Reliability and validity of the persian version of the General Oral Health Assessment Index (GOHAI)

Introduction: As the oral health related quality of life has been important in many dental patients GOHAI is an acceptable tool, preparing its Persian version can be useful in oral health research among Persian populations. The aim of this study was to evaluate the reliability and validity of the Persian version of General Oral Health Assessment Index (GOHAI). Methods: Translation was performed using the forward-backward process. The final Persian version was then tested through an interview and test-retest to evaluate its comprehensibility and reliability. A sample of 150 subjects (20-65 years old) was requested to answer the GOHAI items prior to a clinical examination. Data on the subjects’ socio-demographic characteristics and self-rating report of oral health, general health and dental care needs were recorded. Internal consistency was calculated by Cronbach’s α. Interview and test-retest reliability was evaluated by weighted kappa. Concurrent validity was assessed by comparing GOHAI scores and self-rated measures of oral health, general health and perceived dental care needs. Discriminant validity was tested by comparing GOHAI scores with clinical oral condition. Results: The mean GOHAI score was 46.78±7.85. Cronbach’s α (0.78) showed a high internal consistency and homogeneity between items. Weighted kappa coefficient for the interview varied from 0.60 to 0.96 and was between 0.33 and 0.64 for test-retest. Bland-Altman plot displayed a good agreement between the two GOHAI scores for both the interview and test-retest. There was no significant relationship between GOHAI scores and self-rating oral health (p=0.090), but there was a relationship between self-rating general health and mean GOHAI scores (p=0.047). Also, the low GOHAI scores were associated with the perceived dental care needs (p=0.001). There was an opposite correlation between GOHAI scores and caries and missing teeth (p<0.0001). Conclusions: The Persian version of the GOHAI exhibits acceptable reliability and validity, so it can be used widely throughout the Persian communities

Prevalence, Awareness, Treatment, and Control of Hypertension among Adult Residents of Tehran: The Tehran Cohort Study.

Background High levels of blood pressure (BP) remain undetected and poorly controlled in large segments of the population leading to an enormous burden in terms of disease and mortality. Objective We aimed to assess the prevalence, awareness, treatment, and control of hypertension in Tehran. Methods We used the data of 8,296 adults aged ≥35 years from the Tehran Cohort Study who were enrolled between May 2016 and February 2019. Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, self-report, and/or current antihypertensive medication use. The age- and sex-weighted prevalence of hypertension and high normal BP was calculated using the 2016 national census. Furthermore, awareness, treatment, and control of hypertension were analyzed. Results The mean age of the participants was 53.8 ±12.75 years, and 54.0% were women. The weighted prevalence of hypertension and high normal BP were 36.5% and 12.2%, respectively. Among hypertensive individuals, 68.2% were aware of hypertension, 53.3% were receiving medication, and 40.4% had adequate BP control. The awareness, treatment, and control of hypertension were significantly higher in women (72.2% vs. 63.4% [P < 0.001], 55.1% vs 51.1% [P = 0.020], and 42.7% vs. 37.7% [P = 0.004], respectively) and this gap considerably increased with advancing age. Hypertension was more prevalent in northern Tehran but with a better treatment rate and control in the same regions. Conclusion Despite the high prevalence of hypertension in the adult population of Tehran, the rates of awareness, treatment, and control of hypertension are unsatisfactory and demand comprehensive strategies to improve this situation, especially in younger men

ESOPHAGEAL CANCER AND TYPE OF FOOD AND BEVERAGE CONSUMPTION

Abstract Objective-The high prevalence of esophageal cancer (EC) in northern Iran, along with its unknown etiology, continues to be a major public health problem. Ecological and casecontrol studies have discussed the probable role of dietary factors in this disease. The aim of this study was to determine the relationship between EC and the type and characteristics of consumed food and beverages at the time of the study as well as in the past. Results-There were no significant differences between the case and control groups in respect to the age, sex and ethnic origin. The case group showed significant differences in family history of cancer other than EC, history of gastroesophageal reflux, habit of rapid drinking of hot tea, and eating of hot foods. These factors were found to be related to the presence of EC, whereas eating cheese, vegetables, fresh fruits, black pepper and turmeric were found to be protective factors. Methods-A Conclusion-This study showed some differences in the diet content and habits of patients suffering from EC in comparison to normal controls. Further elaborate studies are required to reveal the true pattern of dietary divergence in these patients. Besides, the authors are aware that recall bias might have distorted some of the results. More objective measures for assessment of diets are recommended

Prevalence, awareness, treatment, and control of type 2 diabetes mellitus among the adult residents of tehran: Tehran Cohort Study.

BACKGROUND The prevalence of type 2 diabetes mellitus has increased in the past decades. We investigated the prevalence of diabetes and its awareness, treatment, and control among adult residents of Tehran. METHODS We used the recruitment phase data of the Tehran Cohort study, enrolling a random sample of adult residents of Tehran aged ≥35 years. Diabetes was defined as self-report, current use of glucose-lowering medications, and/or fasting plasma glucose (FPG) ≥126mg/dl. Impaired fasting glucose (IFG) was defined as an FPG of 100-125mg/dl. Awareness was defined as diabetes self-report, treatment as receiving glucose-lowering medications, and glycemic control as FPG <126mg/dl. The age- and sex-weighted estimates were calculated using the 2016 national census. Logistic regression models were used to determine the factors associated with diabetes awareness, treatment, and control. RESULTS A total of 8151 participants were included. Age- and sex-weighted prevalence of diabetes mellitus and IFG were 16.7% (95% CI: 15.1-18.4) and 25.1% (95% CI: 23.1-27.1), respectively. Diabetes was more prevalent in the eastern and central districts of Tehran. Advanced age (OR per 1-year increase: 1.026, 95% CI: 1.021-1.030), male sex (OR: 1.716, 95% CI: 1.543-1.909), higher BMI levels (OR for BMI ≥35 vs. <20 kg/m2: 4.852, 95% CI: 3.365-6.998), pre-existing hypertension (OR: 1.552, 95% CI: 1.378-1.747), dyslipidemia (OR: 1.692, 95% CI: 1.521-1.883), and chronic kidney disease (OR: 1.650, 95% CI: 1.019-2.673) were associated with an increased odds of diabetes mellitus. On the contrary, diabetes mellitus was less likely in current tobacco (OR: 0.872, 95% CI: 0.765-0.994) and alcohol users (OR: 0.836, 95% CI: 0.703-0.994) compared to non-users. Among diabetic individuals, 82.8% were aware of their condition, 71.9% received treatment, and 31.7% of treated patients had adequate glycemic control. Advanced age and pre-existing comorbidities, including hypertension and dyslipidemia, were associated with higher diabetes awareness and treatment. Furthermore, advanced age, higher levels of education, and female sex were determinants of better glycemic control among treated diabetic participants. CONCLUSION There is a high prevalence of diabetes and IFG among adult residents of Tehran. Additionally, more than two-thirds of treated diabetics living in Tehran remain uncontrolled

Three doses of a recombinant conjugated SARS-CoV-2 vaccine early after allogeneic hematopoietic stem cell transplantation: predicting indicators of a high serologic response—a prospective, single-arm study

BackgroundAllogeneic hematopoietic stem cell transplant (allo-HSCT) recipients must be vaccinated against SARS-CoV-2 as quickly as possible after transplantation. The difficulty in obtaining recommended SARS-CoV-2 vaccines for allo-HSCT recipients motivated us to utilize an accessible and affordable SARS-CoV-2 vaccine with a recombinant receptor-binding domain (RBD)–tetanus toxoid (TT)-conjugated platform shortly after allo-HSCT in the developing country of Iran.MethodsThis prospective, single-arm study aimed to investigate immunogenicity and its predictors following a three-dose SARS-CoV-2 RBD–TT-conjugated vaccine regimen administered at 4-week (± 1-week) intervals in patients within 3–12 months post allo-HSCT. An immune status ratio (ISR) was measured at baseline and 4 weeks (± 1 week) after each vaccine dose using a semiquantitative immunoassay. Using the median ISR as a cut-off point for immune response intensity, we performed a logistic regression analysis to determine the predictive impact of several baseline factors on the intensity of the serologic response following the third vaccination dose.ResultsThirty-six allo-HSCT recipients, with a mean age of 42.42 years and a median time of 133 days between hematopoietic stem cell transplant (allo-HSCT) and the start of vaccination, were analyzed. Our findings, using the generalized estimating equation (GEE) model, indicated that, compared with the baseline ISR of 1.55 [95% confidence interval (CI) 0.94 to 2.17], the ISR increased significantly during the three-dose SARS-CoV-2 vaccination regimen. The ISR reached 2.32 (95% CI 1.84 to 2.79; p = 0.010) after the second dose and 3.87 (95% CI 3.25 to 4.48; p = 0.001) after the third dose of vaccine, reflecting 69.44% and 91.66% seropositivity, respectively. In a multivariate logistic regression analysis, the female sex of the donor [odds ratio (OR) 8.67; p = 0.028] and a higher level donor ISR at allo-HSCT (OR 3.56; p = 0.050) were the two positive predictors of strong immune response following the third vaccine dose. No serious adverse events (i.e., grades 3 and 4) were observed following the vaccination regimen.ConclusionsWe concluded that early vaccination of allo-HSCT recipients with a three-dose RBD–TT-conjugated SARS-CoV-2 vaccine is safe and could improve the early post-allo-HSCT immune response. We further believe that the pre-allo-HSCT SARS-CoV-2 immunization of donors may enhance post-allo-HSCT seroconversion in allo-HSCT recipients who receive the entire course of the SARS-CoV-2 vaccine during the first year after allo-HSCT

Epidemiology of substance and opium use among adult residents of Tehran; a comprehensive report from Tehran cohort study (TeCS)

Background: The prevalence and burden of substance and opium use have increased worldwide over the past decades. In light of rapid population changes in Tehran, we aimed to evaluate the prevalence of opium and other substance use among adult residents in Tehran, Iran. Method: From March 2016 to March 2019, we utilized data from 8 296 participants in the Tehran Cohort Study recruitment phase (TeCS). We calculated the age-sex-weighted prevalence of substance use and the geographic distribution of substance use in Tehran. We also used logistic regression analysis to determine possible determinants of opium use. Result: We analyzed data from 8 259 eligible participants with complete substance use data and the average age of participants was 53.7 ± 12.75 years. The prevalence of substance use was 5.6% (95% confidence interval [CI]: 4.6- 7.1%). Substance use was more common in males than females (Prevalence: 10.5% [95% CI: 8.6- 12.6%] vs. 0.5% [95% CI: 0.2- 1.2%], respectively). The age-sex weighted prevalence of substance use was 5.4% (95% CI: 4.6-7.1%). Moreover, opium was the most frequently used substance by 95.8% of substance users. Additionally, we found that male gender (Odds ratio [OR]: 12.1, P < 0.001), alcohol intake (OR: 1.3, P = 0.016), and smoking (OR: 8.5, P < 0.001) were independently associated with opium use. Conclusions: We found that the prevalence of substance use in Tehran was 5.6%, and opium was the most frequently used substance. In addition, male gender, lower levels of education, alcohol, and tobacco consumption are the main risk factors for substance use in Tehran. Healthcare providers and policymakers can utilize our results to implement preventive strategies to minimize substance use in Tehran

The View Points of General Surgeons Attending CME Programs Regarding their Educational Needs, in Tehran University of Medical Sciences

Introduction. In the current educational system, considering the economic aspects and rational utilization of manpower is essential. In this respect, identifying educational needs, determining priorities and latest educational methods in Continuing Medical Education (CME) programs can provide the opportunity for optimum use of limited available resources. The aim of this study was to determine the educational priorities, effective educational methods and appropriate type of CME activities for general surgeons with respect to their viewpoints in Tehran University of Medical Sciences in the year 2002. Methods. A cross-sectional survey was carried out. The data collection tool was a self administered questionnaire whose validity was confirmed through content validity and its reliability by test-retest. Using census sampling method, 143 surgeons who had participated in CME Programs and received the final certificate, filled the questionnaires. The data analysis was performed by SPSS-9 software using frequency distribution. Results. The most important educational priority was new methods of surgery (25.4%), and the most preferred educational method was lecture accompanied by question and answer (57.3%). Most surgeons preferred the length of the program to be less than three days (61.5%). Conclusion. The new methods of surgery which was mentioned as the first educational priority, is related to their job requirement. Lecture accompanied with question and answer was determined as their preferred educational method which could be due to insufficient knowledge about other educational methods. Therefore, it is recommended to use other educational methods in future CME programs and perform more composed programs compared to other educational programs

Effect of Adding Swedish Massage to Occupational Therapy on Muscle Tone of Spastic Cerebral Palsied Children

Objective: Cerebral palsy is a nonprogressive disorder in body posture and movement, due to different etiologies. Different medical and rehabilitation interventions include massage have been used in these children. This study has been done to determine the effect of adding massage to occupational therapy on muscle tone of children with spastic cerebral palsy. Materials & Methods: This study was a double blind clinical trial. The children were recruited from clinics of University of Welfare & Rehabilitation Sciences. The individuals were divided to intervention and control groups. The routine rehabilitation techniques were done in 3 months in both groups. The intervention group received massage for 30 minutes before rehabilitation. Muscle tonicity was evaluated at the beginning of the study and 3 months later by Ashworth test. The data analysis was done by parametric (t test, paired t test) and nonparametric (Mann Whitney, Wilcoxon) tests. Results: Thirteen subjects of case (intervention) group and 14 subjects of control group were studied. The average age in case group and control group was 49.5, and 42.1 months respectively. There were no statistically significant differences in Tonicity of upper and lower limbs, trunk and neck between intervention group and control group (P>0/05). Conclusion: In general based on the results of this study, adding massage to occupational therapy had no effect on tonicity of spastic cerebral palsied children. Regarding to some effects of massage mentioned in different articles on physical abilities of children with C.P. as well as executive limitations in this research, it is not possible to reject the effects of homeopathy on physical abilities of children with C.P

Unsatisfied Patient’s Rights: A Survey on the Views of Patients, Nurses and Physicians

Neglecting patients' rights in a health care system can give rise to a challenging situation between health care providers and patients. The purpose of this study was to compare the views of patients as recipients of healthcare services and physicians and nurses, as healthcare providers, regarding the unsatisfied demands of different aspects of patients' rights in 3 hospitals representing three types of settings (teaching, private, and public).This was a cross-sectional descriptive analytical study. Data were gathered using a questionnaire which was filled out by an interviewer for the patients and self administered for nurses and physicians. The research venues were one general teaching hospital, one first class private hospital, and one non-teaching public hospital, and all 3 were in Tehran. The questionnaire consisted of some general questions about respondents' demographics, and 21 questions concerning the importance of patients' rights, and how well patients' rights were observed. Overall, 143 patients, 143 nurses (response rate: 61%) and 82 physicians (response rate: 27.5%) completed the questionnaire.The degrees of unsatisfied demands were different depending on the various views within each group regarding the degree of importance and observance of each right, which was measured by the Likert's scale ranging from 0.0 (no importance, no observance) to 10.0 (absolutely important, full observance). Concerning the non-normal distribution, the collected data were analyzed by non-parametric tests using the SPSS software (ver. 11.5).Results showed that the studied groups had significantly different views. The most prominent issue concerned patients' to make an informed decision, which was particularly unsatisfactory in the teaching hospital. The results of this research indicate that healthcare providers, especially physicians, need to be informed to show more respect for patients' rights in terms of access to clinical information and making decisions. The results demonstrated that there was a significant difference between the opinions of patients and health care providers regarding the extent of unsatisfied demands of patients' rights. According to the patients, the level of unsatisfied demands of these rights is far higher than that expressed by physicians