The city of hope-quality of life-ostomy questionnaire: persian translation and validation.

BACKGROUND: Since there is no disease-specific instrument for measuring quality-of-life (QOL) in Ostomy patients in Persian language. AIM: This study was designed to translate and evaluate the validity and reliability of City of Hope-quality of life-Ostomy questionnaire (COH-QOL-Ostomy questionnaire). SUBJECTS AND METHODS: This study was designed as cross-sectional study. Reliability of the subscales and the summary scores were demonstrated by intra-class correlation coefficients. Pearson's correlations of an item with its own scale and other scales were calculated to evaluated convergent and discriminant validity. Clinical validity was also evaluated by known-group comparisons. RESULTS: Cronbach's alpha coefficient for all subscales was about 0.70 or higher. Results of interscale correlation were satisfactory and each subscale only measured a single and specified trait. All subscales met the standards of convergent and discriminant validity. Known group comparison analysis showed significant differences in social and spiritual well-being. CONCLUSION: The findings confirmed the reliability and validity of Persian version of COH-QOL-Ostomy questionnaire. The instrument was also well received by the Iranian patients. It can be considered as a valuable instrument to assess the different aspects of health related quality-of-life in Ostomy patients and used in clinical research in the future.

Overweight and obesity and related factors in urban Iranian population aged between 20 to 84 years.

BACKGROUND: Obesity is one of the most common health problems in the world and is assuming epidemic proportions in both developed and developing countries. AIM: The present study aimed to provide population-based data on the prevalence of obesity and estimation the risk of some of demographic factors associated with obesity. SUBJECTS AND METHODS: From May 2007 through December 2008, we conducted a community-based cross-sectional survey on 3,000 males and females (age ≥ 20 years) in Tehran province. Respondents were asked to give their height and weight in the questionnaire. Body mass index (BMI) is recognized as the measure of overall obesity and calculated as body weight divided by the square body height in meters (kg/m(2)). RESULTS: The overall prevalence of overweight and obesity was 34.1% (924/2708) and 15.4% (417/2708). The combined prevalence of both overweight and obesity was 51.2% (1387/2708) in males and 57.5% (1557/2708) in females. The mean (SD) BMI for the total population studied was 26.14 (4.71) and it was higher in women than in men (P < 0.001). The overall prevalence of overweight and obesity was 39.5% (376/952) and 11.7% (111/952) in men and 36.9% (548/1458) and 20.6% (306/1458) in women. The multivariate-adjusted odds ratios of obesity showed that higher ages, females, married and low educated subjects had more chance to being obese. CONCLUSION: This population-based cross-sectional survey indicates that the prevalence of overweight and obesity are moderately high in the general Iranian population and must be considered as a significant public health problem at national level especially among women.

Epidemiology and histopathological features of esophageal cancer.

INTRODUCTION: Esophageal cancer is the 6th most common cause of cancer death in the world. During the past two decades some changes have occurred in histologic type and primary tumor location in some parts of the world but there is a little information about histopathological aspect of disease in Iran. The purpose of the present study was to clarify the features of histopathological of esophageal cancer in Iran. METHODS: This study designed as a cross sectional study. Data analysis was performed with descriptive and univariate methods. Information required for this study extracted from cancer registry forms. The cases were all patients who received a histopathological diagnosis of EC that were referred to this center from January 2003 to October 2008. RESULTS: A total of 264 EC cases were recruited in the study the lower third of the esophagus was the most frequent site of origin of these tumors. Squamus cell carcinoma was commonest histologic type of tumor. In 15.2% of cases tumor was metastasis to other organs. In 46.6% were in advanced stage at diagnosis. DISCUSSION: Based on result of present study, esophageal cancer in our country more presented in Squamus cell carcinoma histology type, in advanced stage. Since Squamus cell carcinoma have a poorer prognosis and given that these patients have vague symptomatology for approximately several months, therefore, early diagnosis and treatment led to better prognosis.

Family history of cancer and risk of gastric cancer in Iran.

INTRODUCTION: Gastric cancer is one of the major causes of cancer related death in the world. A number of risk factors are now known to be related to the development of the disease. Previous reports indicated that a family history is a serious risk, but there is a little information about this in Iran. The aim of this study was to explore the relation between family history of cancer in first and second degree relatives and the risk of GC in Iran. METHODS: The present study was designed as unmatched case control study. Cases were 746 patients with histologically confirmed GC and the 746 controls were randomly selected among the healthy participants in a health survey. Family history was extracted from a standard history form completed by the patient or from records created by a health care provider. Mantel-Heanszel odds ratios were computed for removing the confounding effect of age and sex. RESULTS: Overall, 9.7% of cases versus 5.6% of controls reported a family history of GC. Risk increased over twofold for this group. There was no significant association among family history of other cancers and GC (P>0.05). CONCLUSION: In conclusion, this study showed that family history of GC, especially in first-degree relatives, increases the risk of development of the disease. Further studies are needed to better understand the roles of genetic and environmental factors and their interaction in gastric cancer development in the Iranian community.

Family History as a Risk for Upper Gastrointestinal Tract Cancer: A Case Control Study.

BACKGROUND: Although, family history of cancer is an important risk factor for upper gastrointestinal cancers development, but limited information is available on the upper gastrointestinal cancers associated with family history in Iran. The purpose of this study was to define upper gastrointestinal cancers risk associated with family history of cancer. METHODS: This study was conducted as a case control study. A total number of 1,010 cases of upper gastrointestinal cancer and 1,010 healthy controls were recruited. For family history of cancer, questions were asked about any malignant tumor in first and second degree relatives. Adjusted odds ratio estimates for the association family history and upper gastrointestinal cancers risk and corresponding 95% confidence intervals were obtained. RESULTS: A family history of any malignant tumor in relatives was associated with 1.3 fold increased risks of upper gastrointestinal cancers. A first-degree family history of esophageal and gastric cancer was significantly associated with upper gastrointestinal cancers development, with an adjusted OR of 4.7(CI 95%: 2.6-8.4). CONCLUSION: Our findings suggested that risk for upper gastrointestinal cancers increases among individuals with family history of cancer. Therefore, appropriate screening strategies especially in relatives of patients should be considered to prevent and control of disease.

Population prevalence of first- and second-degree family history of breast and ovarian cancer.

BACKGROUND: Family cancer history is an important risk factor for common cancers, thus, recognizing pattern of familial cancer can help us to identify individuals who may have higher chance to develop specified cancers. METHODS: This cross-sectional survey assessed family history of cancer in first- and second degree relatives. Totally, 7,300 persons aged > or = 20 years selected by random sampling from Tehran general population. Age- and sex-specified prevalence of breast and ovarian cancer in respondent's family was calculated. RESULTS: Of all, 279(4.3%) individuals reported a history of breast or ovarian cancer in their relatives. The prevalence of breast cancer family history was 1.8% among first-degree relatives and 2.5% among second- degree relatives. For ovarian cancer, first- and second-degree prevalence ranged from 0.05 to 0.12%. Those with family history of cancer were more often young and female. CONCLUSIONS: Overall, the estimates of prevalence presented here are likely to be conservative compared with actual current prevalence because of some limitations. While family history is an important risk factor for common cancers such as breast cancer, recognizing pattern of familial cancer that signify increased risk can help us to identify individuals who may have higher chance to develop specified cancers.

Risk of colorectal cancer in relatives: a case control study.

BACKGROUND: In around 10 to 15% of all colorectal cancer (CRC) cases, a positive family history of colorectal cancer is observed . Although increased risk of colorectal cancer in individuals with a family history of the disease has been observed consistently in the past studies, limited information is available on colorectal cancer associated with family history in Iran. AIMS: The purpose of this study is to define the risk of colorectal cancer associated with a family history of cancer. SETTING AND DESIGN: The present study was designed as an unmatched case control study. The cases were 393 patients with histologically confirmed colorectal carcinomas and there were 393 controls, randomly selected from among the healthy participants in a health survey. METHODS: The family history was extracted from a standard history form completed by the patient or from the record created by a health care provider. STATISTICAL ANALYSIS: Mantel-Heanszel Odds Ratio was computed for removing the confounding effect of age and sex. RESULTS: A positive family history of cancer was reported by 36.4 and 24.4% among the cases and controls, respectively. Colorectal cancer risk increased two-fold in subjects who reported having first degree relatives with cancer. The adjusted odds ratio was 4.76, indicating that having a positive family history of colorectal cancer among relatives increased one's risk of colorectal cancer about 4.5-fold. CONCLUSION: According to our findings, a family history of cancer increased the risk of CRC. Due to this fact that there is no current colorectal cancer screening program in Iran, it is recommended that first degree relatives of patients with colorectal cancer should be considered as a priority group for screening programs.

Heartburn and related factors in general population in Tehran, capital of Iran.

BACKGROUND: Heartburn is a highly prevalent disorder and is one of the most common gastrointestinal (GI) symptoms encountered in clinical practice. Despite the increasing importance of the early diagnosis of heartburn, there are few studies available on the prevalence of the disease and its Symptoms. The aim of this study was to estimate the frequency of heartburn in the Iranian adult population and analyze its associations with possible confounding factors. MATERIAL AND METHODS: This study was designed as an epidemiological, cross-sectional and population based study that was conducted during May to December 2006 in Firoozkou city of Iran. Participants were interviewed by using a questionnaire which included sociodemographic, health relevant life style and clinical factors and GI symptoms. Statistical analysis was performed by using chi-square test and logistic regression model. RESULTS: The frequency of heartburn was 28% and is different between men and women (P < 0.05). Also there was a relationship between self report tension and anxiety, BMI and depression with heartburn in univariate analysis (p < 0.05), but in multivariate analysis only age, self report tension and anxiety had a significant relationship with heartburn. CONCLUSION: Heartburn is very frequent in Iranian population and has a considerable impact on everyday life. Many factors that may affect the prevalence of heartburn should be considered for prevention and control of this disease.

Relationship between uninvestigated dyspepsia and body mass index: a population-based study.

BACKGROUND AND AIM: Recent studies have shown inconsistent results about the association between body mass index and symptoms of gastrointestinal disorders. The aim of this study was to assess the association between body mass index (BMI) and symptoms of uninvestigated dyspepsia in patients with gastrointestinal symptoms and their relations with age. METHODS: This study was designed as a cross-sectional and population based evaluation that was conducted in Iran. The patients were interviewed by using questionnaire which was arranged on the basis of Rome III criteria for functional dyspepsia. The association between body mass index, age and dyspepsia symptoms was determined. RESULTS: A total of 790 patients with gastrointestinal symptoms (249 men, mean +/- SD of age, 49.9 +/- 19 years; mean +/- SD of BMI, 25.4 +/- 4.7) were included and among them 681 (86.2%) had symptoms of dyspepsia. The prevalence of dyspepsia symptoms among females younger and older than 50 years were 83% and 93.8% ,respectively, but these percentages among males younger and older than 50 years were 84.5% and 81.5%.In males younger and older than 50 years 42.9% and 37.6% had BMI over than 25, but these percentages were 51.3% and 54.8% for females. Among overweight and obese patients the prevalence of dyspepsia symptoms were 82.7% and 78%, respectively, compared with normal weight (90.7%). CONCLUSION: After the age of 50, the prevalence of dyspepsia symptoms and high body mass index were increased in females, but were decreased in males. No relation between symptoms of dyspepsia and body mass index in both genders was found.

A comparison between Cox proportional hazard models and logistic regression on prognostic factors in gastric cancer.

BACKGROUND: Despite its decreasing prevalence in industrialized nations, gastric cancer remains one of the most frequent cancers in the world. Since stomach cancer often was not detected until an advanced state, survival rate was rather low. AIM: The aim of the present study is to compare the Cox proportional hazard model and Logistic regression model to estimate prognostic of patients with gastric cancer. MATERIAL AND METHODS: To determine the independent prognostic factors reducing survival time for gastric cancer, we compared the parametric methods (logistic regression) and non-parametric methods (Cox proportional hazard models) applied to patients who registered in one cancer registry center located in southern Iran. RESULTS: Of 442, 266 (60.2 %) died. In multivariate analyses using the Cox proportional hazard model, Age at diagnosis (P = 0.018, Hazard rate = 1.84), grade of tumor (P = 0.018, Hazard rate = 1.56), and metastasis (P = 0.004, Hazard rate = 1.53) were the most independent prognostic factors. As well as, using the stepwise logistic regression model, Age at diagnosis, (P = 0.005, Odds Ratio = 1.01), grade of tumor (P = 0.025, OR = 1.95), and metastasis (P < 0.001, OR = 2.81) were also the most independent factors who affected on survival. CONCLUSION: Although regression coefficients are not all the same, these three factors are the most prognostic factors that affect on survival of gastric patients in both multivariate analyses.

Survival in gastric cancer patients: univariate and multivariate analysis.

BACKGROUND AND AIM: Cancer for a long time has been recognized as a fatal disease. Thus it is known to be major health problem in many countries throughout the world. In recent years, cancer morbidity and mortality increased in our country and especially gastric cancer has second order among all cancers. The aim of this study was to analysis the survival of patients diagnosed with gastric cancer and the factors which modify prognosis. METHODS: Retrospective study of overall patients diagnosed with gastric cancer registered in the cancer registry center of Research Center for Gastroenterology and Liver Disease (RCGLD), Shahid Beheshti University, M.C, Tehran, Iran, between Dec. 2001 and Dec. 2006 was done. Survival status of patients was followed by the telephone contact. The Kaplan-Meier statistical method was employed to determine the probability of survival and log-rank test to compare those. Cox regression was used to determine prognosis factors. P < 0.05 was considered as statistically significant. All calculations were carried out by SPSS (version13.0) statistical software. RESULTS: Of 746 patients, 38.6% are dead. The mean and median survival time was 42.45 and 22.8 months, respectively and five-year survival rate was 25.3%. With univariate analysis, Age at Diagnosis, surgery treatment, type of first treatment, pathologic stage, tumor size, histology type of tumor, extent of wall penetration and pathologic distant metastasis were significant prognostic factors related to overall survival time. Tumor size greater than 35mm (HR = 2.12) and have a metastasis (HR = 2.04) were found to be the statistically significant poor prognostic factors related to survival in multivariate analysis. CONCLUSIONS: According to results, early detection of cancer in lower ages and in primary grades of tumor is important to increase patient's life expectancy.

Predictors of quality of life in breast cancer patients under chemotherapy.

BACKGROUND: Today, the quality of life studies has an important role in health care especially in chronic diseases. Breast cancer has third order among women's malignancies. Now, survival rate for this cancer is long. However breast cancer has several complications that affected the patient's life. AIMS: The aim of this study was to assess the quality of life in Breast cancer patients under chemotherapy. SETTING AND DESIGN: A cross-sectional study conducted on 119 breast cancer patients that were admitted and treated in chemotherapy ward of Namazi hospital in Shiraz city, south of Iran, between Jan and Feb 2006. MATERIALS AND METHODS: The QLQ-C30 questionnaire was used to assess quality of life in these patients. STATISTICAL ANALYSIS: We used univariate methods. A multiple regression analysis was performed to identify predictors of quality of life. RESULTS: Mean age of patients was 48.27+/-11.42 with quality of life total score 64.92+/-24.28. All symptoms scales had reverse association with quality of life except appetite loss (P>0.05) and diarrhea (P=0.752). The results of the regression analyses showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant in predicting patients' quality of life. CONCLUSION: In conclusion, this study demonstrates the strength of the relationship between clinical and sociodemographical factors and breast cancer patients' quality of life. Psychological and financial support for women experiencing breast cancer diagnosis may improve quality of life.

[Traumatic tearing of the mesentery: immediate or deferred emergency surgery]. / Le lacerazioni traumatiche dei mesi: scelta chirurgica in urgenza immediata o differita.

We have considered a 1 year first-aid survey and focused a 6 checked mesentery vascular traumatic tearing cases. We have valued some hypotheses on pathogenic mechanism assumptions about these vascular injuries in abdomen trauma. Among these, we have focused our attention on the relationship between visceral stretching from alimentary bolus and abdominal vascular trauma. During diagnosis, we valued the importance of abdominal sounding, of echotomography and Computerized Tomography; the first one seems to be remarkable for reliability and quickness of accomplishment. In one case we have performed laparoscopic diagnostic-therapeutic approach. We suggested some standards for surgery choice related to injury amount. Monitoring is particularly important for those patients it can performed by invasive or image means seen that the unacknowledged endo-abdominal injury increases mortality by about 5-65%.