Research articles
Mahmood Yousefi; Yousef Behzadi Sheikhrobat; Safa Najaf; Shahram Ghaffari; Hossein Ghaderi; Seyed Ezatollah Memarzadeh; Alireza Mahboub-Ahari; Mohsen Barouni; Mohammad-Hossein Biglu
Volume 19, Issue 5 , 2024, Pages 1-7
Abstract
Background: Mapping from non-performance-based measures onto generic performance-based measures provides an appropriate solution to derive utilities to be used in economic evaluations.Objectives: This study aimed to create a model through which EQ-5D utilities for cataracts can be obtained from scores ...
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Background: Mapping from non-performance-based measures onto generic performance-based measures provides an appropriate solution to derive utilities to be used in economic evaluations.Objectives: This study aimed to create a model through which EQ-5D utilities for cataracts can be obtained from scores on the disease-specific Catquest measure.Patients and Methods: One hundred ninety-nine observations from 103 patients who self-administered the EQ-5D, the Catquest and questions on demographic and clinical characteristics were included in the analysis. Data was divided into estimation and validation datasets. To predict EQ-5D utilities, multiple regression analysis, using the Ordinary Least Square (OLS) and the censored least absolute deviation (CLAD), was performed. Catquest scores, age, gender, and performing surgery were included as explanatory variables. An estimation dataset was used to derive the coefficients, and these coefficients were then validated using a validation dataset. Based on the explanatory power, the consistency, the simplicity, the mean absolute error (MAE) and the correlations between observed and fitted utilities, the most appropriate model was selected.Results: The mean EQ-5D and Catquest scores of the total sample were 0.631 and 15.8, respectively. Age and surgery showed no significant effect for either method. Removing age and surgery, model II was built and given an R2of 0.697, an MAE of 0.1176 for the OLS and an R2 of 0.614, and an MAE of 0.1153 for the CLAD method. In the validation stage, the CLAD revealed better prediction ability, with an MAE of 0.198 versus an MAE of 0.209 for the OLS. ICC and Bland-Altman analysis put the CLAD as a preferred method with the following equation: Utilities (EQ-5D) = 0.988 - 0.0281 × Catquest (PD) + 0.102 × gender (male = 1).Conclusions: Based on these results, a mapping function was obtained which appears to be valuable in predicting EQ-5D utilities from Catquest scores. This function gives an appropriate solution to estimate utilities when primary EQ-5D data is not available. Although the model represents good consistency and predictive ability, further examination of obtained function is required with large samples.
Research articles
Sareh Bagheri Josheghani; Rezvan Moniri; Farzaneh Firoozeh; Mojtaba Sehat; Kamran Dastehgoli; Hasan Koosha; Reza Khaltabadi Farahani
Volume 19, Issue 5 , 2024, Pages 1-7
Abstract
Background: Emergence of multidrug-resistant (MDR) Acinetobacter baumannii infections is becoming a worldwide threat to hospitalized patients, particularly in intensive care units.Objectives: The aim of this study was to investigate the antimicrobial susceptibility patterns and prevalence of blaOXA-type ...
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Background: Emergence of multidrug-resistant (MDR) Acinetobacter baumannii infections is becoming a worldwide threat to hospitalized patients, particularly in intensive care units.Objectives: The aim of this study was to investigate the antimicrobial susceptibility patterns and prevalence of blaOXA-type carbapenemases of A. baumannii isolates in a teaching hospital in Iran.Patients and Methods: The study included a total of 40 isolates of carbapenem-resistant A. baumannii, obtained from 103 tracheal tubes in hospitalized ICU patients. Antimicrobial susceptibility testing was performed according to CLSI guidelines. The blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-58, and ISAba1 genes were detected by PCR.Results: All of the A. baumanniiisolates were resistant to imipenem and meropenem, and 100% of the isolates were MDR. The blaOXA-51 and ISAba1 genes were detected in 100% of the isolates. blaOXA-23 and blaOXA-24 were detected in 90% and 40% of the isolates, respectively, but blaOXA-58 was absent in the A. baumannii isolates. In addition, 32.5% of carbapenem-resistant strains contained at least three genes encoding blaOXA-type carbapenemase. Colistin and polymyxin B were the most effective antibiotics. The sole risk factor for infection of hospitalized patients with carbapenem-resistant Acinetobacter strains was age over 40 years (P = 0.042). The mortality rate was 27.5%.Conclusions: These findings signify the alarming spread of OXA genes in A. baumannii strains in our intensive care unit. The spread of carbapenem-resistantAcinetobacter strains has serious health implications and requires the application of strict infection-control measures.
Research articles
Mojgan Mirghafourvand; Sakineh Mohammad -Alizadeh-Charandabi; Mohammad Asghari Jafarabadi; Azam Mohammadi; Sedigheh Soltanpour
Volume 19, Issue 5 , 2024, Pages 1-9
Abstract
Background: The functional status questionnaire is aimed as a self-administered functional assessment of the mothers’ performance in the postpartum period based on five different areas, including baby care, personal care, household, social and community, and occupational activities.Objectives: ...
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Background: The functional status questionnaire is aimed as a self-administered functional assessment of the mothers’ performance in the postpartum period based on five different areas, including baby care, personal care, household, social and community, and occupational activities.Objectives: The aim of this study was to evaluate the psychometric properties of the functional status questionnaire for assessing Iranian women in the postpartum period.Methods: In this cross-sectional, methodological study, 200 Iranian women were selected randomly via a two-stage cluster sampling method at the end of the postpartum 6th week from healthcare centers in six areas of Tehran (the capital of Iran). The translation validity of the questionnaire was confirmed by forward and backward translation. Content-related validity was determined in two qualitative and quantitative sections, respectively, by evaluating the experts’ opinions and calculating of content validity ratio (CVR) and content validity index (CVI), while the face validity was evaluated by a sample of 30 mothers in the postpartum period. To determine the construct validity, exploratory factor analysis was used. The reliability was determined in terms of reproducibility via the intra-class correlation coefficient (ICC) by test-retest and internal consistency (Cronbach’s alpha).Results: The CVI and CVR as the indices for content validity were 0.88 and 0.82, respectively. Further, the reliability was good, both in terms of reproducibility (ICC = 0.96) and internal consistency (α= 0.73). The construct validity was also supported by the exploratory factor analysis for all four areas of functional status. The Kaiser-Meyer-Olkin (KMO) index of household, social and community, baby care, and personal care activities subscales was calculated as 0.85, 0.85, 0.56, and 0.50, respectively. The total variance (%) for household activities, social and community, baby care, and personal care was 56.86, 53.94, 38.07, and 43.39. All items with a minimum and maximum factor loading of 0.2 and 0.96 are placed at the right factor.Conclusions: The findings support the instrument’s validity and reliability. Therefore, it is recommended to be used for both clinical and research purposes.
Case reports
Manzhen Zuo; Hongying Du; Aihua Chen; Yan Wang; Dandan Quan; Yaling Tao; Huamei Song
Volume 19, Issue 5 , 2024, Pages 1-5
Abstract
Introduction: Ovarian borderline serous papillary epithelioma is a rare epithelial ovarian tumor between adenoma and carcinoma. This study was carried out to compare six cases of ovarian borderline serous papillary epithelioma.Case Presentation: This retrospective study was conducted on 6 patients with ...
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Introduction: Ovarian borderline serous papillary epithelioma is a rare epithelial ovarian tumor between adenoma and carcinoma. This study was carried out to compare six cases of ovarian borderline serous papillary epithelioma.Case Presentation: This retrospective study was conducted on 6 patients with ovarian borderline serous papillary epithelioma regarding clinical symptoms, auxiliary examination, treatment process, and prognosis. These six patients were diagnosed with the disease from January 2010 to June 2013 in the People’s hospital of three Gorges university, Yichang, Hubei, China. Two patients were diagnosed with ovarian surface serous papillary epithelioma. One patient was diagnosed with ovarian surface serous papillary epithelioma transferred to bilateral fallopian tubes. One patient was diagnosed with ovarian borderline serous papillary epithelioma while parts of tissues had become cancerous. One patient was diagnosed with ovarian borderline serous papillary epithelioma with pelvic lymph node metastasis, which had transferred to bilateral fallopian tubes, omentum majus, and epityphlon. One patient was diagnosed with ovarian surface serous papillary epithelioma with epithelial hyperplasia. All the six patients received surgical resection.Conclusions: We recommend ovarian borderline serous papillary epithelioma evaluation for patients as preoperative observations, intraoperative careful exploration, and pathological diagnosis in order to find and timely treat ovarian borderline serous papillary epithelioma patients.
Research articles
Amir Hamta; Anoshirvan Kazemnejad; Mohammad Gholami Fesharaki; Roya Farhadi
Volume 19, Issue 5 , 2024, Pages 1-6
Abstract
Background: The effectiveness of cervical cerclage (CC) in mothers suffering cervical incompetence (CI) for preventing preterm birth (PTB) in twin gestations remains controversial. Some studies show that it plays a preventive role in the occurrence of PTB, while others suggest it is ineffective.Objectives: ...
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Background: The effectiveness of cervical cerclage (CC) in mothers suffering cervical incompetence (CI) for preventing preterm birth (PTB) in twin gestations remains controversial. Some studies show that it plays a preventive role in the occurrence of PTB, while others suggest it is ineffective.Objectives: Our aim was to evaluate the effectiveness of CC in preventing PTB and negative neonatal outcome (e.g., respiratory distress syndrome (RDS) and birth weight) based on a new statistical framework: multilevel analysis and propensity score matching (PSM) in twin pregnancies.Methods: A cross-sectional study was conducted in the maternity wards of three general and teaching hospitals in Tehran, Iran, during January 2014 to February 2015. Using stratified random sampling with the proportional allocation method, twin pregnancieswere randomly selected from the medical files list. Of 431 eligible individuals, 31 patients underwent CC as a result of CI, and the others had healthy cervixes and no CC. Next, variables that confound the relationships between CC and PTB (e.g., assisted reproductive technology (ART), preterm rupture of membrane (PROM), nulliparous, history of abortion, and mother’s age) by applying 1:2 PSM were matched in both groups. The CC group was considered the case group and, based on PSM, 61 patients, whose characteristics were similar to the CC group, were selected from 400 healthy mothers as a control group. For considering twins dependencies, multilevel modeling was used, and prevalence of PTB, LBW, and RDS, as well as mean gestational age in the two groups, were compared.Results: The standardized mean difference (SMD) shows that the distribution of confounding variables in the propensity-matched data is the same in both groups. Results revealed that, although gestational age in the case group was significantly less than the control group, the prevalence of PTB in case and control was not significantly different (P = 0.190). The prevalence of neonatal outcome of RDS and LBW in the case and control groups was not significant (P > 0.05).Conclusions: It appears that CC has an effective role in prevention of PTB, LBW, and RDS, because their prevalence in both groups was the same. However, drawing a clear conclusion regarding its role requires more research with a random clinical trial (RCT) design.
Research articles
Mohammad Esmaeil Motlagh; Seiyed Davoud Nasrollahpour Shirvani; Reza Ghadimi; Majzobeh Taheri; Zahra Hassanzadeh-Rostami
Volume 19, Issue 5 , 2024, Pages 1-7
Abstract
Background: Body mass index (BMI) is the most applicable measure to screen overweight and obesity. However, individual and demographic factors affect the BMI cutoff values.Objectives: The current study aimed to determine the cutoff points for waist circumference (WC), waist-to-hip ratio (WHpR), waistto-height ...
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Background: Body mass index (BMI) is the most applicable measure to screen overweight and obesity. However, individual and demographic factors affect the BMI cutoff values.Objectives: The current study aimed to determine the cutoff points for waist circumference (WC), waist-to-hip ratio (WHpR), waistto-height ratio (WHtR) and neck circumference (NC) as indicators of overweight and obesity in Iranian females.Methods: This cross-sectional survey was conducted on 2466 females, aged 30 - 59 years, recruited from five ethnic groups; Arab, Kurd, Sistani and Baluchi, Turk and Turkmen in Iran, from Nov 2015 to Feb 2016. The subjects were selected by cluster multistage random sampling through five provinces. Receiver operating characteristics (ROC) analyses and Youden index were used to estimate the optimal anthropometric cutoff points.Results: Overall, 38.1% of females were overweight and 38.0% were obese. Significant differences of nutritional status were observed among different ethnic groups (P < 0.001). The higher rates of overweight were observed in Kurd and Turk subject. Furthermore, the obesity was more common among Arab and Kurd subjects. Sistani and Baluchi showed the lowest rate of obesity and highest underweight. ROC analysis showed the highest area under curve (AUC) for WHtR and WC, followed by NC and WHpR was in the lowest area. The optimal cutoff points to diagnose overweight and obesity were WC, 90.25 and 95 cm, WHtR, 0.57 and 0.62, NC, 33 and 34 cm, and WHpR, 0.90 and 0.93 in total population, respectively.Conclusions: Higher cutoff values were proposed for anthropometric parameters in different ethnic groups of Iranian females compared to international cutoff points to predict overweight and obesity.
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