[Predicting type two diabetes and determination of effectiveness of risk factors applying logistic regression model]

Background and Aim: Diabetes is one of the chronic diseases with no curative treatment; also, it is the most common cause of amputation, blindness and chronic renal failure and the most important risk factor of heart diseases. Logistic regression is one of the statistical analysis models for predicting that can be used to find out the relationship between dependent and predictor independent variables and control of the confounding variables. The aim of this study was to determine the rate of effective variables on diabetes and estimation of the logistic regression model for predicting

Methods: 5357 persons in Kerman city, Iran, were enrolled. Diabetes considered as the response variable and weight, height, body mass index [BMI], waist circumference, hip circumference, waist-to-hip ratio [WHR], age, gender, occupation, education, drugs, drug abuse, activities, systolic and diastolic blood pressure, and levels of total cholesterol, the high-density lipoprotein [HDL], the low-density lipoprotein [LDL], and triglycerides were considered as independent variables in the model. Measures of sensitivity, specificity, accuracy, Kappa measure of agreement and ROC [receiver operating characteristic] curve was applied for determining the power of test

Results: The Sensitivity, specificity, accuracy rate, Kappa measure of agreement and area under the ROC curve for the model were 0.764, 0.725, 0.731, 0.312 and 0.822, respectively. The following variables were significant according to their impact and their importance, respectively: WHR [beta = 2.66, OR=14.32], anti-hypertensive drug [beta =1.279, OR= 3.59], sex [beta =0.707, OR= 2.028], level of education, walking and cycling [beta = 0.136, OR= 1.146], waist circumference [beta =0.12, OR= 1.127], weight [beta = 0.112, OR= 1.118], BMI [beta = 0.053, OR= 1.054], systolic blood pressure [beta =0.052, OR= 1.054], age [beta =0.046, OR= 1.047], diastolic blood pressure [beta =0.043, OR= 1.044], total cholesterol [beta = 0.003, OR= 1.003], triglycerides [beta =0.01, OR= 1.011], LDL [beta = 0.001, OR= 1.001], hip circumference [beta = - 0.025, OR= 1.025], height [beta = -0.071, OR= 0.932], HDL [beta = -0.078, OR= 0.925], an intense 10-minute work activities [beta = -0.507, OR=0.602]

Conclusion: According to the criteria of accuracy and power of prediction, and considering ROC curve value [0.822] which could perform test accuracy as well for the diagnosis of diabetes, the logistic regression model was an appropriate model for the prediction of diabetes in this study

[ prevalence of hypothyroidism based on risk factors in pregnant women referred to Shahid Dadbin Clinic, Kerman, Iran]

Since at early pregnancy [<20 week] fetal thyroid gland is undeveloped, normal development of the Fetal brain is highly dependent on maternal thyroid hormones. There are excessive adverse perinatal outcomes associated with overt and subclinical hypothyroidism such as increase of Abortion, preeclampsia, placenta Abruption, LBW, preterm labor, impaired fetal neuropsychological development and low IQ scores. The aim of this study was to determine the prevalence of hypothyroidism and its relationship with some known risk factors among pregnant women with gestational age<20 wk. A total of 620 pregnant women referred to Dadbin clinic [Kerman/Iran] for their first prenatal care before the 20th week of gestational age were studied for TSH and FT4 levels by Elexis method. A questionnaire including known risk factors of hypothyroidism was filled out for each participant. The prevalence of both clinical and subclinical hypothyroidism and its probable association with some risk factors were studied. The prevalence of hypothyroidism was 10.15% [clinical=2.25% and subclinical=7.9%]. Except for allergy, no relationship between hypothyroidism and considered risk factors was found. Due to the high prevalence of hypothyroidism [clinical and subclinical] and its neonatal and maternal outcomes, hypothyroidism screening in all pregnant women as one of the routine prenatal cares is suggested

comparison of prevalence of diabete and hypertension between rural areas of Fars and rural area of EMRO region

Since monitoring and evaluation of diabetes and hypertension in individuals/the population greatly contribute to improving both clinical care and following identification of disease in the region and even the country, and to manage prevent and control diabetes and hypertension and their risk factors, the goal of this study was to compare disease status in rural areas of Fars province and rural areas of the EMRO region. The current study is a descriptive-analytic cross sectional one that has been conducted in 2008 by randomized cluster sampling, based on data obtained from an extensive provincial screening plan for adults aged over 30 years in rural areas of Fars province. Based on these data, the prevalence of diabetes, hypertension and their risk factors were calculated and the relationship between diabetes and hypertension was determined by risk factors including age, sex, family history, and Ml using Chi square and t-test and SPSS software version 17 and Minitab version, prevalences in 15 is rural areas were compared with the ones in EMRO region countries. The prevalence of hypertension and diabetes rural areas of Fars province were calculated to be 21.8% and 11.14% respectively as compared with rural areas of EMRO region countries.The prevalence of diabetes was also lower on the average and the prevalence of obesity [BMI>30], was less than other countries in the region and Iran. In general, although, the prevalence obtained in this study was lower than other regional countries, raising a wareness in high rish groups affected public commitment to basic information transmitting to high risk classes of the society should be taken into account and commitment by the health system administration and the government to sustain monitoring of health, to ensure curtailing the burden of diabetes and hypertension and associated risk factors among countries of the region

[Five-year epidemiological study and estimation of accidents distribution in construction industry workers in Yazd city by the year 2011 by applying time series model]

Occupational accidents are known as one of the most important causes of disabilities and mortality in developed and developing countries. Construction industry is one of the most high risk occupations which its hazardous are not known completely. In addition to occupational accidents, construction workers are faced many diseases factors such as asbestos, silicon, fumes and noises. The aim of this research was an epidemiological study and determination of a model for estimating accidents of instructor industry by the year 2011 in Yazd city. This study is a descriptive, analytical and distribution modeling. The questionnaire contained the variables of age, occupation, type of accident, injured part and the results of accident. In this research 247 construction workers injured along five years in Yazd were studied. Most of the injured workers had worked less than one year [34.8%] and 12.55% had worked more than 20 years. Fatal rate of workers with no insurance was significantly more than those who had insurance [p<0.01]. The most prevalent accident was falling [48.58%] and the less was chocking [2%]. The highest level of injury was in hands and feet [27.53%] followed by head injury [22.27%]. The relationships of accident results with occupation and also part of body were statistically significant [P<0.001]. More than 51% of head injuries lead to death. After testing many models, time series model of quadratic form was found to be the closest model to the trend of data. According to time series model estimation, with this trend the rate of occupational injuries would be more than 300 cases by the year 2011 and this recommends serious measures for prevention

Patient satisfaction and related factors in Kerman hospitals

To determine the level of patient satisfaction in hospitals in Kerman and to determine the factors affecting satisfaction, we did an analytic cross-sectional study on 3017 patients from March 2002 to March 2003. We used a 4-part questionnaire covering demographics, satisfaction, patients' needs and mental health status. Just over 50% of the patients were female. Mean age was 37.4 years [range 1-99 years]. Just under 50% of patients were satisfied. There was a significant relationship between satisfaction and type of hospital [P < 0.001], ward [P < 0.006], education level [P < 0.004], history of hospitalization [P < 0.001], need for medical services [P < 0.001], health status [P < 0.001] and duration of hospitalization [P < 0.002]

[ effect of opium addiction on response to major operation stress]

Internal medicine consultants are frequently asked to evaluate patients' tolerance against the stress of an intended surgical operation. Classification of surgical operations to mild, moderate and major is based on the morbidity and mortality rates due to the procedure, duration of procedure and underlying risk factors of the patient. Body response to surgical stress is via some hormonal alterations following the activation of hypothalamo pituarity adrenal axis [HPA] and hormonal changes reflect the degree of surgical stress. Due to high prevalence of addict patients operated in our surgery center and the established effect of opioid agents on HPA, this case - control study designed to detect the effect of chronic opioid usage on body response to major operation stress. Twenty six patients selected for laparatomy, thoracotomy or thyroidectomy in two equal and matched groups of opium - addict and nonaddict were studied for alterations in serum cortisol, CRP, Glucose and interleukin -6 immediately after the induction of anesthesia and 4 and 24 hours postoperatively. The obtained results were analyzed by t-test. Serum cortisol level of addict group 24 hours after operation [288 ng/dl] showed significant increase comparing to that of non-addict group [195 ng/dl]. The obtained result show more severe response of opium addicts to major surgery stress comparing to non addicts

[ evaluation of pain in neurosurgical patients before and after operation in Kerman Shahid Bahonar hospital according to the McGIl pain questionnaire]

The McGill Pain Questionnaire [MPQ consists primarily of 3 major classes of word descriptors -sensory, affective and evaluative that are used by patients to specific subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience the questionnaire was designed to provide questionnaire measures of clinical pain that can be treated statistically. This paper describes the procedures for administration of the questionnaire and the various measures that can be derived from-an Iranian version in comparison with previous results, which were obtained from other countries. The mean and standard deviation of these numbers, based on data obtained from 46 neurosurgical patients suffering from several kind of psych cognitive and emotional status, before and after surgery in Kerman Shahid Bahonar Hospital is presented. In addition, an experimental study utilizing the questionnaire was analyzed in order to describe the nature of the information obtained by an Iranian version. The data, taken together, indicate that the McGill Pain Questionnaire provides quantitative information that can be treated statistically, and is sufficiently sensitive to detect differences among deferent method of pain relieve which work with Iranian pain patients. These results show that the dimensions are close to the previous studies conducted by MeIzak and Torgerson [1971] and Ebrahimi-Nejad [1997]