Journal of Arak University of Medical Sciences

Evaluation of Parametric Models with Estimating the Prediction Error by Apparent Loss Method in Analyzing Survival of Colorectal Patients

Arezoo Orooji

Background: Colorectal cancer is the most common gastrointestinal cancer. Investigating the factors that predict survival time for these patients is important.The purpose of this study was comparison of parametric models by estimating the prediction error and also identifying the effective factors on predicted survival time of patients with colorectal cancer.

Materials and Methods: This cohort study was conducted with 600 patients who were suffered from colorectal cancer in Taleghani Hospital of Tehran between 2001 to 2005 and they were followed up for at least 5 years. For identifying the effective factors on survival time, of the patients we analyzed the data by some parametric models such as Weibull, Exponential and Log logistic and compared these models with the estimation of prediction error by apparent loss method.

Results: Among 600 patients there was 344 men (57.3%) and 256 wemon (47.7%). Of total, 151 patients were died that 62.3% of them were men. Univariate analysis showed that the effect of BMI, sex, staging of tumor, tumor site were significant but in multivariate model staging of tumor and BMI were significant. By the estimation of prediction error, the best model was Log logistic.

Conclusion: With respect to the importance of survival time prediction, we found that we can use the prediction error to compare the parametric models. In addition, because of effectiveness of tumor stages and BMI in the patients’ survival time, survival time could be increased by an on-time diagnosis and an appropriate controled diet.

An Investigation of Glucose-6-phosphate Dehydrogenase Deficiency, Hyper Bilirubinemia, and Blood Incompatibility in Newborn Babies

Rouhi Afkari

Background: Glucose-6- phosphate Dehydrogenase enzyme (G6PD) is an enzyme deficiency that is transported inheritably. The lack of this enzyme decreases the energy revival of red blood cells and leads to Hemolysis which is the cause of severe neonatal jaundice. This study aims to investigating glucose-6-phosphate dehydrogenase deficiency, hyperbilirubinemia, and blood incompatibility in newborn babies in larestan city, located in south of Fars province, following the newborn screening national plan.

Materials and Methods: This study is a cross-sectional and descriptive study on 12079 newborns in larestan city that referred to the screeing center from the start of 2010 to the end of 2012. The blood samples were taken from the newborns' heels and were evaluated through G6PD tluorescent spot test. They were examined regarding their blood group, hematocrit, hemoglobin, Coombs test, reticulocyte count and bilirubin levels as well as demographic information.

Results: In this research, among the 12079 screened newborns, 2345 ones showed G6PD deficiency with a prevalence of 19.41 which is a high percentage in comparison to those of other cities in Iran. The prevalence of O+ blood group among sick babies and their mothers was significantly higher than of other blood groups. (60% and 56%, respectively). The Hyperbilirubinemia and the indirect coombs tests were positive in 52% and 12% of the sick babies, respectively.

Conclusion: The prevalence percentage of lack of this enzyme in girls of Larestan city is a little higher than in boys, even though since this disease depends on X, it should be more prevalent in boys.

Assessing the Effect of Gabapentin on Improving Quality of Life and Sleep Disruption in Postmenopausal Women

Hamid Reza Jamilian

Background: About 40% of postmenopausal women experience sleep disruption which can affect their quality of life. Various medications were used for managing the sleep disruption. There are some studies on the effectiveness of gabapentin in the management of post menopausal vasomotor symptoms and sleep disruption. The aim of present study was to assess the effect of gabapentin on improving quality of life and sleep of post menopausal women .

Materials and Methods: In this double blind clinical trial, 90 post menopausal women with sleep disruption were selected and randomly divided into two groups for 12 weeks intervention (300 mg gabapentin, twice daily) and control groups. SF36 questionnaire of quality of life and PSQI questionnaire of sleep quality were surveyed and compared before and after the intervention in patients.

Results: The mean age of participants were 52.7 ± 3.14 and 53.4±3.68 years in intervention and placebo groups respectively. There was no significant difference in demographic information and the mean score of SF36 and PSQI questionnaires between groups before the intervention (p>0.05). Significant improvement was seen in score of SF36 and PSQI in gabapentin group after the intervention and in comparison with placebo group (p=0.0001).

Conclusion: According to the results of present study, it seems that gabapentin 300 mg/twice daily for 12 weeks can improve quality of life and sleep of post menopausal women.

To Compare the Effect of Doxepin and Citerizine in Treatment of Allergic Rhinitis

Neda Salehjafari

Background: Allergic rhinitis is a common disease which is present in 20% of general population. Major symptoms include sneezing, rhinorrhea, nasal congestion, and nasal pruritus. It seems that tricyclic antidepressants blocking histamine receptors may be used as an effective treatment in allergic rhinitis.

Materials and Methods: In this clinical trial study, 84 patients with allergic rhinitis entered the study and randomly divided into two groups. Patients of 1st group received cetirizine and 2nd group received doxepin for 2 weeks. After 2 weeks patients were evaluated about sneezing, rhinorrhea, nasal congestion, and nasal pruritus.

Results: The results of our study showed that clinical score of patients after 2 weeks was not different in both groups (p=0.261). The only symptom that was affected by the kind of treatment and was significantly different between groups was sneezing (p=0.005).

Conclusion: It seems that there is not much difference in using cetirizine and doxepin in treatment of seasonal allergic rhinitis sympotoms. It is recommended that future studies use TCAs with more potent blocking anti-histamine receptors feature and on more samples.

To Compare the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Group Therapy in Reducing Depression in Mothers of Children with Disabilities

Narges Zamani

Background: Depression is on the top list of mental disorders which account for about 25 percent of patients referred to health centers in your world. So, is presented in different ways to treat it. Therefore, the aim of this study is to compare the effectiveness of Dialectical Behavior Therapy and Cognitive Behavioral Group Therapy in reducing depression in mothers of children with disabilities.

Materials and Methods: This study is quasi-experimental and consists of experimental and control groups. This study population was mothers referred to mobility, occupational therapy and physiotherapy centers who had depressive symptoms. 8 patients in each group were selected by convenience sampling. The research instrument were the Structured Clinical Interview for DSM-IV Axis I disorders and the revised Beck Depression Inventory form (1996). Dialectical behavior therapy and cognitive behavior therapy groups were instructured for 2 months (8 sessions of 2 to 2.5 hours). But the control group did not receive intervention.

Results: The results showed that there were significant differences between the mean depression scores of dialectical behavior therapy and cognitive therapy group with control group (p<0.001). Also, there is a significant difference between the mean depression scores of dialectical behavior therapy with cognitive therapy (p<0.001).

Conclusion: In the area of treatment and working with depressed people and those who are in crisis mode, it seems that dialectical behavior therapy and cognitive therapy group in view of its nature is very efficient and promising.

Investigation of the Effect of Recombinant Neutrophil Activating Protein (Hp-NapA) of Helicobacter Pylori on Proliferation and Viability by Peritoneal Macrophage from BALB/c Mice

Ashraf Mohabati Mobares

Background: The neutrophil-activating protein (HP-NAP) of Helicobacter pylori is a protective antigen and a major virulence factor of this bacteria. Stimulating the immune system for helicobacter infection treatment could have an important role. The aim of study is to assess the effect of recombinant Neutrophil activating protein (Hp-NapA) of helicobacter pylori on proliferation and viability of peritoneal macrophages from BALB/c mice.

Materials and Methods: In this experimental study, recombinant Hp-NapA of helicobacter pylori was produced in vitro. Mice peritoneal macrophages were purified and cultured. Different concentrations of recombinant Hp-NapA was used for macrophages stimulation. MTT assay was performed to assess the viability and proliferation of macrophages.

Results: The results elucidated that the increasing effect of stimulation with recombinant Hp-NapA was significant at the dose of 30 µg/ml (p=0.01). The rate of viabitity was significantly higher than control group at the doses of 30 and 60 µg/ml and in the concurrency series of recombinant protein with lipopolysaccharid, there was a statistically significarit increase in proliferation at just these doses.

Conclusion: According to our findings, recombinant Hp-NapA has a positive effect on proliferation, viability and function of peritoneal macrophages. Therefore, it is proposed that recombinant Hp-NapA can be studied as an immunomodulator for immunotherapy.

Head Circumference Index in Children and Adolescents with Autism Spectrum Disorders in Comparison to Intellectual Disability and its Relationship with Cognitive Factors

Reza Mastery Farahani

Background: Head circumference (and its related morphologic factors such as head length and width) is one of the morphologic indices that people with autism spectrum disorders (ASD) have different developmental patterns in comparison to their peers. So the aim of this study is to assess head circumference indices in relation to cognitive factors in ASD children and adolescents.

Materials and Methods: In this cross-sectional study, the case group was consisted of 129 students with ASD aged 7-18 years old. The control group was consisted of 103 students with intellectual disability (ID) aged 7-18 years old. Head circumference, head length and width was measured by meter and caliper respectively. In addition, socio- cognitive factors questionnaire was responded by parents.

Results: Results showed that the head circumference, length and width of ASD group was significantly greater than ID group (p<0.001). Moreover, ASD group achieved lower score on SSIS questionnaire than ID group (p<0.001). Furthermore, results showed that in ASD group with increasing the size of head circumference the score on socio-cognitive abilites and skills decreased (p<0.05).

Conclusion: Generally, this study indicated that the developmental trajectory as well as the relation of anthropmetric indices of head circumference and socio-cognitive factors in children and adolescents with ASDs is different from ID population.

The Effects of One Period of Exercise Walking Program on Textured Surface on Balance in Multiple Sclerosis Patients

Atena Shams

Background: Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system with signs and symptoms such as fatigue and balance that are disable. The purpose of this study was to assess the effect of training which instructions focus of attention on postural sway of multiple sclerosis patients.

Materials and Methods: The present quasi-experimental study used a pretest-posttest design. The subjects with the age of 27-42, expanded disability status scale 1-4 and were purposefully and voluntarily selected and randomly allocated to the experimental and control groups. Training program for groups was carried out in 3 weeks, five sessions per week, and each session lasted about one hour. Berg Balance Scale was used to measure balance. The data was analyzed by using analysis of independent and dependent sample t-test at a significance level of p≤0.05.

Results: The results showed that significant improvements observed in balance (p≤0.05). Also significant differences observed between post hoc scores in the experimental and control groups (p≥0.05).

Conclusion: According to research findings, the exercise walking program on textured surface resulted in considerable improvements in balance in multiple sclerosis. Also, the respective specialists can use these exercies as a complementary treatment along with the drug therapy for patiens with multiple sclerosis.

The Measurement of Health Belief Model (HBM) Constructs in the Prevention of Accidents and Injuries in Children in Khorramabad, 2014

Mohsen Shamsi

Background: Accidents and injuries one of the main causes of death and disability in the world and the most significant causes in children referred to hospital. So, this study aimed to assess the health belief model constructs and function of the mothers referred to health centers in the city of Khorramabad in the preventive behaviors of accidents and injuries in children.

Materials and Methods: This cross sectional and analytical study was done on 261 mothers with children aged less than 5 years are referred to health centers in the city of Khorramabad in 2014. Data was collected with a questionnaire based on the Health Belief Model. The data collected were analyzed by software SPSS-20.

Results: In this study the mean and standard deviation of age of mothers was 28.98±5.37 years and the mean score of function and self-efficacy were 59.1±14.74 and 69.1±11.07 respectively. Moreover, the mean scores of the other health belief model constructs such as perceived sensitivity, severity, benefits and barriers was higher than average. There was significant negative correlation between self-efficacy and perceived barriers (r=-0.256, p<0.01), and also between the perceived barriers and function (r=-0.391, p<0.01).

Conclusion: According to the score of the function of mothers and the other constructs of health belief model, training programs based on the model directly and indirectly in the form of multimedia training package recommended to promote preventive behaviors of accidents occur in children.

The Effect of High Intensity Interval Training (HIIT) on Gelatinase-A (MMP-2) Serum Levels and Muscle Damage Indices in Young Sedentary Girls

Maryam Nazari

Background: The current study aims to investigate the impact of high intensity interval training (HIIT) on serum levels of CK and LDH as the muscle damage indicators and on Gelatinase-A (MMP-2) serum levels as the tissae inflammatory marker among young sedentary girls.

Materials and Methods: For this quasi-experimental study, 14 sedentary female college students were selected and randomly divided into two groups including the exercise HIIT group (means and standard deviations of age: 21.28 ± 2.56 (years) weight:52.86 ±4.95 (kg) and height: 163.1±3.7 (cm)) and the control group (means and standard deviations of age: 20.25 ±7.50 (years) weight:52.64 ±3.67 (kg) and height: 162.4±4.5 (cm)). The experimental group performed six repetitions of one-minute runs at 90%- 95% of HRmax. The blood samples were collected before and 30 minutes after the exercise protocol. The serum CK, LDH and MMP-2 levels were measured using corresponding kits. The data were analyzed through the independent t-test at the significance level of 0.05 (p<0.05).

Results: After collecting and analyzing Data, the results showed that CK and LDH levels increased significantly after performing HIIT, while there was no significant change in MMP-2 due to the HIIT.

Conclusion: It can be concluded that the HIIT protocol will lead to an increase in some indicators of muscle damage such as CK, LDH, and that no significant changes could be observed for MMP-2 as the body's inflammation response.