Self-reported versus proxy reported quality of life for breast cancer patients in the Islamic Republic of Iran

Since quality of life [QoL] is subjective, self-reported QoL is the main source of assessment; however, in some situations the patient cannot evaluate his/her own status. In this cross-sectional study, 148 patients with breast cancer referred to the Cancer Institute of the Islamic Republic of Iran and their caregivers were selected through the consecutive sampling method. Five oncologists from this centre also evaluated the QoL of these patients. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was completed by these 3 groups and the results compared. The patient-caregiver intra-class correlation coefficient [ICC] for all 15 QLQ.C30 domains was moderate to good [ICC = 0.41-0.76]. Agreements between QoL scores of patients and those of oncologists were moderate to good, except in the 4 domains. In the patient-caregiver comparison there was 55% exact agreement, and for the patient-physician comparison agreement was 45%. The findings can be used in the patients' decision-making process and care planning when patients with breast cancer are unable to self-report the QoL

Fostering population-based cancer registries in developing countries

Due to the marked increase in the burden of eancer both in the developed and developing countries, World Health Organization recommends planning and implementation of comprehensive cancer control program in all countries. We evaluated evolutionary progress of the population based cancer registries [PBCR], an essential component of the cancer control program. We studied frequency and coverage of cancer registries worldwide in overall and stratified by regions and countries, using the data published in the [Cancer in Five Continents [CI5]] volume I-IX. Using the population proportion of the study unit as the weight, we estimated weighted average of the registration coverage in the studied countries and regions. We found that coverage of cancer registry is increasing worldwide. In overall, 224 PBCRs estimate cancer incidence in 19.6% of world population. While the coverage was almost complete in the western countries, some counties particularly in Africa and Asia lack even a single cancer registry. The lowest coverage was generally observed in Africa [1.4%] and Southeastern Asia [2%]. Using information technology, lead to a considerable increase in the coverage of cancer registries in the US, where it increased from 14% percent in 1997 to 96% in 2002. Developing countries must prioritize establishment of cancer registration system. Looking at the developed countries with well-functioning registries may help establish an efficient registration system in developing countries. Using advance information technology will help achieve an efficient and optimal PBCR

Metabolic and clinical effects of Ramadan fasting in patients with type 2 diabetes

To evaluate the effects of fasting on anthropometric indices and carbohydrate and lipid metabolism in patients with type II diabetes. Design: Observational non-interventional study. Place and Duration of Study:: Diabetes clinic, Shariati Hospital, Tehran, Iran during Ramadan 1419 [winter 1998-99]. Patients and Fifty-seven volunteers with type II diabetes underwent anthropometric and biochemical evaluation before and on the 14th and 28th days of Ramadan. Biochemical markers were measured by standard laboratory methods and anthropometric indices by WHO criteria. Statistical analysis was done by ANOVA for repeated measurements and Friedman's two-way ANOVA using SPSSv6 software. Daily cholesterol intake increased in all subjects [p<0.03]. Body mass index increased in women [p<0.03], but BMI and waist-hip ratio both decreased in men [p<0.01]. Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin [p<0.05], C-peptide [p<0.01] and insulin resistance [p<0.01] decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study. Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in patients with type II diabetes given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavourably altered due to changes in both diet and biochemical response to starvation