Validity and reliability of the Persian translation of the SF-36 version 2 questionnaire.

To assess the validity and reliability of a Persian translation of the SF-36 questionnaire (version 2) as a tool for use in the general population and outpatients, we carried out a cross-sectional study of the staff of Shiraz Medical School during November 2001. Response rate was 83.6%. Internal consistency for 8 scales using Cronbach's alpha was 0.87 (minimum recommended 0.85). Construct validity was acceptable as correlation between scales and some sociodemographic characteristics was significant. The correlation coefficient between 8 scales and related principal components was also acceptable. This translation is an appropriate tool for assessing health perceptions of the population.

Validity and reliability of the Persian translation of the SF-36 version 2 questionnaire

To assess the validity and reliability of a Persian translation of the SF-36 questionnaire [version 2] as a tool for use in the general population and outpatients, we carried out a cross-sectional study of the staff of Shiraz Medical School during November 2001. Response rate was 83.6%. Internal consistency for 8 scales using Cronbach's alpha was 0.87 [minimum recommended 0.85]. Construct validity was acceptable as correlation between scales and some sociodemographic characteristics was significant. The correlation coefficient between 8 scales and related principal components was also acceptable. This translation is an appropriate tool for assessing health perceptions of the population

A simple model for potential use with a misclassified binary outcome in epidemiology.

STUDY OBJECTIVE: Error in determination of disease outcome occurs in epidemiology, but such error is not usually corrected for in statistical analysis. A method of correction of risk estimates for misclassification of a binary disease outcome is developed here. METHODS: The method is a simple, closed form correction to the logistic regression estimate. A closed form variance estimate is also developed. SETTING: The method is illustrated in two studies, a cross sectional survey of cervicitis in Iran in 1996-97, as determined by inflammation on cervical smear specimens, and a case-cohort study of benign proliferative epithelial disease of the breast, in Canada 1980-88. MAIN RESULTS: The method provides corrected odds ratio estimates and corrects the spurious precision conferred by misclassification. CONCLUSIONS: The method is easy to apply and potentially useful, although potential failures of the assumptions involved should be borne in mind. It is necessary to give careful consideration to the plausibility or otherwise of the assumptions in the context of the individual study. Correction for misclassification of disease outcome may become more common with the development of readily applicable methods.

Assessment of a breast cancer screening programme in Shiraz, Islamic Republic of Iran.

A breast cancer screening programme was evaluated for approximately 10,000 women aged 35 years and older. There were 67 cases of breast cancer. Highest rates of attendance were seen among younger women (35-44 years) and middle socioeconomic groups. Lowest rates were among those aged over 65 years and low socioeconomic groups. The rate of detection by self-examination was similar to that by health personnel examination. At all stages of screening, positive findings were most common among the high socioeconomic class. Attendance decreased steadily from first to last stages of serial screening. Although mammography is the most sensitive method of detection, because of its high cost we suggest establishing breast self-examination education programmes and encouraging women to self-examine.

Assessment of a breast cancer screening programme in Shiraz, Islamic Republic of Iran

A breast cancer screening programme was evaluated for approximately 10,000 women aged 35 years and older. There were 67 cases of breast cancer. Highest rates of attendance were seen among younger women [35-44 years] and middle socioeconomic groups. Lowest rates were among those aged over 65 years and low socioeconomic groups. The rate of detection by self-examination was similar to that by health personnel examination. At all stages of screening, positive findings were most common among the high socioeconomic class. Attendance decreased steadily from first to last stages of serial screening. Although mammography is the most sensitive method of detection, because of its high cost we suggest establishing breast self-examination education programmes and encouraging women to self-examine

Risk factors for and relationship between bacterial vaginosis and cervicitis in a high risk population for cervicitis in Southern Iran.

In 1990, a study of the reproductive habits and cervical pathology in women of the Qashgha'i nomadic tribe, resulted in a high prevalence of cervicitis. This led us to explore the likely infectious agents responsible for a such high prevalence; to assess the difference in cervicitis rates between nomadic and non-nomadic populations in the same area; and to determine the risk factors for and the relationship between cervicitis and bacterial vaginosis (BV). In 1996-1997 a study was carried out of 839 married women of the Qashgha'i, 274 of the Lor nomadic tribes, and 388 non-nomadic urban women. A gynaecological examination, Pap smear and vaginal secretion for assessing BV by gram staining were performed. Data was analysed by logistic regression. Backward stepwise regression was used to assess multivariable effects on risk of cervicitis. The prevalence of cervicitis was 88% in the Qashgha'i, 85% in the Lor and 71% in the urban population. In the multivariate backward stepwise regression analysis for predictors of cervicitis in the Qashgha'i, significant factors were decreased association with those over 40 (p < 0.004) and postpartum bleeding. In the Lor tribe the predictors were an increased risk after more than four pregnancies (p < 0.01) and the use of contraception. Among the urban population, the risk of cervicitis was increased with the use of oral contraceptive previously (p < 0.03) or currently (p < 0.01). BV was strongly associated with cervicitis, with a relatively high attributable risk. Both sexual and childbirth exposures may be associated with cervicitis in these populations.

Tuberculosis among never-jailed drug abusers.

The best way to control tuberculosis in a community is active case-finding and treatment among high-risk groups. Upon admission to a correctional centre in 1997, 319 never-jailed drug addicts were enrolled in the present study. Statistically significant differences in skin-test positivity were found among males over 40 years old, those unemployed and injecting drug abusers. Among the sample, 8 cases of pulmonary tuberculosis were found. This is approximately 170 times the rate in the general population. Because of cost and time, we recommend the screening of drug addicts by mini-radiography instead of tuberculin skin test at admission.

Tuberculosis among never-jailed drug abusers

The best way to control tuberculosis in a community is active case-finding and treatment among high-risk groups. Upon admission to a correctional centre in 1997, 319 never-jailed drug addicts were enrolled in the present study. Statistically significant differences in skin-test positivity were found among males over 40 years old, those unemployed and injecting drug abusers. Among the sample, 8 cases of pulmonary tuberculosis were found. This is approximately 170 times the rate in the general population. Because of cost and time, we recommend the screening of drug addicts by mini-radiography instead of tuberculin skin test at admission

Reproductive behaviour in women in Shiraz, Islamic Republic of Iran.

Data on the reproductive behaviour of women in Shiraz are presented. A total of 9934 randomly selected women aged > or = 35 years of all socioeconomic levels were interviewed. The mean age at menarche +/- standard deviation was 13.96 +/- 1.23 years, mean age at first marriage was 17.10 +/- 4.24 years and mean age at first pregnancy was 19.50 +/- 3.90 years. The mean number of children was 4.56 +/- 1.70 children, although for illiterate women it was 6.76 +/- 1.76 children and for high-school- or university-educated women it was 3.36 +/- 1.70 children. The mean age at menopause was 47.80 +/- 3.78 years.

Prevalence of reproductive morbidity among women of the Qashqa'i tribe, Islamic Republic of Iran

Gynaecological problems related to childbearing were studied in 1010 married women of the semi-nomadic Qashqa'i tribe. The most common problems were cystocele [56.0%], uterine prolapse [53.6%] and rectocele [40.4%]. The prevalence of other problems such as cervical erosion and inflammation, urinary incontinence and dyspareunia was found to be between 24% and 40%. Early age at marriage and childbearing, high parity and poor access to medical facilities are considered to be the most important factors leading to these high prevalence rates, although the lifestyle of the women in this community could also be a major contributing factor

Tuberculosis among drug addicts in Shiraz, Islamic Republic of Iran

The relation between drug addiction and tuberculosis was assessed in a comparative prevalence study. A group of 561 male addicts were compared with a group of 1532 non-addicts of similar sociocultural background. The results of infection rate showed a statistically significant difference X[2] = 72, P < 0.001] in the proportion of positive tuberculin sensitivity between the groups [66.7% among addicts versus 45.6% in the control group]. Fourteen active cases of pulmonary tuberculosis were found among the addicts with no case in the control group. This gives a prevalence rate of 2500/100 000 addicts, more than 150 times the rate in the general population. Thus, drug addicts are a high-risk group for tuberculosis and a "hidden source" of the disease in the community

The characterization of Leishmania from patients with lymphadenopathy in Shiraz, Iran.

Leishmania were cultured from enlarged lymph nodes of 6 of 18 patients with localized lymphadenitis and no other sign or symptom of leishmaniasis in Shiraz, Iran. The organisms failed to produce visible lesions when injected intradermally or intraperitoneally into Swiss outbred white or Balb/c mice. Golden hamsters similarly injected appeared well 16 weeks later, but histological examination of their spleens and livers revealed a few amastigotes in sections of the liver of one. Lectin agglutination profiles of promastigotes cultured from 2 of the patients were identical with those obtained with the World Health Organization reference strain of L. tropica (MHOM/SU/74/K27). Isoenzyme characterization of one of the isolates showed it to be L. tropica zymodeme LON18.