Development and validation of a postpartum depression risk score in delivered women, Iran

Background: Investigators describe a dramatic increase in the incidence of mood disorder after childbirth, with the largest risk in the 90 days after delivery. This study is designed to develop a relatively simple screening tool and validate it from the significant variables associated with postpartum depression (PPD) to detect delivered women at high risk of having PPD. Materials and Methods: In the cross-sectional study, 6,627 from a total of 7,300 delivered women, 2-12 months after delivery were recruited and screened for PPD. Split-half validation was used to develop the risk score. The training data set was used to develop the model, and the validation data set was used to validate the developed the risk factors of postpartum depression risk score using multiple logistic regression analysis to compute the β coefficients and odds ratio (OR) for the dependent variables associated with possible PPD in this study. Calibration was checked using the Hosmer and Lemeshow test. A score for independent variables contributing to PPD was calculated. Cutoff points using a trade-off between the sensitivity and specificity of risk scores derived from PPD model using the Receiver Operating Characteristic (ROC) curve. Results: The predicted and observed PPD were not different (P value = 0.885). The aROC with area under the curve (S.E.) of 0.611 (0.008) for predicting PPD using the suggested cut-off point of -0.702, the proportion of participants screening positive for PPD was 70.9% (sensitivity) (CI 95%; 69.5, 72.3) while the proportion screening negative was 60.1% (specificity) (CI 95%; 58.2, 62.1). Conclusion: Despite of the relatively low sensitivity and specificity in this study, it could be a simple, practical and useful screening tool to identify individual at high risk for PPD in the target population

Evaluation of wet bulb globe temperature index for estimation of heat strain in hot/humid conditions in the Persian Gulf

Background: Heat exposure among construction workers in the Persian Gulf region is a serious hazard for health. The aim of this study was to evaluate the performance of wet bulb globe temperature (WBGT) Index for estimation of heat strain in hot/humid conditions by the use of Physiological Strain Index (PSI) as the gold standard. Material and Methods : This cross-sectional study was carried out on 71 workers of two Petrochemical Companies in South of Iran in 2010 summer. The WBGT index, heart rate, and aural temperature were measured by Heat Stress Monitor (Casella Microtherm WBGT), Heart Rate Monitor (Polar RS100), and Personal Heat Strain Monitor (Questemp II), respectively. The obtained data were analyzed with descriptive statistics and Pearson correlation analysis. Results: The mean (SD) of WBGT values was 33.1 (2.7). The WBGT values exceed from American Conference of Governmental Industrial Hygienists (ACGIH) standard (30°C) in 96% work stations, whereas the PSI values were more than 5.0 (moderate strain) in 11% of workstations. The correlation between WBGT and PSI values was 0.61 ( P = 0.001). When WBGT values were less and more than 34°C, the mean of PSI was 2.6 (low strain) and 5.2 (moderate strain), respectively. Conclusion: In the Persian Gulf weather, especially hot and humid in the summer months, due to the WBGT values exceeding 30°C (in 96% of cases) and weak correlation between WBGT and PSI, the work/rest cycles of WBGT Index is not suitable for heat stress management. Therefore, in Persian Gulf weather, heat stress evaluation based on physiologic variables may have higher validity than WBGT index

Effect of intranasal oxytocin combination therapy with applied behavior analysis on social impairments in pediatric’s children with autism spectrum disorder

Abstract Background The use of oxytocin as a therapy to treat social deficiencies in autism spectrum disorders (ASD) is gaining popularity. This study aimed to determine oxytocin nasal spray’s effect in combination with applied behavior analysis (ABA) method in improving social impairments in pediatrics with ASD. Results Our study’s main findings have revealed that intervention with INT-OXT compared to NS effectively reduced the ASD index and stereotyped behaviors on the GARS-2 scale (p < 0.05), in addition to teacher and parent’s SDQ mean score (p < 0.001). Also, during the follow-up time, the intervention with INT-OXT in ASD index, stereotyped behaviors, communication, social interaction, and parent and teacher mean SDQ scores were statically significant (p < 0.001). Conclusions In pediatrics with autism aged between 4 and 17 years, a 6-week course of INT-OXT combination therapy with ABA improved GARS-2 and teacher and parent SDQ scores compared to NS

Can adjustment disorders and depressive episodes be distinguished? Results from ODIN

Background: No large-scale epidemiological study has included adjustment disorders (AD) for consideration yet it is considered to be a common psychiatric diagnosis. Methods:Using a two stage screening method, those above a threshold score for possible caseness on the Beck Depression Inventory (BDI), were interviewed using SCAN to identify those with depressive episode and AD. Variables that might distinguish AD from depressive episode were examined. Results:The prevalence of AD was extremely low with one centre having no cases. Finland, the country with the highest prevalence, only achieved a frequency of 0.8% and 1%, respectively, for urban and rural sites. Logistic regression failed to identify any variables that independently differentiated AD from depressive episode. Findings relating to severity of symptoms using BDI were robust. Limitations: The small sample size might have contributed to a failure to identify distinguishing features between AD and other disorders. Conclusions:Reasons for the failure of even robust results, such as BDI severity, to distinguish AD from depressive episode are considered of which problems in conceptualising AD are the most likely. Further studies are required

Prevalence and risk factors of hepatitis B and C viruses among hemodialysis patients in Isfahan, Iran

Background: The aim of this study was to assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and their associated risk factors among hemodialysis patients in Isfahan, Iran in 2011. Materials and Methods : In this cross-sectional study, a total of 499 chronic hemodialysis patients from eight governmental hemodialysis centers were tested. Demographic information, time duration on hemodialysis, history of blood transfusion, and the number of transfused blood units as risk factors to HBV and HCV infections were calculated. The status of HBsAg and anti-HCV was assessed by serological testing. Results: The overall prevalence of HBV-positive and HCV-positive among study population was 1.2% and 5.2%, respectively. Age, sex, and time duration on hemodialysis were not statistically significant in HBV- and HCV-patients compared with other hemodialysis patients (P0 > 0.05). History of blood transfusion and the number of transfused blood units in HBV infected patients were similar to other patients (P > 0.05). The main risk factors in hemodialysis patients infected by HCV were history of blood transfusion and the number of transfused blood units (P < 0.0001). Conclusion: In conclusion, the prevalence of HBV and HCV infections in hemodialysis centers in Isfahan is lower than in some other cities of Iran. History of blood transfusion and the number of blood units transfused might be a risk factor for HCV gaining. However, further studies are needed to assess the role of other demographic and clinical risk factors in these patients

Altered Th17/Treg Ratio in Recurrent Miscarriage after Treatment with Paternal Lymphocytes and Vitamin D3: a Double- Blind Placebo-Controlled Study

ABSTRACT Background: Recurrent miscarriage (RM) affects 2-5% of pregnant women. Paternal lymphocyte immunotherapy is a common treatment for RM patients but the outcome has not been consistent. Therefore, combined therapy with other immunosuppressive drugs such as 1a, 25-dihydroxy-vitamin-D3 (vitamin D3) may improve the outcome. Objectives: To investigate the effect of vitamin D3 on the balance of two essential T cells subsets, T helper (Th) 17 and T regulatory (Treg) cells, which contribute to the immune tolerance during pregnancy. Methods: The expression levels of CD4 and forkhead box protein 3 (FOXP3) in Treg cells, and the expression levels of CD4 and IL-17 in Th17 cells, were evaluated pre-and 3 months post-immunotherapy in RM patients treated with a combination of paternal lymphocytes and vitamin D3 compared with RM patients receiving lymphocyte immunotherapy alone. Results: Vitamin D3 therapy decreased the frequency of Th17 cells in addition to reducing the Th17/Treg ratio in peripheral blood of RM patients compared with the control group (p&lt;0.05). Conclusion: Considering that RM patients have a higher Th17/Treg ratio in peripheral blood, vitamin D3 may be a candidate therapeutic approach in this disease. Rafiee M, et al. Iran J Immunol. 2015; 12(4):252-262