JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2009 | Volume:14 | Issue:2|Papers Count:10

BACKGROUND: Strengths and difficulties questionnaire (SDQ) is a widely used instrument for screening mental problems in children and adolescents. The main aim of this study was to evaluate the validity and psychometric properties of this questionnaire in comparison with the children behavior checklist (CBCL) and psychiatric interview.METHODS: The study was done in two stages. At stage one, 600 children aged between 6 and 12 were evaluated using the parent and teacher versions of SDQ and CBCL. At stage two, 25 children with the scores above the cut point reported by the developer of SDQ and 27 children with the score below this point were selected to be interviewed by a child and adolescent psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) classification and by another clinician using the K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version) as a semi structured interview.RESULTS: The mean scores of SDQ subscales found in this study were comparable to what found in other studies in other countries. The cut-off points of SDQ were almost similar to that of other researches. The internal consistency and concurrent validity of this questionnaire was good.CONCLUSIONS: The current study showed that both parent and teacher versions of SDQ in Persian language can be used as a valid tool in screening the mental problems in children and adolescents.

BACKGROUND: Drowning is a preventable cause of morbidity and mortality. We studied drowning deaths in Isfahan province, focusing on the activity victims were involved in and the setting of the incident.METHODS: Retrospective analysis was done on all drowning deaths referred to Legal Medicine Organization of Isfahan province over a period of 5 years from 1 January 2002 to 31 December 2006.RESULTS: During these 5 years, 355 persons suffered fatal drowning in Isfahan province. The annual incidence rate was 1.6 per 100000 populations (2.6 & 0.4 for males and females, respectively). Mean age was 21.99±14.86 and M/F ratio was 6.5:1. Most victims were 15-24 and 5-14 years of age (172 and 62 decedents, 3.0 and 1.8 per 100000 population/ year, respectively). Most incidents occurred in natural settings, of which rivers, canals, lakes and ponds were the most common sites, respectively. The most frequently connected activity was swimming and wading, followed by accidental fall into water. The manner of death was found as following: 85.1% accidental, 1.7% suicidal, 0.3% homicidal and 12.9% undetermined.CONCLUSIONS: Although the drowning related mortality in Isfahan province is comparable to developed countries, effective prevention of drowning with better programming and policies might reduce its rate.

BACKGROUND: Aphasia diagnosis is particularly challenging due to the linguistic uncertainty and vagueness, inconsistencies in the definition of aphasic syndromes, large number of measurements with imprecision, natural diversity and subjectivity in test objects as well as in opinions of experts who diagnose the disease.METHODS: Fuzzy probability is proposed here as the basic framework for handling the uncertainties in medical diagnosis and particularly aphasia diagnosis. To efficiently construct this fuzzy probabilistic mapping, statistical analysis is performed that constructs input membership functions as well as determines an effective set of input features.RESULTS: Considering the high sensitivity of performance measures to different distribution of testing/training sets, a statistical t-test of significance is applied to compare fuzzy approach results with NN results as well as author’s earlier work using fuzzy logic. The proposed fuzzy probability estimator approach clearly provides better diagnosis for both classes of data sets. Specifically, for the first and second type of fuzzy probability classifiers, i.e. spontaneous speech and comprehensive model, P-values are 2.24E-08 and 0.0059, respectively, strongly rejecting the null hypothesis.CONCLUSIONS: The technique is applied and compared on both comprehensive and spontaneous speech test data for diagnosis of four Aphasia types: Anomic, Broca, Global and Wernicke. Statistical analysis confirms that the proposed approach can significantly improve accuracy using fewer Aphasia features.

BACKGROUND: The purpose of this study was to develop a simple risk score as screening tool for retinopathy in type II diabetic patients.METHODS: A cross-sectional study was carried out recruiting 3734 patients with type II diabetes in an outpatient clinic in Isfahan Endocrinology and Metabolism Research Center (IEMRC), Iran. The logistic regression was used as a model to predict diabetic retinopathy. The cut-off value for the risk score was determined using the Receiver Operating Characteristic (ROC) curve procedure.RESULTS: According to final models, being male, having lower body mass index (BMI), being older, longer duration of diabetes and higher HbA1c were correlated with increased risk of diabetic retinopathy. Area under the Curve (ROC) was 0.704 (95% CI: 0.685-0.723). A value³52.5 had the optimum sensitivity (60%) and specificity (69%) for determining diabetic retinopathy.CONCLUSIONS: The results indicated that risk factors for retinopathy were sex, BMI, age, duration of diabetes and HbA1c levels. In conclusion, applying developed retinopathy risk score is a practical way to identify patients who are at high risk for developing diabetic retinopathy for an early treatment.

BACKGROUND: To determine the prevalence of metabolic syndrome in survivors of childhood leukemia in Isfahan, Iran.METHODS: During a 4-year period (2003 to 2007), 55 children (33 male and 22 female) diagnosed with ALL at Unit of Hematology/ Oncology, Department of Pediatrics, Isfahan University of Medical Science, were enrolled in this crosssectional study. Metabolic syndrome was defined using the modified version of Adult Treatment Panel (ATP III) criteria. Insulin resistance was defined based on the homeostasis model assessment index (HOMA-IR).RESULTS: The mean age of participates was 10.4 years (range 6-19 years) and the mean interval since completion of chemotherapy was 35 months. Twenty percent (11/55) of survivors (10 male, 1 female) met criteria for diagnosis of metabolic syndrome. Obesity was observed in one forth of patients and nearly 3/4 of obese patients had metabolic syndrome. High serum insulin levels were found in 16% of participants and in 63% of obese survivors. The mean insulin levels in survivors with metabolic syndrome was three-times more than those without (28.3 mu/l vs. 9.57 mu/l, p=0.004). Insulin resistance was detected in 72.7% of survivors with metabolic syndrome and it was positively correlated with serum triglycerides (0.543, p³0.001), systolic and diastolic BP (0.348, p=0.01 and 0.368, p=006 respectively), insulin levels (0.914, p<0.001) and blood sugar (0.398, p=003).CONCLUSIONS: The prevalence of metabolic syndrome in survivors of childhood leukemia in Iran is higher than developed countries. Nearly all of the obese patients had metabolic syndrome. Weight control and regular physical exercise are recommended to the survivors.

BACKGROUND: The prevalence of carotid artery stenosis (CAS) in the general population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS) among patients with severe peripheral vascular disease (PVD).METHODS: Between March 2005 and February 2006, 54 consecutive patients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A questionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.RESULTS: The mean age was 62.5 years (51-72). Out of 54 patients, 2 (3.7%) had an occluded internal carotid artery. Significant CAS was found in 9 (16.7%) and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.CONCLUSION: The prevalence of significant ACAS is higher among patients with severe PVD. This patient population may indicate a suitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.

BACKGROUND: Acute myocardial infarction (AMI) is complicated by cardiogenic shock in 7~10% of patients. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Large thrombolytic trials demonstrate 60% mortality with most effective thrombolytic agent.METHODS: In between September 2005 to August 2008 total PCI in Shahid Gangalal National Heart Center (SGNHC) in Nepal was 452. Among them primary PCI (PPCI) in AMI with cardiogenic shock was done in only 16 patients (3.5%).RESULTS: This study showed in-hospital mortality of 50% (n= 8). Of 50% (n=8) alive patients with cardiogenic shock who underwent PPCI, 6 patients are in routine follow-up over 12 months and 2 were doing well in subsequent 6 months but not in follow up after that.CONCLUSION: Primary PCI in AMI complicated by cardiogenic shock has lower mortality and improved outcome. High cost, high in-hospital mortality and lack of trained personnel are major limitations.

BACKGROUND: To assess the prevalence of thinness among 5-10 year old school children of Nandigram, Purba Medinipur District of West Bengal, India.METHODS: A total of 596 students (323 boys and 288 girls) aged 5-10 years were included in this cross-sectional study. Height and weight were measured and the body mass index (BMI) was computed. The new international BMI-based classification cut-off points proposed by Cole et al were utilized to identify thinness.RESULTS: The overall (age-combined) mean BMI among boys and girls were 13.9 kg/m2 (SD=1.4) and 13.8 kg/m2 (SD=1.2), respectively. In general, mean BMI increased with age in both sexes. There was no significant sex difference in mean BMI. The overall (age-combined) prevalence of thinness was 62.9% and 61.6% in boys and girls, respectively.CONCLUSIONS: The present study clearly indicated that the nutritional situation of these children was unsatisfactory.

Osteoblastoma is rarely found in the hand or wrist. Review of literature revealed that only five cases of osteoblastoma have been reported in scaphoid bone. This paper presents a rare case of scaphoid osteoblastoma with unusual course in a young patient and its treatment process.

according to WHO report in 2002, lung cancer was the 9th cause of death and responsible for 2% of mortalities and it is predicted to be the 7th cause of death and responsible for 3% of mortalities by 2030. In southern Iran, lung cancer ASR is 2.18 in males and 0.82 in females. This active hospital-based study aimed to investigate the characteristic of lung cancer in southern Iran.