Predicting Hospital Readmission in Heart Failure Patients in Iran: A Comparison of Various Machine Learning Methods / 대한의료정보학회지

Objectives@#Heart failure (HF) is a common disease with a high hospital readmission rate. This study considered class imbalance and missing data, which are two common issues in medical data. The current study’s main goal was to compare the performance of six machine learning (ML) methods for predicting hospital readmission in HF patients. @*Methods@#In this retrospective cohort study, information of 1,856 HF patients was analyzed. These patients were hospitalized in Farshchian Heart Center in Hamadan Province in Western Iran, from October 2015 to July 2019. The support vector machine (SVM), least-square SVM (LS-SVM), bagging, random forest (RF), AdaBoost, and naïve Bayes (NB) methods were used to predict hospital readmission. These methods’ performance was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Two imputation methods were also used to deal with missing data. @*Results@#Of the 1,856 HF patients, 29.9% had at least one hospital readmission. Among the ML methods, LS-SVM performed the worst, with accuracy in the range of 0.57–0.60, while RF performed the best, with the highest accuracy (range, 0.90–0.91). Other ML methods showed relatively good performance, with accuracy exceeding 0.84 in the test datasets. Furthermore, the performance of the SVM and LS-SVM methods in terms of accuracy was higher with the multiple imputation method than with the median imputation method. @*Conclusions@#This study showed that RF performed better, in terms of accuracy, than other methods for predicting hospital readmission in HF patients.

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data / 한국역학회지

OBJECTIVES@#Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.@*METHODS@#This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.@*RESULTS@#The risk of mortality from TB was found to increase with the unemployment rate (β

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data / 한국역학회지

OBJECTIVES: Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran. METHODS: This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages. RESULTS: The risk of mortality from TB was found to increase with the unemployment rate (β

Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data / 한국역학회지

OBJECTIVES: Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.METHODS: This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.RESULTS: The risk of mortality from TB was found to increase with the unemployment rate (β

Evaluating the impact of risk factors on birth weight and gestational age: a multilevel joint modeling approach

Background: Abnormalities in birth weight and gestational age cause several adverse maternal and infant out- comes. Our study aims to determine the potential factors that affect birth weight and gestational age, and their association

Materials and Methods: We conducted this cross-sectional study of 4415 pregnant women in Tehran, Iran, from July 6-21, 2015. Joint multilevel multiple logistic regression was used in the analysis with demographic and obstetrical variables at the first level, and the hospitals at the second level

Results: We observed the following prevalence rates: preterm [5.5%], term [94%], and postterm [0.5%]. Low birth weight [LBW] had a prevalence rate of 4.8%, whereas the prevalence rate for normal weight was 92.4, and 2.8% for macrosomia. Compared to term, older mother's age [odds ratio [OR]=1.04, 95% confidence interval [CI]: 1.02-1.07], preeclampsia [OR=4.14, 95% CI: 2.71-6.31], multiple pregnancy [OR=18.04, 95% CI: 9.75- 33.38], and use of assisted reproductive technology [ART] [OR=2.47, 95% CI: 1.64-33.73] were associated with preterm birth. Better socioeconomic status [SES] was responsible for decreased odds for postterm birth com- pared to term birth [OR=0.53, 95% CI: 0.37-0.74]. Cases with higher maternal body mass index [BMI] were 1.02 times more likely for macrosomia [95% CI: 1.01-1.04], and male infant sex [OR=1.78, 95% CI: 1.21-2.60]. LBW was related to multiparity [OR=0.59, 95% CI: 0.42-0.82], multiple pregnancy [OR=17.35, 95% CI: 9.73-30.94], and preeclampsia [OR=3.36, 95% CI: 2.15-5.24]

Conclusion: Maternal age, SES, preeclampsia, multiple pregnancy, ART, higher maternal BMI, parity, and male infant sex were determined to be predictive variables for birth weight and gestational age after taking into consideration their association by using a joint multilevel multiple logistic regression model

comparative study of cathepsin d expression in peripheral and central giant cell granuloma of the jaws by immunohistochemistry technique

Statement of the Problem: Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage

Purpose: This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics

Materials and Method: The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells [labeling index], the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared

Results: The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9 +/- 4.03 and 95.6 +/- 2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups [p= 0.586]. The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma [p> 0.001]. Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion [p= 0.001]

Conclusion: The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma

Diabetic peripheral neuropathy class prediction by multicategory support vector machine model: a cross-sectional study / 한국역학회지

OBJECTIVES: Diabetes is increasing in worldwide prevalence, toward epidemic levels. Diabetic neuropathy, one of the most common complications of diabetes mellitus, is a serious condition that can lead to amputation. This study used a multicategory support vector machine (MSVM) to predict diabetic peripheral neuropathy severity classified into four categories using patients' demographic characteristics and clinical features. METHODS: In this study, the data were collected at the Diabetes Center of Hamadan in Iran. Patients were enrolled by the convenience sampling method. Six hundred patients were recruited. After obtaining informed consent, a questionnaire collecting general information and a neuropathy disability score (NDS) questionnaire were administered. The NDS was used to classify the severity of the disease. We used MSVM with both one-against-all and one-against-one methods and three kernel functions, radial basis function (RBF), linear, and polynomial, to predict the class of disease with an unbalanced dataset. The synthetic minority class oversampling technique algorithm was used to improve model performance. To compare the performance of the models, the mean of accuracy was used. RESULTS: For predicting diabetic neuropathy, a classifier built from a balanced dataset and the RBF kernel function with a one-against-one strategy predicted the class to which a patient belonged with about 76% accuracy. CONCLUSIONS: The results of this study indicate that, in terms of overall classification accuracy, the MSVM model based on a balanced dataset can be useful for predicting the severity of diabetic neuropathy, and it should be further investigated for the prediction of other diseases.

Evaluation of Related Risk Factors in Number of Musculoskeletal Disorders Among Carpet Weavers in Iran

BACKGROUND: Musculoskeletal disorders (MSDs) are a common problem among carpet weavers. This study was undertaken to introduce affecting personal and occupational factors in developing the number of MSDs among carpet weavers. METHODS: A cross-sectional study was performed among 862 weavers in seven towns with regard to workhouse location in urban or rural regions. Data were collected by using questionnaires that contain personal, workplace, and information tools and the modified Nordic MSDs questionnaire. Statistical analysis was performed by applying Poisson and negative binomial mixed models using a full Bayesian hierarchical approach. The deviance information criterion was used for comparison between models and model selection. RESULTS: The majority of weavers (72%) were female and carpet weaving was the main job of 85.2% of workers. The negative binomial mixed model with lowest deviance information criterion was selected as the best model. The criteria showed the convergence of chains. Based on 95% Bayesian credible interval, the main job and weaving type variables statistically affected the number of MSDs, but variables age, sex, weaving comb, work experience, and carpet weaving looms were not significant. CONCLUSION: According to the results of this study, it can be concluded that occupational factors are associated with the number of MSDs developing among carpet weavers. Thus, using standard tools and decreasing hours of work per day can reduce frequency of MSDs among carpet weavers.

effect of family-centered care on management of blood glucose levels in adolescents with diabetes

Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus [T1DM]. This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were [Supervisory Behaviors of Caregiver] [SBC], [Management Behaviors of adolescents] [MBA] questionnaires, and the [Blood Glucose Levels Record Sheet]. Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. There was a significant difference between the subjects' MBA and SBC mean scores before [110.17 +/- 26.6] and after [134.6+/-1.28] intervention in four domains: [blood glucose testing], [insulin therapy], [meal plan] and [physical activity] [P<0.001]. There were significant differences between the mean levels of recorded blood glucose during a week before and after intervention and between the mean levels of Glycated Hemoglobin level [HbA1c] before [8.4 +/- 1.12] and three months after [7.78 +/- 1.2] it [P<0.001]. Pearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention [P<0.001]. Empowering adolescents with T1DM and their caregivers in home-centered care could improve diabetic adolescents' management of blood glucose levels and reduce their HbAlC levels. Therefore, Family-centered care could provide for better regime adherence at home

Study of p21 expression in oral lichen planus and oral squamous cell carcinoma by immunohistochemical technique

Statement of the Problem: Lichen planus is a mucocutaneous disease that is relatively common in middle aged individuals. Some studies have shown that oral lichen planus has a potential to progress to squamous cell carcinoma.p21 is a cyclin-dependent kinase inhibitor that regulates the cell cycle, thus it acts as an inhibitor in cell proliferation

Purpose: This study was aimed to evaluate and compare the immunostaining of p21 [as a proliferation inhibitory factor] in oral lichen planus [OLP] and oral squamous cell carcinoma [OSCC]

Materials and Method: In this descriptive cross-sectional study, p21expression was investigated in 24 samples of oral lichen planus [OLP], 24 samples of oral squamous cell carcinoma [OSCC] and 24 samples of oral epithelial hyperplasia [OEH] by employing immunohistochemical staining

Results: The mean percentage of p21-positive cells in OSCC [54.5 +/- 6.6] was significantly higher than that in OLP [32.8 +/- 6.08] and OEH [9.4 +/- 3.8]. Moreover, OLP samples expressed p21 significantly higher than the OEH. Kruskal Wallis test revealed a statistically significant difference between the groups regarding the intensity of staining [p< 0.001]

Conclusion: According to the findings of this study, the expression of p21 might be related to the potential carcinogenic transformation of lichen planus to SCC. Therefore, continuous follow-up periods for OLP are recommended for diagnosis of the malignant transformations in early stages

Three-dimensional analysis of the distal movement of maxillary 1st molars in patients fitted with mini-implant-aided trans-palatal arches / 대한치과교정학회지

OBJECTIVE: The aim of this study was to investigate three-dimensional molar displacement after distalization via miniscrews and a horizontal modification of the trans-palatal-arch (TPA). METHODS: The subjects in this clinical trial were 26 Class II patients. After the preparation of a complete set of diagnostic records, miniscrews were inserted between the maxillary 2nd premolar and 1st molar on the palatal side. Elastic modules connected to the TPA exerting an average force of 150-200 g/side parallel to the occlusal plane were applied. Cone-beam computed tomography was utilized to evaluate the position of the miniscrews relative to the adjacent teeth and maxillary sinus, and the direction of force relative to molar furcation. The distances from the central point of the incisive papilla to the mesiopalatal cusps of the 1st maxillary molars and the distances between the mesiopalatal cusps of the left and right molars were measured to evaluate displacement of the maxillary molars on the horizontal plane. Interocclusal space was used to evaluate vertical changes. RESULTS: Mean maxillary 1st molar distalization was 2.3 +/- 1.1 mm, at a rate of 0.4 +/- 0.2 mm/month, and rotation was not significant. Intermolar width increased by 2.9 +/- 1.8 mm. Molars were intruded relative to the neighboring teeth, from 0.1 to 0.8 mm. CONCLUSIONS: Distalization of molars was possible without extrusion, using the appliance investigated. The intrusive component of force reduced the rate of distal movement.

Prediction the groundwater level of Hamadan-Bahar Plain, west of Iran using support vector machines

Water is considered as the main source of life but water resources are limited and nonrenewable. Different factors have caused groundwater to decrease. Therefore, modeling and predicting groundwater level is of great importance. Monthly groundwater level data of about 20 years [October 1991 to February 2012] from the Hamadan-Bahar Plain, west of Iran were used based on peizometric height related to hydrologic years. The support vector machine [SVM], a new nonlinear regression technique, was used to predict groundwater level. The performance of the SVM model was assessed by using criteria of R[2], root mean square error [RMSE], means absolute error [MAE], means absolute percentage error [MAPE], correlation coefficient and efficiency coefficient [E] and was then com-pared with the classic time series model. The SVM model had greater R[2] [=0.933], E [=0.950] and Correlation [=0.965]. Moreo-ver, SVM had lower RMSE [=0.120], MAPE [=0.140] and MAE [=0.124]. There was no signifi-cant difference between the estimated values using two models and the observed value. The SVM outperforms classic time series model in predicting groundwater level. Therefore using the SVM model is reasonable for modeling and predicting fluctuations of groundwater level in Hamadan-Bahar Plain.

Prevalence and risk factors of five most common upper extremity disorders in diabetics

In addition to macrovascular and along with other microvascular complications, diabetic patients suffer from some common musculoskeletal complications. The aim of this study was to assess the prevalence of five musculoskeletal disorders of upper extremity including shoulder capsulitis [SC], limited joint mobility [LJM], Dupuytren's contracture [DC], carpal tunnel syndrome [CTS], and trigger finger [TF] as well as identify their related risk factors in diabetic patients. We recruited 432 types 1 or 2 diabetic patients and evaluated them for the presence of musculoskeletal disorders and their-related risk factors in 2012-13. The patients were exam-ined by an endocrinologist and then suspected subjects evaluated by a rheumatologist for defin-ing final diagnosis. The most prevalent musculoskeletal disorder of upper extremity was SC [8.79%], fol-lowed by CTS [8.56%], LJM [6.94%], DC [7.4%], and TF [6.71%]. Advanced age, female sex, smoking, and duration of diabetes were associated with the appearance of SC; female sex and duration of diabetes with CTS; advanced age and smoking with LJM; advanced age, duration of diabetes and history of foot ulcer with DC; and history of laser photocoagulation was associated with TF. The results show lower prevalence of upper musculoskeletal disorders and differ-ent associated risk factors in our diabetic population in comparison with previous studies on other populations.

gene selection method for survival prediction in diffuse large B-cell lymphomas patients using 1D discrete wavelet transform

An important aspect of microarray studies includes the prediction of patient survival based on their gene expression profile. To deal with the high dimensionality of this data, use of a dimension reduction procedure along with the survival prediction model is necessary. This study aimed to present a new method based on wavelet transform for survival relevant gene selection. The data included 2042 gene expression measurements from 40 patients with Diffuse Large B-Cell Lymphomas [DLBCL]. The pre-processing gene expression data is decomposed using third level of the 1D discrete wavelet transform. The detail coefficients at levels 1 and 2 are filtered out and expression data reconstructed using the approximation and detailed coefficients at the third level. All the genes are then scored based on the t score. Then genes with the highest scores are selected. By using forward selection method in Cox regression model, significant genes were identified. The results showed wavelet-based gene selection method presents acceptable survival prediction. Using this method, six significant genes were selected. It was indicated the expression of GENE3359X andGENE3968X decreased the survival time, whereas the expression of GENE967X, GENE3980X, GENE3405X andGENE1813X increased the survival time. Wavelet-based gene selection method is a potentially useful tool for the gene selection from microarray data in the context of survival analysis

clinicopathological study of odontogenic cysts and tumors in Hamadan, Iran

Statement of the Problem: Odontogenic cysts and tumors are the most frequent osseous destructive lesions of the jaws; however, there is little information regarding the relative frequency of these lesions among the Iranian population

Purpose: The purpose of this study was to determine the distribution of clinically and histologically- diagnosed odontogenic cysts and tumors during a period of 13 years in Hamadan, and also its correlation with age, gender, and the site of the lesion

Materials and Method: A descriptive cross-sectional study was performed on 413 oral and maxillofacial specimens during 1996 to 2008.The age and the gender of patients, as well as the site of lesion were recorded. The data were analyzed using SPSS software

Results: Totally, 70 specimens were recorded as odontogenic cysts and 11 specimens were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were dentigerous cysts [27.2%], followed by radicular cysts [18.6%] and odontogenic keratocysts [18.6%]. In addition, cysts were more frequent in male than female individuals. Ameloblastoma was the most frequent odontogenic tumor [64%]

Conclusion: Odontogenic cysts were in correlation with age, gender and location. These results showed that dentigerous cyst and odontogenic keratocyst were more frequent than other studies. More investigations should be performed to determine the frequency of odontogenic tumors in Iran

immunohistochemical survey to evaluate the expression of cd105 and cd34 in ameloblastoma and odontogenic keratocyst

Statement of the Problem: Ameloblastoma is the most common odontogenic tumor which is slow-growing, locally invasive and exhibit specific biologic behavior and high recurrence rate. Likewise, odontogenic keratocyst is a developmental odontogenic cyst that has a high recurrence rate and aggressive behavior. There are limited studies considering the relationship between the angiogenesis factors and the biologic behavior of these lesions

Purpose: the aim of this study was to evaluate the mean density of vessels in odontogenic keratocysts and ameloblastoma and investigate its possible relationship with biological behavior of these lesions

Materials and Method: In this descriptive-analytic cross-sectional study, 40 cases, comprising 10 odontogenic keratocysts and 30 ameloblastomas [10 plexiform, 10 follicular, and 10 unicystic type] were selected and were stained immuno-histochemically with CD34 and CD105. The micro vessel density was assessed and compared in all groups. T- test for the independent samples' One- way Anova, Wilcoxon test and Tukey tests were adopted for statistical analysis

Results: A statistically significant difference was observed in mean vascular density [MVD] between the odontogenic keratocyst and ameloblastoma groups concerning the CD105 and CD34 markers [p= 0.005, p= 0.000, respectively]. The MVD was significantly higher in ameloblastomas than odontogenic keratocyst. MVD with CD34 was significantly higher than MVD with CD105 in ameloblastomas [p= 0.00]

Conclusion: It can be suggested that angiogenesis might be one of the mechanisms that is more possible to contribute the aggressive biological behaviors in ameloblastoma rather than odontogenic keratocyst

Survival Analysis of Gastric Cancer Patients with Incomplete Data

PURPOSE: Survival analysis of gastric cancer patients requires knowledge about factors that affect survival time. This paper attempted to analyze the survival of patients with incomplete registered data by using imputation methods. MATERIALS AND METHODS: Three missing data imputation methods, including regression, expectation maximization algorithm, and multiple imputation (MI) using Monte Carlo Markov Chain methods, were applied to the data of cancer patients referred to the cancer institute at Imam Khomeini Hospital in Tehran in 2003 to 2008. The data included demographic variables, survival times, and censored variable of 471 patients with gastric cancer. After using imputation methods to account for missing covariate data, the data were analyzed using a Cox regression model and the results were compared. RESULTS: The mean patient survival time after diagnosis was 49.1+/-4.4 months. In the complete case analysis, which used information from 100 of the 471 patients, very wide and uninformative confidence intervals were obtained for the chemotherapy and surgery hazard ratios (HRs). However, after imputation, the maximum confidence interval widths for the chemotherapy and surgery HRs were 8.470 and 0.806, respectively. The minimum width corresponded with MI. Furthermore, the minimum Bayesian and Akaike information criteria values correlated with MI (-821.236 and -827.866, respectively). CONCLUSIONS: Missing value imputation increased the estimate precision and accuracy. In addition, MI yielded better results when compared with the expectation maximization algorithm and regression simple imputation methods.

Evaluation of the relation between salivary beta-2 microglobulin and viral proliferation in HBS Ag[+] HBV DNA PCR[+]and HBV DNA PCR[-] subjects

Hepatitis includes a wide range of clinical and pathological conditions. The beta-2 microglobulin [B[2][M], as part of the HLA complex, is responsible for transmission of viral antigens on the surface of liver cells. The purpose of this study is to determine the concentration of salivary B2M as a marker of viral proliferation in subjects who are HbsAg[1], HBV DNA PCR[+] compared with those who are HbsAg[+], HBV DNA PCR[-]. In this case-control study, we enrolled 25 patients who were Hbs Ag[+], HBV DNA PCR[+] in addition to 21 patients who were Hbs Ag[+], HBV DNA PCR[-]. We obtained sputum samples from all patients and measured salivary B[2]M levels by nephelometry. Data analyses were performed by the descriptive, student's t- and chi-square tests. There were 25 men [54.3%] and 21 women [45.7%] with a mean age of 35.72 +/- 11.86 years who participated. Of PCR[+] patients, 72% were on medication, however 85.7% of the PCR[-] patients did not take medication [p<0.001]. Salivary B[2]M concentration in the PCR[+] patients [5.28 +/- 5.45] was greater than observed in the PCR patients [1.51 +/- 0.77], of which this difference was statistically significant [p<0.003]. Salivary B2M levels, as a marker of viral replication, could be used in patients with hepatitis B

effect of viewing conditions on reader performance in radiographic images

Accurate interpretation of radiographic images is dependent on viewing conditions. Recently the number of radiology departments has been increased so it needs to use a workstation for reporting. The aim of this study was assess monitor performance and the effect of viewing conditions on object detection. This investigation aimed to quantify the effects of changes in box brightness and ambient light level on reader performance. Radiographs of the contrast-details phantom were taken in multiple exposures and were viewed by six observers. The viewing test was performed in 50,100 and 150 lux of ambient light in compound with 1000,1500 and 2000 cd m-2 box brightness. The percentage of uniformity was also 85. The results were analyzed by SPSS software. Low contrast visibility generally increased when the ambient light was 100 lux. The greatest performance was obtained in 2000 cd m-2 brightness and 15% non uniformity in mentioned ambient lighting. Reader performance not affected by ambient light and view box luminance although it seems those factors influenced on detection of low-contrast features in some studies

Prevalence and related factors for choosing self-medication among pharmacies visitors based on health belief model in Hamadan province, west of Iran

Self-medication has increased in the last decade in Iran; can be followed several complications. The aim of this study was to determine the prevalence and factors influencing self-medication based on health belief model. A cross-sectional study was conducted among 1400 Hamadan Province pharmacies visitors, during spring and summer 2012 which was randomly selected with the proportional to size among different pharmacy at Hamadan for participation in this study. A structured questionnaire was applied for collecting data, which were analyzed by SPSS version 16 using bivariate correlations and logistic regression statistical tests. 35.4% of the participants had self-medication. Pain medication [10.6%], antibiotics [7.3%] and anti-cough and cold medications [4.5%] had the largest consumption. The main reasons of self-medication among participants were previous use of medication, symptoms improve and similar prescribed. The best predictor for self-medication was perceived severity with odds ratio estimate of 0.790 [95% CI: 0.694, 0.900]. It seems that designing and implementation of educational programs to increase seriousness about side effect of self-medication may be usefulness of the results in order to prevent of self-medication