[Personal-social developmental screening of 0- 60 months old children by using DDST-II and ASQ]

Objective: This research was made to personal- social developmental screening of 4-60 months old children in Tehran city by DDST-II and ASQ and determining the agreement coefficient of two tests

Materials and Methods: In this study, the personal-social developmental status of 197 children 4-60 months old were screened by using ASQ and PDQ [93 girls and 104 boys]. Convenient sampling was used. Data was analyzed by SPSS software

Results: By using DDST-II and ASQ personal- social developmental delay detected in 11% and 1.5% of children respectively. The estimated consistency coefficient between DDST-II and ASQ for Personal- social domain was 0.06

Conclusion: In this study personal- social developmental screening of children showed different results and kappa measure agreement of two tests was weak. For selecting a suitable tool we must consider the psychometric characteristics [sensitivity, specificity, positive and negative predicting power] of the tool. This study showed that the results of developmental screening of 4-60 months old children in Tehran by using ASQ and PDQ lead to different results. This finding emphasizes the need to comparing the results of screening tests with a diagnostic gold standard test

Effect of teaching reading and traditional methods of language therapy on grammatical quotient of children with down syndrome

The present study compares the effects of reading instruction and traditional methods on grammar quotient of 4 to 10 years old children with down syndrome having IQ scores of 40 to 60. In this quasi-experimental and interventional study, 20 children with down syndrome, average mean age of 63 months, and 40 to 60 IQ scores were selected from 96 children with down syndrome from rehabilitation clinics within Tehran and Karaj, using convenience sampling. Then, they were assigned into two groups in the presence of their parents, using balanced randomized method. The first group was educated by whole-word reading method and the second group by traditional methods. Both groups had three 15-minute sessions per week for a period of 6 months. Pre-test and post-test grammar quotient of both groups was assessed using the Test of Persian language development. The obtained data were analyzed using the Kolmogorov-Smirnov test, t-test, and paired t-test. Both groups were quite similar in age, IQ, and grammar quotient, prior to training. However, the first group showed significant development in grammar quotient, after training [p<0.001]. In comparison with traditional methods of language therapy that emphasize on weakness of children with down syndrome by employing auditory modality, teaching reading through whole-word method based on their strength "visual memory" has more influence on grammar quotient of them

Investigation the role of gender on the HLA-DRB1 and -DQB1 association with type 1 diabetes mellitus in Iranian patients

Type 1 diabetes mellitus [T1D] is an autoimmune and multifactorial disorder. Subsequent analysis on human leukocyte antigen [HLA] region shows that HLA-DRB1 and -DQB1 genes have the strongest association with T1D. In this study, for the first time, we investigated the influence of gender on the HLA-DRB1 and -DQB1 association with type 1 diabetes mellitus in Iranian patients in order to determine gender dependent HLA heterogeneity in Iranian T1D patients. In this case control study, the HLA-DRB1 and -DQB1 typing were performed on 105 Iranian T1D patients and 100 healthy controls. The data were evaluated by using Fisher exact test. Our results indicate that DRB1*04:01, DQB1*03:02 alleles and DRB1*04:01-DQB1*03:02 haplotype were significantly more frequent in male T1D patients than females. Also, DRB1*03:01, DRB1*15:01, DQB1*06:01 alleles, DQB1*03:01/05:01 genotype, DRB1*03:01-DQB1*02:01 and DRB1*15:01-DQB1*06:01 haplotypes were significantly higher in female T1D group than males. Furthermore, our results showed that DRB1*04:01 and DQB1*03:02 alleles were significantly more frequent in male T1D patients 1-5 years old at onset than females with similar condition. The DRB1*03:01 allele and DRB1*03:01-DQB1*02:01 haplotype were significantly higher in female T1D patients 6-10 years old at onset than males with similar condition. The DRB1*15:01 allele and DRB1*15:01-DQB1*06:01 haplotype were significantly more frequent in female T1D patients 16-20 years old at onset than males with similar condition. Our findings suggest that gender has a significant influence on the distribution of HLA-DR and -DQ alleles, genotypes and haplotypes. Also, distribution of the HLA-DRB1 and -DQB1 alleles, genotypes and haplotypes vary based on the gender of T1D patients in different age at onset

[Investigation of the e-cadherin promoter methylation in patients with colorectal cancer in Iran]

E-cadherin is widely down-regulated and tightly associated with tumor invasion and metastasis in multiple human cancer types. Recent studies have shown that aberrant methylation of the E-cadherin gene promoter contributes to its silencing. However, information regarding epigenetic inactivation of E-cadherin in colorectal cancer is insufficient. Herein, we correlate association of the methylation of the ECadherin promoter with pathological features of colorectal cancer as well as history and demographic data. We used methylation specific polymerase chain reaction [MSPCR] to examine methylation status of the 5' CpG island of E-cadherin along with its expression by using RT-PCR following surgical resection of 66 unrelated patients with colorectal cancer. Results showed that 35 out of 66 tumor DNA samples [53%] showed aberrant methylations. In contrast, all normal tissues were unmethylated. The obtained results show a similarity with the Japanese [54.5%] and Greek [55.7%] populations. The results have confirmed methylation of this gene in sporadic colorectal cancer cases [40.8%] in the Iranian population by researchers in Shiraz. These data suggest that epigenetic silencing via aberrant methylation of the E-cadherin promoter plays a critical role in the inactivation of this tumor suppressor gene in colorectal cancer.

[Effect of exercise on quality of sleep in post-partum women]

Rapid changes experienced after child birth expose mothers to unpleasant experiences such as disturbances in sleep pattern. These experiences threaten health of mothers and infants. Some studies have shown that exercise can be an effective and nonpharmacologic method in improving sleep quality. The purpose of this study was to examine the effect of exercise on sleep quality among postpartum mothers. This was a randomized clinical trial. Eighty primiparous women aged 18-35 years were recruited from health centers in Rafsanjan in 2009. The inclusion criteria were singleton pregnancy, lack of any acute and chronic physical and mental illnesses, having healthy and term babies, and having vaginal deliveries. Participants were randomly allocated to the intervention [n=40] and control [n=40] groups. Women in the intervention group received five 30-minutes sessions of Pilates weekly for eight weeks. The PSQI instrument was used to measure the related variables at baseline, forth and eighth weeks after the deliveries. Data were analyzed using the repeated measures ANOVA. Significant improvement was seen in the intervention group within eight weeks follow-up; the interaction within time and group was significant [P=0.02]. Comparison of mean sleep quality between the two groups has shown that the intervention was effective [P<0.001]. The Pilates exercise was effective in improving quality of sleep in postpartum period

[Adherence of family caregivers of patients with stroke to rehabilitation regimen]

Due to physical and mental complications, stroke causes disability in self-care and adherence to rehabilitation in patients. The purpose of this study was to assess the adherence to rehabilitation regimen in family caregivers of patients with stroke. In this cross-sectional study, 180 family caregivers of patients with stroke were recruited to the study using convenience sampling method. The participants were asked to complete demographic sheet and the Adherence-of-Therapeutic-Regime Questionnaires during two months of stroke. Data were statistically analyzed using descriptive and inferential tests in the SPSS-16. Findings indicated that only about 10% of caregivers were in good levels of adherence to the rehabilitation regimen; and about 25% of them were weak. The weaknesses of the adherence were related to rehabilitation of motion, cognitive and emotional deficiencies, and also prevention of respiratory and skin disorders. According to the study, a small number of family caregivers were in appropriate level for adherence to the rehabilitation regimen. The nurses should be able to empower the family caregivers to decrease physical and psychological disorders related to stroke in patients

[Relationship between concentration of inhaled pollutants, Sulfur Dioxide and Nitrogen Dioxide and spontaneous abortion]

Living in polluted areas could be considered a risk factor for preterm labor and low birth weight. Few studies examined the association between air pollution and abortion. The aim of this study was to determine the relationship between ambient air pollutant and rate of spontaneous abortion. This study was a case-control research conducted on 148 cases of spontaneous abortion [case group] and 148 pregnant women [control group]. Samples were collected randomly from 10 hospitals in Tehran in 2011. The correlation between spontaneous abortion and air pollution was investigated by the SPSS software using independent sample t-test, multiple and linear regression models and also Arc View geospatial information system [GIS] software using circular buffer. The mean of environmental sulfur dioxide and nitrogen dioxide concentration in case group [35.91 +/- 20/46, 49.62 +/- 19.87] was significantly higher than that of the control group [29.1 +/- 11.11, 45.67 +/- 13.2] [p=0.000, p=o.o45]. Also it was determined that the rate of abortion was higher in those living within 100 meters of the highways. According to the findings of this study it seems that air pollution and living near crowded areas threaten the health of pregnant women and fetus. Thus, it is suggested to present necessary training about the hazardous effects of air pollution on pregnancy of women residing in crowded areas of city and also to adopt ways to reduce these pollutions.

[Education of how-to-use peak flow meter and following up via SMS on asthma self-management]

Asthma is one of the most prevalent chronic diseases worldwide. About 6.5 million people suffer from asthma in Iran. The Effective strategy to control asthma is related to education. The self-management has a major role in the standard education program. This study aimed to assess the effect of education on using peak flow meter and follow up via SMS on asthma self management. This study was a quasi-experimental controlled clinical trial. The samples included 98 patients, suffering from asthma referred to the pulmonary clinic in Imam Khomeini and Shariati hospitals. Patients were selected using convenient sampling method and were randomly assigned into the experiment [n=47] and control [n=51] groups through blocking method. Two educational sessions were held in the experiment group about how-to-use peak flow meter. Accordingly, the patients in the experiment group sent their peak flow rates via SMS to the researcher within 12 weeks. The researchers provided feedback to the patients about their asthma control via phone, weekly. Patients in the control group did not receive any education. Data were collected using the Asthma Control Test before and three months after the intervention. Data were analyzed using the statistical tests of Chi-square, Mann-Whitney, Independent t-test and Kolmogorov-Smirnov. There was a significant statistical difference between the two groups of experiment and control in terms of asthma control [P=0.002]. The education using peak flow meter and following up via SMS promotes asthma self-management. With regard to the significant role of nurses in patient education, educating patients with asthma by nurses is recommended at the Iranian Society of Asthma and Allergies clinics and medical centers

comparative study of the effect of massage with sunflower oil or sesame oil on infants5 crying and sleep times: a randomized clinical trial

Infants are very sensitive and special attention is needed to take care of their physical and mental health. Some studies showed that massage by parents can improve infants' sleep quality. The aim of this study was to compare the effect of massage with sunflower oil or sesame oil on infants' crying and sleep times. This triple-blinded clinical trial was conducted on 120 infants who were 10-15 days old, full-term, single, exclusively breastfed and with no history of hospitalization. The infants were assigned randomly into three groups of sunflower oil massage, sesame oil massage and massage with no oils. Mothers administered 15 minutes of massage to their infants twice per day [morning and afternoon] for 28 days. Times of crying and sleep were measured by a parents' information form at baseline, and at the end of the first, second, third, and fourth weeks of the study. Data were analyzed using the repeated measures ANOVA. Within four weeks of following, decreasing pattern of infants crying time was not significant [P=0.18]; however, the mean of crying time between the three groups was significant [P=0.007]. The interaction effect of crying time and groups was not significant [P=0.18]. Increasing pattern of infant sleep time was statistically significant in the fourth weeks of the following [P<0.001]; however, the mean of sleep time between three groups was not significant [P<0.56]. The interaction effect of sleeping time and groups was not significant [P<0.10]. Since there were not statistical significant differences between the infants' crying and sleep times between the three groups, and despite the fact that increasing pattern of infants sleep time is a normal pattern, it is not possible to have a proper conclusion

[ influence of HLA-DRB1,-DQB1 genes on age at onset of type 1 diabetes in Iranian T1D patients]

Survey of the influence of HLA-DRB1,-DQB1 alleles, genotypes and haplotypes on age at onset of type 1 diabetes [T1D] in an Iranian population 105 Iranian T1D patients of different ethnic group and 100 ethnically, age and sex matched individuals were selected from Tehran's hospitals and HLA-DRB,-DQB typing was performed. According to the age at onset of T1D, the patients were divided into 4 groups [1-5, 6-10, 11-15, 16-20 years]. The frequency of susceptible and protective alleles, genotypes and haplotypes was calculated in each group. The data were evaluated by using fisher's exact test. Odds Ratio or relative Risk was measured for all samples. The results illustrated that the frequency of the HLA-DRB1*0401 allele decreased with increasing age, whereas the frequency of the HLA-DQB1*0201 allele increased with increasing age. The HLA-DRB1*0301 and HLA-DQB1*0302 alleles demonstrated the highest frequency in the 6-11 and 1-5 years age at onset group, respectively. HLA-DRB1*0401-DQB1*0302 haplotype had the most frequency among the 1-5 years age at onset group [p: 2x10-7, OR: 69.919] and the frequency of HLA-DRB1*0301-DQB1*0201 haplotype was the highest in the 6-11 years age at onset group among others [p: 2x10-6, OR: 6.243]. The current study indicated that HLA-DRB1,-DQB1 alleles, genotypes and haplotypes are associated with age at onset of type1 Diabetes in Iranian T1D patients. The individuals carrying alleles that are associated with younger age at onset should take care under preventive treatment

[Has denver developmental screening test-II appropriate validity and reliability for screening of developmental disorders in 0-6 years old children in Tehran city?]

To identify the validity and reliability of Denver Developmental Screening Test II [DDST II] in Iranian children, in order to provide an appropriate developmental screening tool for evaluation of Iranian children development. A precise translation of the original test to Persian was done and it was revised by three developmental pediatricians. Then, DDST II was performed on 221 children aged 0 to 6 years, in four child health care centers of Tehran city. Available sampling was used. In order to determine agreement coefficient, these children were also evaluated by ASQ test in 4-60 months old children, and by developmental pediatricians in children who were out of this range. Obtained data was analyzed by SPSS software. There were developmental disorders in 34% and 12% of children who were examined by DDST II, and ASQ test respectively. The estimated consistency coefficient between DDST II and ASQ was weak [0.21], and between DDST II and physician's examination was 0.44. All of the questions in DDST II had content validity, and there was no need to change them. Test-retest and interrater methods were used in order to determine reliability of test, and Cronbach's alpha and Kauder-Richardson coefficients. Kauder- Richardson coefficient for different developmental domains was 61- 74%. Kappa measure of agreement for test-retest and interrater were 87% and 76% respectively. DDST II has a good validity and reliability, and can be used as a screening tool for developmental screening of Iranian children, but it is necessary to prepare and standardize of diagnostic developmental tests in Iran due to the low and medium consistency coefficient between DDST II and ASQ and physician's examination respectively

Evaluating the validity and reliability of PDQ-II and comparison with DDST-II for two step developmental screening

This research was designed to identify the validity and reliability of the Prescreening Developmental Questionnaire 2 [PDQ-II] in Tehran in comparison with the Denver Developmental Screening Test-II [DDST-II]. After translation and back translation, the final Persian version of test was verified by three pediatricians and also by reviewing relevant literature for content validity. The test was performed on 237 children ranging from 0 to 6 years old, recruited by convenient sampling, from four health care clinics in Tehran city. They were also evaluated by DDST II simultaneously. Interrater methods and Cronbach's alpha were used to determine reliability of the test. The Kappa agreement coefficient between PDQ and DDST II was determined. The data was analyzed by SPSS software. All of the questions in PDQ had satisfactory content validity. The total Cronbach's alpha coefficient of 0-9 months, 9-24 months, 2-4 years and 4-6 years questionnaires were 0.951, 0.926, 0.950 and 0.876, respectively. The Kappa measure of agreement for interrater tests was 0.89. The estimated agreement coefficient between PDQ and DDST II was 0.383. Based on two different categorizing possibilities for questionable scores, that is, "Delayed" or "Normal", sensitivity and specificity of PDQ was determined to be 35.7-63% and 75.8-92.2%, respectively. PDQ has a good content validity and reliability and moderate sensitivity and specificity in comparison with the DDST-II, but by considering their relatively weak agreement coefficient, using it along with DDST-II for a two-stage developmental screening process, remains doubtful

[Comparison of artificial neural network and Cox regression models in survival prediction of gastric cancer patients

Cox regression model is one of the statistical methods in survival analysis. Proportionality of hazard rate is an assumption of this model. In the recent decades, artificial neural network [ANN] model has increasingly used in survival prediction. This study aimed to predict the survival probability of Gastric cancer patients using Cox regression and ANN models. In this historical-cohort study, information of total of 436 gastric cancer patients with adenocarcinomas pathology who underwent surgery at the Taleghani hospital of Tehran between 2002 and 2007 were included. Data were divided to training and testing [or validation] groups, randomly. The Cox regression model [semi-parametric model] and a three layer ANN model were used for analyzing of database. Furthermore, the area under receiver operating characteristic curve [AUROC] and classification accuracy were used to compare these models. Prediction accuracy of ANN and Cox regression models were 81.51% and 72.60%, respectively. In addition, AUROC of ANN and Coz regression models were 0.826 and 0.754, respectively. ANN was better than Cox regression model in terms of AUROC and accuracy of prediction. Therefore, ANN model is recommended for prediction of survival probability. These finding are very important in health research, particularly in allocation of medical resources for patients who predicted as high-risks

Validity and reliability determination of Denver developmental screening test-II in 0-6 year-olds in Tehran

This research was designed to identify the validity and reliability of the Persian version of Denver Developmental Screening Test II [DDST-II] in Iranian children, in order to provide an appropriate developmental screening tool for Iranian child health workers. At first a precise translation of test was done by three specialists in English literature and then it was revised by three pediatricians familiar with developmental domains. Then, DDST-II was performed on 221 children ranging from 0 to 6 years, in four Child Health Clinics, in north, south, east and west regions of Tehran city. In order to determine the agreement coefficient, these children were also evaluated by Ages and Stages Questionnaires [ASQ] test. Because ASQ is designed to use for 4-60 month- old children, children who were out of this rang were evaluated by developmental pediatricians. Available sampling was used. Obtained data was analyzed by SPSS software. Developmental disorders were observed in 34% of children who were examined by DDST-II, and in 12% of children who were examined by ASQ test. The estimated consistency coefficient between DDST-II and ASQ was 0.21, which is weak, and between DDST-II and the physicians' examination was 0.44. The content validity of DDST-II was verified by reviewing books and journals, and by specialists' opinions. All of the questions in DDST-II had appropriate content validity, and there was no need to change them. Test-retest and Inter-rater methods were used in order to determine reliability of the test, by Cronbach's alpha and Kauder-Richardson coefficients. Kauder-Richardson coefficient for different developmental domains was between 61% and 74%, which is good. Cronbach's alpha coefficient and Kappa measure of agreement for test-retest were 92% and 87% and for Inter-rater 90% and 76%, respectively. Persian version of DDST-II has a good validity and reliability, and can be used as a screening tool for developmental screening of children in Tehran city

[Analysis of antibody response to measles vaccine with censored data]

Analysis of measles serum antibody responses is an important tool for evaluating the level of immunity in vaccinated people and for determining the factors which influence protective immunity. Usually antibody concentration values which are determined by quantitative assays are left censored, so standard analysis such as simple linear regression model may not be appropriate. Measles antibodies were measured using Enzyme Linked Immunosorbent Assay [ELISA] in 200 person aged 5-25 years before and after vaccination. A censored regression model proposed in order to reduce the effects of censored data in parameter estimating. Twenty two persons [11 percent] of the sample had titer below detection limit which made censored data. 83 percent of children and teenagers [less than 16 years] and 88 percent of participant aged 16 and more were protective against measles disease, but there was no statistically significance between age and immunity [P= 0.4]. Although the number of females who had protective antibodies against measles was less than males, they possessed an average titer 42 percent higher than males [without considering covariates]. This proportion changed into 39% by using the censored regression model and adjusting with respect to [antibody titer before vaccination]. Both ratios showed higher vaccine- induced protection in females [P< 0.05]

Comparison of the mental health post abortion and post partum [normal vaginal delivery and cesarian section]

To assess and compare mental health after spontaneous abortion, normal vaginal delivery [NVD] and cesarian section [C/S]. This prospective analytical descriptive study was carried out in university-affiliated teaching hospitals in Tehran city, Iran. The specific questionnaire [PANAS and SCL-90] was applied in this study. The sample population of this study included 48 women during their post abortion period as well as 48 women after NVD and 48 women after C/S. The subjects' mental changes and disorders have been measured. It has been followed by interview and completing the questionnaires at first 24 hours and the weeks of 6th and 12th. The negative emotional change in the first 24 hours showed no significant differences between abortion and delivery [P=0/002] but on the week 6th and 12th after abortion and delivery the AN OVA test showed significant differences between [NVD and C/S] and abortion [P=0/00]. The frequency of mental disorders in the first 24th in the case and control groups were 33.3% and 10.3% respectively and the difference was statistically significant [P=0/00]. The severity of emotional changes after spontaneous abortion was more than NVD and in the C/S was more than the rate in NVD. The statistics reveals that abortion and delivery threaten women's psychological well-being and through the time the intensity of negative mental changes and disorders in all three mentioned groups was decreasing

Association between asthma severity and obesity in two asthma clinics in Tehran

The prevalence of both obesity and asthma has increased in recent years. Thus we decided to investigate the relation between obesity and asthma severity. We undertook a cross-sectional study in outpatient asthma clinics of 2 tertiary hospitals in Tehran. Obesity was defined as a body mass index greater than 30. Asthma severity was defined by using the Guide for Asthma Management and Prevention 2004 guidelines, according to patients' clinical and/or spirometerical parameters. Active cigarette smoking patients and patients with a history of other lung diseases were excluded. A total of 116 individuals, aged 16-83 years with a mean age of 46.57 +/- 15.05 years, met the entry criteria. There were 73 females and 43 males. The prevalence of obesity in our study population was 29.3%. The Spearman correlation coefficient between asthma severity and body mass index was r= 0.275 [p= 0.001]. Mean body mass index of females and males were 28.95 +/- 5.41 and 25.17 +/- 4.17, respectively. Mean body mass index of females with asthma was significantly higher than males [p< 0.0001]. The odds ratios for obesity were 8.650, 8.746, and 22.491 for mild, moderate and severe persistent asthma, respectively, compared to patients with mild intermittent asthma. With increasing asthma severity, we observed higher occurrence of obesity in adults. The association of asthma severity with obesity suggests that obesity may be a potentially modifiable risk factor for asthma or asthma exacerbation

Development of a sensitive quantitative competitive PCR assay for detection of human cytomegalovirus DNA

Accurate and rapid diagnosis of human cytomegalovirus [HCMV] disease in immunocompromised patients has remained as a challenge. Quantitative competitive PCR [QC-PCR] methods for detection of HCMV in these individuals have improved the positive and negative predictive values of PCR for diagnosis of HCMV disease. In this study we used QC-PCR assay, using a co-amplified DNA standard, to quantitate the HCMV glycoprotein B [gB] gene in different samples. A DNA internal standard [IS] was designed by replacing HCMV primer binding site at 5' ends of primers that amplifies a 156-bp fragment of lambda genome, and a 200 bp amplicon was produced. Two DNA fragments of 257 bp wild type and 200-bp [IS] were co-amplified with the same oligonucleotide primer sets, analyzed by gel electrophoresis and used for construction of a standard curve. From this, the copy number of the gB gene present in different samples could be determined. Co-amplification with 1,000 copies of IS, allowed quantitation of 10-100,000 of HCMV DNA in a single PCR. This rapid assay avoids using radioactive components and other less efficient quantitative systems. It has the potential for early identification of patients at high risk of development of HCMV disease, and is useful for therapeutic monitoring