group C). After the procedure, patients were evaluated for the PEP development. Results During the procedure, 66 patients were randomized to the epinephrine group (group A), 68 cases to the indomethacin group (group B), and 58 individuals to the indomethacin-epinephrine group (group C). The mean age of patients in the epinephrine group was 59.59 ± 15.680 years, in the indomethacin group it was 58.06 ± 17.125 years, and in the combination group it was 59.62 ± 15.369 years. In the present study, we did not observe a significant difference between the 3 groups in sex, age, pre-ERCP amylase, lipase, and patient and procedure risk factors including pancreatic duct (PD) dilation (p = 0.404), PD cannulation (p = 0.329), and difficult cannulation (p = 0.076) among others. PEP developed in 7 of the 192 individuals (3.6%), 6 PEP cases occurred in the indomethacin group and 1 in the epinephrine group (p = 0.016). Univariate analysis of risk factors for PEP in patients with and without pancreatitis revealed no significant difference between the pancreatitis group and the non-pancreatitis group. Conclusion In comparison to the administration of indomethacin alone, a single application of epinephrine and the combination of epinephrine and indomethacin seem to be effective in reducing the cases of PEP. A further randomized clinical trial with a larger sample size is required to confirm the efficacy of our medication in the prevention of pancreatitis after ERCP.
Collapse
Affiliation(s)
- Behzad Hatami
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Hossein Kashfi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Abbasinazari
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Nazemalhosseini Mojarad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Houshang Mohammad Alizadeh
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Abdi S, Abbasinazari M, Valizadegan G, Kamarei M, Panahi Y, Sarafzadeh F, Pourhoseingholi MA. Does the Addition of Melatonin to Quadruple Therapy Increases the Eradication Rate of Helicobacter pylori? A Double-Blind Randomized Clinical Trial. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/35589.11543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
11
|
As’adi N, Kariman N, Mojab F, Pourhoseingholi MA. The effect of Saqez (Pistacia atlantica) ointment on the treatment of nipple fissure and nipple pain in breastfeeding women. Electron Physician 2017; 9:4952-4960. [PMID: 28979728 PMCID: PMC5614278 DOI: 10.19082/4952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 06/16/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nipple fissure is a common problem in breastfeeding women, and the main reason for the early discontinuation of breastfeeding. OBJECTIVE To determine the effect of Saqez (Pistacia atlantica) ointment on the treatment of nipple fissure and nipple pain in breastfeeding women. METHODS This randomized clinical trial was conducted on 100 subjects admitted to the health centers in Tehran, Iran from mid-July to mid-November 2015. The subjects were randomly divided into two equal groups of 50 for the Saqez ointment group and the control group. The subjects were divided into the two groups through random allocation in Excel. The subjects were monitored on day 1, 3 and 7. Data were analyzed in SAS using the Cumulative Logit model and in SPSS-21 using Mann-Whitney, independent-samples t-test, the Chi square and Fisher's exact test. RESULTS No significant differences were observed between the two groups in terms of their demographic and fertility characteristics. The Cumulative Logit model showed that high levels of nipple fissure and pain were significantly less frequent in the Saqez group compared to the control group (p<0.001). There was about 83% reduction in the severity of fissure and 85 %in the severity of pain in the Saqez group compared to the control group (p<0.001). CONCLUSION Saqez ointment is more effective in the treatment of nipple fissures and pain than breast milk. As this study was done for the first time, judgment about the conclusive efficacy of Saqez ointment on the nipple fissure, needs further similar studies. TRIAL REGISTRATION The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2015080723535N1. FUNDING The authors received no financial support for the research, authorship, and/or publication of this article.
Collapse
Affiliation(s)
- Nayereh As’adi
- M.Sc. of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nourossadat Kariman
- Ph.D. of Reproductive Health, Assistant Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faraz Mojab
- Ph.D. of Pharmacognosy, Professor, Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Ph.D., Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
Chouhdari A, Yavari P, Pourhoseingholi MA, Sohrabi MR. Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of Colorectal Cancer Patients. Iran J Cancer Prev 2016; 9:e4809. [PMID: 27482334 PMCID: PMC4951766 DOI: 10.17795/ijcp-4809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/08/2016] [Accepted: 03/14/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Approximately 15% to 25% of colorectal cancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program. OBJECTIVES The aim of this study is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs. PATIENTS AND METHODS This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi-square, exact fisher and multiple logistic regression were executed by SPSS 19. RESULTS The results indicated 58.5% participants underwent colonoscopy screening test at least once to the time of the interview. There was not an association between participation in colonoscopy screening program and socioeconomic status to the time of the interview in binomial analysis. But statistical significance between intention to participate and educational and income level were found. We found, in logistic regression analysis, that high educational level (Diploma and University degree in this survey) was a predictor to participate in colonoscopy screening program in FDRs. CONCLUSIONS According to this survey low socioeconomic status is an important factor to hinder participation of FDRs in colonoscopy screening program. Therefore, planned interventions for elevation knowledge and attitude in FDRs with low educational level are necessary. Also, reducing colonoscopy test costs should be a major priority for policy makers.
Collapse
Affiliation(s)
- Arezoo Chouhdari
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Parvin Yavari
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad-Reza Sohrabi
- Department of Health and Community Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| |
Collapse
|
13
|
Jafari MJ, Khajevandi AA, Mousavi Najarkola SA, Yekaninejad MS, Pourhoseingholi MA, Omidi L, Kalantary S. Association of Sick Building Syndrome with Indoor Air Parameters. Tanaffos 2015. [PMID: 26221153 PMCID: PMC4515331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Energy crisis in 1973 led to smaller residential and office buildings with lower air changes. This resulted in development of Sick Building Syndrome (SBS). The objective of this study was to assess the association of SBS with individual factors and indoor air pollutants among employees in two office buildings of Petroleum Industry Health Organization in Tehran city. MATERIALS AND METHODS The association between personal and environmental factors and SBS symptoms was examined by a reliable and valid combined questionnaire. Environmental parameters were measured using calibrated instruments. RESULTS The results suggested that SBS symptoms were more common in women than men. Malaise and headache were the most common symptoms in women and men. Throat dryness, cough, sputum, and wheezing were less prevalent among employees in both offices. Light-intensity was significantly associated with some symptoms such as skin dryness (P = 0.049), eye pain (P = 0.026), and malaise (P = 0.043). There were no significant differences in prevalence of SBS symptoms between female workers of the two offices (P>0.05). CONCLUSION The main causes of SBS among the employees were recycling of air in rooms using fan coils, traffic noise, poor lighting, and buildings located in a polluted metropolitan area.
Collapse
Affiliation(s)
- Mohammad Javad Jafari
- Occupational Health Engineering Department, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Khajevandi
- Occupational Health Engineering Department, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Omidi
- Occupational Health Engineering Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Omidi L, Address: Occupational Health Engineering Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Email address:
| | - Saba Kalantary
- Occupational Health Engineering Department, School of Public Health, Arak University of Medical Sciences, Arak, Iran
| |
Collapse
|
14
|
Dadaei T, Safapoor MH, Asadzadeh Aghdaei H, Balaii H, Pourhoseingholi MA, Naderi N, Zojaji H, Azimzadeh P, Mohammadi P, Zali MR. Effect of vitamin D3 supplementation on TNF-α serum level and disease activity index in Iranian IBD patients. Gastroenterol Hepatol Bed Bench 2015; 8:49-55. [PMID: 25584176 PMCID: PMC4285932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
AIM The aim of the study was to assess the effectiveness of vitamin D3 [1, 25(OH)2D3] treatment in IBD with regard to tumor necrosis factor-alpha (TNF-α) serum level and clinical disease activity index (CDAI). BACKGROUND Vitamin D has immune-regulatory functions in experimental inflammatory bowel disease (IBD) and vitamin D deficiency is common in IBD patients. PATIENTS AND METHODS This was a randomized clinical trial on 108 IBD patients with serum 25-OHD levels less than 30ng/ml, which divided into vitamin D and control groups. Vitamin D group received 50000 IU vitamin D3 for 12 weeks. Before and after the study, TNF-α and 25-OHD serum levels were measured by ELISA method. Data were analyzed using paired t-test, chi-square test and Spearman correlation coefficient. P-values less than 0.05 were considered statistically significant. RESULTS Before the intervention no significant difference was found between baseline characteristics and TNF-α serum level of two groups. After intervention TNF-α serum level reduced but this reduction was not statistically significant (p= 0.07, 95% CI: -0.45 to 8.14). The mean serum 25-OHD level of vitamin D increased from 15.54 to 67.89, which was statistically significant (p= 0.00, 95% CI: -61.40 to -43.30). TNF-α level was also associated significantly with CDAI before (Spearman's rho: 0.3, p<0.0001) and after (Spearman's rho: 0.27, P=0.01) intervention. CONCLUSION Oral supplementation vitamin D3 significantly increased serum vitamin D levels and insignificantly reduced serum TNF-α level. More studies with larger samples would be beneficial to assess vitamin D3 supplementation efficient effect in IBD.
Collapse
|
15
|
Abbasinazari M, Panahi Y, Mortazavi SA, Fahimi F, Valizadegan G, Mohtashami R, Pourhoseingholi MA, Shirvani Bakhtiari K. Effect of a Combination of Omeprazole Plus Sustained Release Baclofen Versus Omeprazole Alone on Symptoms of Patients with Gastroesophageal Reflux Disease (GERD). Iran J Pharm Res 2014; 13:1221-6. [PMID: 25587310 PMCID: PMC4232787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous studies have reported the efficacy of baclofen in the treatment of Gastroesophageal Reflux Diseases (GERD). The objective of present study is to evaluate the effect of co-administration of omeprazole 20 mg/d plus sustained Release baclofen (SR baclofen) vs. omeprazole 20 mg/d plus placebo on alleviation of symptoms in patients with a diagnosis of GERD. A prospective, double blind, placebo controlled trial included 60 patients with diagnosis of GERD have been done. Patients were randomly selected to receive either SR baclofen or a placebo in addition to omeprazole 20 mg/d for a period of 2 weeks. Patients were questioned regarding heartburn, regurgitation, chest pain and hoarseness at the base line and after 2 weeks. All patients tolerated the medications and no patients failed to complete the study due to adverse drug reactions. A total of 53 patients completed the study, 25 in SR baclofen and 28 in placebo group. After 2 weeks, 1 patient (4%) in SR baclofen group reported heartburn and regurgitation. However 13(46.4%) and 15 (53.6%) of patients in the placebo group had heartburn and regurgitation respectively. The analysis of the data shows that there is a significant difference between the two groups in heartburn and regurgitation (p < 0.0001, p < 0.0001 respectively). Statistical analysis revealed a significant difference in two groups regarding total GERD score (p <0.0001). The results of the present study suggest that a combination of SR baclofen and omeprazole may be a more effective treatment for heartburn and regurgitation than omeprazole alone.
Collapse
Affiliation(s)
- Mohammad Abbasinazari
- Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran,E-mail:
| | - Yunes Panahi
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | | | - Fanak Fahimi
- Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghasem Valizadegan
- Baqiyatallah Research Center for Gastroentrology and Liver Diseases, Tehran, Iran.
| | - Reza Mohtashami
- Medicine Quran& Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Mohammad Amin Pourhoseingholi
- Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | |
Collapse
|
16
|
Ghamar Chehreh ME, Vahedi M, Pourhoseingholi MA, Ashtari S, Khedmat H, Amin M, Zali MR, Alavian SM. Estimation of diagnosis and treatment costs of non-alcoholic Fatty liver disease: a two-year observation. Hepat Mon 2013; 13:e7382. [PMID: 23914227 PMCID: PMC3728974 DOI: 10.5812/hepatmon.7382] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 02/18/2013] [Accepted: 04/06/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are insufficient data available on utilization and health care costs of non-alcoholic fatty liver disease. The cost data for different health conditions and services is a major gap in Iranian health system. So this study is the primary or first step towards filling this gap. OBJECTIVES This study aims to estimate the diagnosis and treatment costs of Non-alcoholic Fatty Liver. PATIENTS AND METHODS This cross-sectional study was conducted on 528 subjects. The subjects had been diagnosed with non-alcoholic fatty liver. All the subjects had been referred to the Tehran Fatty Liver Clinic, a clinic of the Baqiyatallah Research Center for Gastroenterology and Liver Diseases, in 2009 and they had been observed for 2 years to determine the frequency of health care utilization (physician visit, laboratory tests, medication and cost of sonography). The costs of diagnosis and treatment for each person were estimated in Purchasing Power Parity dollars (PPP$). RESULTS The average total cost was 5,043 PPP$ per person in the 2 years of observation. Majority of these 528 patients (87.9%) had a BMI ≥ 25 (kg/m2). Also, 33.9% were diagnosed with comorbid diseases such as Diabetes Mellitus (DM), Coronary Artery Disease (CAD), hypertension (HTN) and hypothyroidism (HYPO). CONCLUSIONS The results confirmed that the total costs for non-alcoholic fatty liver among the Iranian adult urban population alone exceeded 1 billion PPP$ per year. These costs can be saved or reduced by effective disease management and early prevention.
Collapse
Affiliation(s)
- Mohammad Ebrahim Ghamar Chehreh
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Vahedi
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Sara Ashtari
- Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
- Corresponding author: Sara Ashtari, Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-2122432515, Fax: +98-2122432517, E-mail:
| | - Hossein Khedmat
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Amin
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Disease Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| |
Collapse
|
17
|
Ashtari S, Vahedi M, Pourhoseingholi MA, Karkhane M, Kimiia Z, Pourhoseingholi A, Safaee A, Moghimi-Dehkordi B, Zali MR, Alavian SM. Direct medical care costs associated with patients diagnosed with chronic HCV. Hepat Mon 2013; 13:e8415. [PMID: 23930132 PMCID: PMC3736623 DOI: 10.5812/hepatmon.8415] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 12/26/2012] [Accepted: 02/18/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND HCV virus (HCV) is a significant global problem with wide-ranging socio-economic impacts. Because of the high morbidity and mortality associated with end-stage liver disease, cirrhosis, and hepatocellular carcinoma (HCC), the economic burden of HCV infection is substantial. OBJECTIVES This study aimed to estimate the direct medical care costs of chronic HCV infection. PATIENTS AND METHODS For this cross-sectional study, 365 courses of HCV treatment were extracted from medical records of 284 patients being referred to Tehran HCV clinic, a clinical clinic of Baqiyatallah Research Center for Gastroenterology and Liver diseases, from 2005 to 2010. All the patients had been diagnosed with HCV. Direct medical care costs for each course of HCV treatment have been calculated based on Purchasing Power Parity Dollar (PPP$). RESULTS Average direct medical costs for the courses treated with conventional interferon plus ribavirin (INF-RBV) were 4,403 PPP$, and 20,010 PPP$ for peg-interferon plus ribavirin (PEG-RBV) courses. There was an increase of the direct costs in both courses of treatment to achieve Sustain Viral Response (SVR). The costs amounted to 10,072 PPP$ in (INF-RBV) treatment and 34,035 PPP$ in (PEG-RBV). The significant difference between the costs of these two courses of treatment is attributable to high cost of Peg-interferon. This indicates that the medication costs are the dominant costs. CONCLUSIONS According to the results, total direct medical costs for HCV patients in Iran exceeded 12 billion PPP$ in (INF-RBV) treatment and 55 billion PPP$ in (PEG-RBV).
Collapse
Affiliation(s)
- Sara Ashtari
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Mohsen Vahedi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
- Corresponding author: Mohammad Amin Pourhoseingholi, Research Center of Gastroenterology and Liver Diseases, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, 7th Floor, Tabnak St., Velenjak, Tehran, IR Iran. Tel: +98-2122432515, Fax: 98-2122432517, E-mail:
| | - Maryam Karkhane
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Zahra Kimiia
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Asma Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Azadeh Safaee
- Department of Disease Control and Prevention, Deputy of Health, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Bijan Moghimi-Dehkordi
- Department of Disease Control and Prevention, Deputy of Health, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Science, Tehran, IR Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| |
Collapse
|
18
|
Mohebbi SR, Rostami Nejad M, Tahaei SME, Pourhoseingholi MA, Habibi M, Azimzadeh P, Naghoosi H, Karayiannis P, Zali MR. Seroepidemiology of hepatitis A and E virus infections in Tehran, Iran: a population based study. Trans R Soc Trop Med Hyg 2012; 106:528-31. [PMID: 22835757 DOI: 10.1016/j.trstmh.2012.05.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 05/30/2012] [Accepted: 05/30/2012] [Indexed: 01/02/2023] Open
Abstract
Hepatitis A virus (HAV) and hepatitis E virus (HEV) are enteric hepatotropic viruses and their prevalence is related to the sanitary conditions of the region under investigation. There are only a few studies on the seroepidemiology of these two viruses in the general Iranian population. The purpose of this investigation was to measure the prevalence of hepatitis A and E infections in the general population. Between 2006 and 2007, a cross sectional study was performed in Tehran, Iran. Blood specimens were collected and questionnaires were filled in for 551 persons. Patient sera were tested by ELISA for anti-HEV and anti-HAV IgGs. The χ(2) test and independent t-test were used for statistical analysis and p<0.05 was considered significant. The overall seroprevalence rates of anti-HEV IgG and anti-HAV IgG were 9.3% and 90%, respectively. The prevalence of antibodies to HAV and HEV was greater among men than women and increased with age. However, there was no significant relationship between age and gender with the existence of anti- HAV and HEV IgG antibodies. Our results show the seroprevalence of HAV and HEV antibodies are high and both viruses are endemic in this region. These findings are in accordance with results obtained from previous studies. We recommend that foreign travelers to Iran are vaccinated against HAV.
Collapse
Affiliation(s)
- Seyed Reza Mohebbi
- The Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, 7th floor, Taleghani Hospital, Yaman Ave., Velenjak, PO Box 19835-187, Tehran, Iran.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Moghimi-Dehkordi B, Safaee A, Vahedi M, Pourhoseingholi MA, Pourhoseingholi A, Ashtari S. History of upper gastrointestinal cancers in relatives: a community-based estimate. Gastroenterol Hepatol Bed Bench 2012; 5:100-5. [PMID: 24834208 PMCID: PMC4017460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 01/18/2012] [Indexed: 11/24/2022]
Abstract
AIM The present study aimed to evaluate the prevalence of positive family history of these cancers in a large population-based sample of Tehran province, capital of Iran. BACKGROUND Upper gastrointestinal (UGI) cancers (gastric and esophagus cancer) constitute a major health problem worldwide. A family history of cancer can increase the risk for developing cancer and recognized as one of the most important risk factors in predicting personal cancer risk. PATIENTS AND METHODS This study designed as a cross-sectional survey in general population (2006-2007) of Tehran province. Totally 7,300 persons (age > = 20 years) sampled by random sampling on the basis of the list of postal, of whom 6,700 persons agreed to participate (response rate 92%). Respondents were asked if any first-degree (FDR) or second-degree (SDR) relatives had gastric or esophageal cancer. RESULTS Totally, 6,453 respondents (48% male) entered to the study. The mean age of responders with positive FH was significantly higher than those with negative FH (P < 0.05). In total, 341 respondents (5.3%) reporting a history of UGI cancers in their relatives, 134(2.1%) in FDRs, and 207(3.2%) in SDRs. CONCLUSION Our findings showed that the reported prevalence of FH of UGI cancers was relatively low and varied by specific respondent characteristics such as age and sex. However, the estimates of prevalence presented here are likely to be conservative compared with actual prevalence because of self-reported data gathering.
Collapse
Affiliation(s)
| | - Azadeh Safaee
- Gastroenterology ward, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Vahedi
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Tehran University of Medical Science, Tehran, Iran
| | | | - Asma Pourhoseingholi
- Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Sarah Ashtari
- Gastroenterology ward, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
20
|
Moghimi-Dehkordi B, Safaee A, Vahedi M, Pourhoseingholi MA, Pourhoseingholi A, Zali MR. Population prevalence of first- and second-degree family history of breast and ovarian cancer. East Afr J Public Health 2011; 8:275-277. [PMID: 23120936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Family cancer history is an important risk factor for common cancers, thus, recognizing pattern of familial cancer can help us to identify individuals who may have higher chance to develop specified cancers. METHODS This cross-sectional survey assessed family history of cancer in first- and second degree relatives. Totally, 7,300 persons aged > or = 20 years selected by random sampling from Tehran general population. Age- and sex-specified prevalence of breast and ovarian cancer in respondent's family was calculated. RESULTS Of all, 279(4.3%) individuals reported a history of breast or ovarian cancer in their relatives. The prevalence of breast cancer family history was 1.8% among first-degree relatives and 2.5% among second- degree relatives. For ovarian cancer, first- and second-degree prevalence ranged from 0.05 to 0.12%. Those with family history of cancer were more often young and female. CONCLUSIONS Overall, the estimates of prevalence presented here are likely to be conservative compared with actual current prevalence because of some limitations. While family history is an important risk factor for common cancers such as breast cancer, recognizing pattern of familial cancer that signify increased risk can help us to identify individuals who may have higher chance to develop specified cancers.
Collapse
Affiliation(s)
- B Moghimi-Dehkordi
- Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | | | | | | | | |
Collapse
|
21
|
Solhpour A, Safaee A, Pourhoseingholi MA, Moghimi-Dehkordi B, Habibi M, Qafarnejad F, Pourhoseingholi A, Zali MR. Relationship between uninvestigated dyspepsia and body mass index: a population-based study. ACTA ACUST UNITED AC 2011; 7:318-22. [PMID: 22066328 DOI: 10.4314/eajph.v7i4.64755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Recent studies have shown inconsistent results about the association between body mass index and symptoms of gastrointestinal disorders. The aim of this study was to assess the association between body mass index (BMI) and symptoms of uninvestigated dyspepsia in patients with gastrointestinal symptoms and their relations with age. METHODS This study was designed as a cross-sectional and population based evaluation that was conducted in Iran. The patients were interviewed by using questionnaire which was arranged on the basis of Rome III criteria for functional dyspepsia. The association between body mass index, age and dyspepsia symptoms was determined. RESULTS A total of 790 patients with gastrointestinal symptoms (249 men, mean +/- SD of age, 49.9 +/- 19 years; mean +/- SD of BMI, 25.4 +/- 4.7) were included and among them 681 (86.2%) had symptoms of dyspepsia. The prevalence of dyspepsia symptoms among females younger and older than 50 years were 83% and 93.8% ,respectively, but these percentages among males younger and older than 50 years were 84.5% and 81.5%.In males younger and older than 50 years 42.9% and 37.6% had BMI over than 25, but these percentages were 51.3% and 54.8% for females. Among overweight and obese patients the prevalence of dyspepsia symptoms were 82.7% and 78%, respectively, compared with normal weight (90.7%). CONCLUSION After the age of 50, the prevalence of dyspepsia symptoms and high body mass index were increased in females, but were decreased in males. No relation between symptoms of dyspepsia and body mass index in both genders was found.
Collapse
|
22
|
Moghimi-Dehkordi B, Vahedi M, Pourhoseingholi MA, Khoshkrood Mansoori B, Safaee A, Habibi M, Pourhoseingholi A, Zali MR. Economic burden attributable to functional bowel disorders in Iran: a cross-sectional population-based study. J Dig Dis 2011; 12:384-92. [PMID: 21955432 DOI: 10.1111/j.1751-2980.2011.00526.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE While few population-based studies on the economic burden of functional bowel disorders (FBD) have been published from developing countries like Iran, this study aimed to estimate their direct and indirect costs for five groups of patients: irritable bowel syndrome (IBS), functional constipation (FC), unspecified-FBD (U-FBD), functional abdominal bloating (FAB) and functional diarrhea (FD). METHODS Up to 18,180 adults randomly sampled from Tehran, Iran (2006-2007) were interviewed using two questionnaires based on the Rome III criteria to detect FBD patients and to estimate their medical expenses (such as visiting the doctor, drugs, hospitalization and laboratory tests) and productivity loss in the previous 6 months. All costs were converted to dollar purchasing power parity (PPP$) to facilitate cross-country comparisons. RESULTS The mean total 6-month costs were approximately: 160, 147, 103, 96 and 42 PPP$ for IBS, FC, U-FBD, FAB and FD, respectively. The highest proportion of drug consumption was found in IBS patients. The highest mean duration of absence from work was seen in IBS patients (2.26 days). Overall, doctor visit costs accounted for approximately 1/3 of the total costs for FBD, followed by hospitalization. A higher indirect cost of illness was found in IBS (54 PPP$), whereas it was zero in FD. CONCLUSION The economic burden of FBD seems to be moderately high in Iran and it imposes a relatively heavy financial burden on the Iranian national health system because of its high prevalence and its impact on quality of life, productivity and waste of resources.
Collapse
Affiliation(s)
- Bijan Moghimi-Dehkordi
- Research Center for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Mohaghegh Shalmani H, Soori H, Khoshkrood Mansoori B, Vahedi M, Moghimi-Dehkordi B, Pourhoseingholi MA, Norouzinia M, Zali MR. Direct and indirect medical costs of functional constipation: a population-based study. Int J Colorectal Dis 2011; 26:515-22. [PMID: 20957375 DOI: 10.1007/s00384-010-1077-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2010] [Indexed: 02/04/2023]
Abstract
BACKGROUND Constipation causes a large number of medical visits each year and imposes significant financial toll on healthcare systems worldwide. So the present community-based study was conducted in order to estimate attributable direct and indirect costs to functional constipation (FC) and to provide an overview of related physician visits in general population of Iran. METHODS From May 2006 to December 2007, a total of 19,200 adult persons (aged 16 and above) were drawn randomly in Tehran province, Iran (response rate 94%). Participants who reported any gastrointestinal symptoms (2,790 persons) were referred to assigned physicians to be questioned about symptoms of functional bowel disorders according to the Rome III criteria. Direct and indirect costs to FC were calculated. Attributable costs were reported as purchasing power parity dollars (PPP$). RESULTS Of the total 18,180 consenting participants in this study, 435 (2.4%) had FC according to Rome III criteria. Mean total cost of constipation per person was 146.84 PPP$, of which 128.68 PPP$ was related to direct costs and 18.16 PPP$ to indirect costs. Higher educated persons (189.75 PPP$), those above 64 years of age (373.42 PPP$), subjects with BMI of less than 18.5 kg/m(2) (510.84 PPP$), and widowed persons (258.50 PPP$) had the highest costs. CONCLUSIONS This study determined that although the economic burden of FC does not seem to be substantial in comparison to other major health problems, it still exacts a substantial toll on the health system for two reasons: chronicity and ambiguity of symptoms.
Collapse
Affiliation(s)
- Hamid Mohaghegh Shalmani
- Research Center for Gastroenterology and Liver Disease, 7th floor, Taleghani Hospital, Shahid Beheshti University (MC), Evin, Tehran, Iran.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Abbasinazari M, Mohammad Alizadeh AH, Moshiri K, Pourhoseingholi MA, Zali MR. Does allopurinol prevent post endoscopic retrograde cholangio- pancreatography pancreatitis? A randomized double blind trial. Acta Med Iran 2011; 49:579-583. [PMID: 22052140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is a frequent complication either for diagnosis or treatment of pancreatobiliary diseases. A number of pharmacological agents have been tried for prevention or alleviation of the complication. Allopurinol with free radical scavenger property has been considered as an effective prophylactic agent in some clinical trials. Administration of allopurinol in these trials was done in a long period before doing ERCP. Hence allopurinol converts to oxupurinol in the liver rapidly; it seems that clinical judgment about the net effect of allopurinol on prevention of post ERCP pancreatitis is doubtful. In this randomized double blind clinical trial, effect of allopurinol on prevention or alleviation of clinical and laboratory signs of pancreatitis has been evaluated in 74 patients undergoing ERCP. Results showed that there is not any difference between allopurinol and placebo in occurrence and severity of post ERCP pancreatitis (P=0.97). Also there is not any significant difference in amylase rises between 2 groups in 8 and 16 hours after ERCP (P=0.947, 0.287 respectively). Beneficial effects of allopurinol in some of the previous studies may be attributed to its active metabolite (oxypurinol). Further studies recommended about the net effect of allopurinol and oxypurinol in the complication.
Collapse
Affiliation(s)
- Mohammad Abbasinazari
- Department of Clinical Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | | | | |
Collapse
|
25
|
Gohari MR, Biglarian A, Bakhshi E, Pourhoseingholi MA. Use of an artificial neural network to determine prognostic factors in colorectal cancer patients. Asian Pac J Cancer Prev 2011; 12:1469-1472. [PMID: 22126483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to determine the prognostic factors of Iranian colorectal cancer (CRC) patients and their importance using an artificial neural network (ANN) model. METHODS This study was a historical cohort study and the data gathered from 1,219 registered CRC patients between January 2002 and October 2007 at the Research Center for Gastroenterology and Liver Disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. For determining the risk factors and survival prediction of patients, neural network (NN) and Cox regression models were used, utilizing R 2.12.0 software. RESULTS One, three and five-year estimated survival probability in colon patients were 0.92, 0.71, and 0.48 and for rectum patients were 0.86, 0.71, and 0.42, respectively. By the ANN model, pathologic distant metastasis, pathologic regional lymph nodes, tumor grade, high risk behavior, pathologic primary tumor, familial history and tumor size variables were determined as ordered important factors for colon cancer. Tumor grade, pathologic stage, age at diagnosis, tumor size, high risk behavior, pathologic distant metastasis and first treatment variables were ordered important factors for rectum cancer. The ANN model lead to more accurate predictions compared to the Cox model (true prediction of 89.0% vs. 78.6% for colon and 82.7% vs. 70.7% for rectum cancer patients). CONCLUSION This study showed that ANN model is a more powerful tool in survival prediction and influential factors of the CRC patients compared to the Cox regression model. Therefore, this model is recommended for predicting and determining of risk factors of these patients.
Collapse
Affiliation(s)
- Mahmood Reza Gohari
- Department of Biostatistics and Hospital Management Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | |
Collapse
|
26
|
Safaee A, Moghimi-Dehkordi B, Pourhoseingholi MA, Vahedi M, Maserat E, Ghiasi S, Fatemi SR, Zali MR. Risk of colorectal cancer in relatives: a case control study. Indian J Cancer 2010; 47:27-30. [PMID: 20071786 DOI: 10.4103/0019-509x.58855] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND In around 10 to 15% of all colorectal cancer (CRC) cases, a positive family history of colorectal cancer is observed . Although increased risk of colorectal cancer in individuals with a family history of the disease has been observed consistently in the past studies, limited information is available on colorectal cancer associated with family history in Iran. AIMS The purpose of this study is to define the risk of colorectal cancer associated with a family history of cancer. SETTING AND DESIGN The present study was designed as an unmatched case control study. The cases were 393 patients with histologically confirmed colorectal carcinomas and there were 393 controls, randomly selected from among the healthy participants in a health survey. METHODS The family history was extracted from a standard history form completed by the patient or from the record created by a health care provider. STATISTICAL ANALYSIS Mantel-Heanszel Odds Ratio was computed for removing the confounding effect of age and sex. RESULTS A positive family history of cancer was reported by 36.4 and 24.4% among the cases and controls, respectively. Colorectal cancer risk increased two-fold in subjects who reported having first degree relatives with cancer. The adjusted odds ratio was 4.76, indicating that having a positive family history of colorectal cancer among relatives increased one's risk of colorectal cancer about 4.5-fold. CONCLUSION According to our findings, a family history of cancer increased the risk of CRC. Due to this fact that there is no current colorectal cancer screening program in Iran, it is recommended that first degree relatives of patients with colorectal cancer should be considered as a priority group for screening programs.
Collapse
Affiliation(s)
- A Safaee
- Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University (M.C.), Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Rostami Nejad M, Nazemalhosseini Mojarad E, Dabiri H, Nochi Z, Pourhoseingholi MA, Sahebekhtiari N, Habibi M, Zali MR. A case-control study of Blastocystis hominis among Iranian population. East Afr J Public Health 2010; 7:101-104. [PMID: 21413584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES A case-control study was conducted to investigate the epidemiology and clinical features of Blastocystis hominis among Iranian patients with and without GI symptoms. METHODS Six hundred and seventy patients with GI and Six hundred and seventy patients without GI symptoms were enrolled as cases and controls respectively during 2006-07. Standard microscopic examinations following in vitro culture were used to examine the stool samples for presence of trophozoites and cysts of B. hominis. RESULTS Infection with B. hominis occurred most commonly in those with GI symptoms (5.67 %) compared with those patients without GI symptoms (3.43 %). The most common symptom in case group was abdominal pain (86.84 %). B. hominis was mostly found with Giardia lamblia in case group and with Entamoeba coli in control group. In addition, there was no significant relation between the presence of GI symptoms and the incidence of B. hominis. CONCLUSION B. hominis has long been described as a non-pathogenic protozoan parasite until recently, when claims have been made that it could result in pathogenic conditions. Thus, to confirm the complication is needed to additional study especially on molecular pathogenesis of this organism.
Collapse
Affiliation(s)
- Mohammad Rostami Nejad
- The Research Center of Gastroenterology and Liver Disease, Shaheed Beheshri University, M.C. Taleghani hospital, Yemen St., Evin, Tehran, Iran
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Nazari MA, Malayeri SH, Pourhoseingholi MA, Mohebi SR, Zali MR. Evaluation of Zinc Plasma Level in Iranian Cirrhotic Patients due to Hepatitis B and Hepatitis C. Hepat Mon 2010; 10:62-4. [PMID: 22308129 PMCID: PMC3270348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 01/01/2010] [Accepted: 01/20/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Zinc (Zn) has various significant roles in physiological functions of the liver. Furthermore, it has been reported that the administration of zinc has an important role in pharmacotherapy of viral hepatitis. Cirrhotic patients with decrease in plasma zinc level have been covered in previous studies. It is seemingly necessary to assess the zinc level, in Iranian cirrhotic patients, as a distinct population, Because of the large phytate amounts in Iranians diet. Regarding to etiology, disease progress, and treatment, there are some differences in the 2 most common causes of cirrhosis in the Iranian population (hepatitis B and hepatitis C) and it is possible that the zinc level may be different between the two. This study was done to shadow some lights on the subject. METHODS Between April 2008 and November 2008, plasma zinc level was determined, by atomic absorption method, in 60 cirrhotic inpatients treated due to hepatitis B or hepatitis C in Talighani hospital (a referral center for gastrontestinal and liver diseases in Tehran, Iran). RESULTS Mean ± standard deviation (SD) plasma zinc levels determined 0.34±0.22 mg/L and 0.37±0.22 mg/L in hepatitis B and hepatitis C patients respectively. Analysis of t-test showed there is no significant difference between 2 groups regarding to plasma zinc level (P = 0.745). CONCLUSIONS It is concluded that zinc level of studied cirrhotic patients is less than half of the normal range. Moreover, there is no difference in plasma zinc level between cirrhotic patients due to hepatitis B or hepatitis C. Regarding to this result, supplementation with complementary zinc, may be recommended in both groups in order to optimize the nutritional support and probably better the treatment response.
Collapse
Affiliation(s)
- Mohammad Abbasi Nazari
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Research Center for Gastrointestinal and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding author at: Mohammad Abbasi Nazari, Ph.D., Assistant Professor of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel.: +982188873704, Fax: +98 21 8887 3704, E-mail:
| | - Sahar Hasani Malayeri
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Pourhoseingholi
- Research Center for Gastrointestinal and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Mohebi
- Research Center for Gastrointestinal and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Research Center for Gastrointestinal and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29
|
Nejad MR, Mojarad EN, Dabiri H, Nochi Z, Pourhoseingholi MA, Habibi M, Zali MR. PP-174 A case-control study of Blastocystis hominis among Iranian population. Int J Infect Dis 2009. [DOI: 10.1016/s1201-9712(09)60568-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
30
|
Pourhoseingholi MA, Moghimi-Dehkordi B, Safaee A, Hajizadeh E, Solhpour A, Zali MR. Prognostic factors in gastric cancer using log-normal censored regression model. Indian J Med Res 2009; 129:262-267. [PMID: 19491418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND & OBJECTIVE Gastric cancer is one of the most common cancers in the world. It is rarely detected early, and the prognosis remains poor. Cox proportional hazard model is used to examine the relationship between survival and covariates. Parametric survival models such as log normal regression model can also be used for this analysis. We used log normal regression model in this study to evaluate prognostic factors in gastric cancer and compared with Cox model. METHODS We retrospectively studied the 746 patients diagnosed with gastric cancer admitted in a referral hospital in Tehran, Iran, from February 2003 through January 2007. Age at diagnosis, sex, extent of wall penetration, histology type, tumour grade, tumour size, pathologic stage, lymph node metastasis and presence of metastasis were entered into a log normal model. Hazard rate (HR) was employed to interpret the risk of death and the results were compared with Cox regression. The AIC (Akaike Information Criterion) was employed to compare the efficiency of models. RESULTS Univariate analysis indicated that with increasing age the risk of death increased significantly in both log normal and Cox models. Patients with greater tumour size were also in higher risk of death followed by those with poorly differentiated and moderately differentiated in tumour grade and advanced pathologic stage. The presence of metastasis was significant prognostic factor only in log normal analysis. In final multivariate model, age was still a significant prognostic factor in Cox regression but it was not significant in log normal model. Presence of metastasis followed by histology type were other prognostic features found significant in log normal results. Based on AIC, log normal model performed better than Cox. INTERPRETATION & CONCLUSION Our results suggest that early detection of patients in younger age and in primary stages and grade of tumour could be important to decrease the risk of death in patients with gastric cancer. Comparison between Cox and log normal models indicated that log normal regression model can be a useful statistical model to find prognostic factors instead of Cox.
Collapse
Affiliation(s)
- M A Pourhoseingholi
- Research Center for Gastroenterology & Liver Disease, Shahid Behashti University, M.C., Iran
| | | | | | | | | | | |
Collapse
|
31
|
Azadeh S, Moghimi-Dehkordi B, Fatem SR, Pourhoseingholi MA, Ghiasi S, Zali MR. Colorectal cancer in Iran: an epidemiological study. Asian Pac J Cancer Prev 2008; 9:123-126. [PMID: 18439090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common cancers worldwide. But information regarding CRC in Iran is limited; the aim of this study was to investigate the epidemiologic features of CRC in Iran, using 5-year data from cancer registry. METHODS This survey is a descriptive-analytic study consists of 1138 colorectal cancer patients who registered in Cancer Registry Center of Research Center for Gastroenterology and Liver Disease, Tehran, Iran. These data gathered using interview and pathology reports that registered in cancer registry forms. Data analysis was performed with descriptive and univariate methods. RESULTS Of 1138 patients, 696 cases were male and 442 female. There was no significant difference between males and females regarding age at diagnosis. 400 patients (35.1%) had a family history of cancer. The most common histology type of tumor was adenocarcinoma, NOS. In most cases (39.1%) tumor grading was well differentiated and there was no significant difference between males and females. CONCLUSION Colorectal cancer is a disease with nonspecific symptoms. Family history of cancer was evident in 35.1% of our cases and also 42.9% of patients were below the age of 50 years old, suggests that genetic factors may be play an important role in the development of this disease in our country.
Collapse
Affiliation(s)
- Safaee Azadeh
- Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | | | | | | | | |
Collapse
|