Validation of the Edinburgh Postnatal Depression Scale in an Iranian sample

Background: Considering the adverse effects of postpartum depression on both mother and infant, a screening instrument for early diagnosis seems to be of importance. Aims: To assess the psychometric properties of the Persian version of Edinburgh Postnatal Depression Scale (EPDS) on a sample of Iranian postpartum women. Method: The EPDS was translated and back-translated in the standard method. The questionnaire was completed by 600 postpartum women. Hundred cases with an EPDS score of �9 and 100 cases with an EPDS of <9 were randomly selected for interview. Sensitivity, specificity, positive likelihood ratio, and receiver operating characteristics were calculated by comparing the EPDS sum score against the DSM-IV diagnoses. The correlation coefficient of the EPDS score with GHQ-12 score was calculated. Principal component analysis and internal consistency were assessed. Results: The best cutoff scores for major depression were 12=13 with a sensitivity and specificity of 95.3% and 87.9%, respectively. The correlation coefficient of the total score of the Persian version of EPDS with the GHQ-12 total score was 0.76 (P<0.001). A two-factor solution was selected as the most appropriate model based on both values and the score plot. The coefficient alpha for the whole scale was 0.83. Conclusion: The Persian version of EPDS is a reliable and valid measure for detecting postpartum depression. Furthermore, it seems acceptable to patients and a valid screening instrument for depression in postpartum women

Prevalence of Cannabis Lifetime Use in Iranian High School and College Students: A Systematic Review, Meta-Analyses,and Meta-Regression

Cannabis is the most widely used substance in the world. This study aimed to estimate the prevalence of cannabis lifetime use (CLU) in high school and college students of Iran and also to determine factors related to changes in prevalence. A systematic review of literature on cannabis use in Iran was conducted according to MOOSE guideline. Domestic scientific databases, PubMed/Medline, ISI Web of Knowledge, and Google Scholar, relevant reference lists, and relevant journals were searched up to April, 2014. Prevalences were calculated using the variance stabilizing double arcsine transformation and confidence intervals (CIs) estimated using the Wilson method. Heterogeneity was assessed by Cochran's Q statistic and I-2 index and causes of heterogeneity were evaluated using meta-regression model. In electronic database search, 4,000 citations were retrieved, producing a total of 33 studies. CLU was reported with a random effects pooled prevalence of 4.0 (95 CI = 3.0 to 5.0). In subgroups of high school and college students, prevalences were 5.0 (95 CI = 3.0 to -7.0) and 2.0 (95 CI = 2.0 to -3.0), respectively. Meta-regression model indicated that prevalence is higher in college students (beta = 0.089, p < .001), male gender (beta = 0.017, p < .001), and is lower in studies with sampling versus census studies (beta = -0.096, p < .001). This study reported that prevalence of CLU in Iranian students are lower than industrialized countries. In addition, gender, level of education, and methods of sampling are highly associated with changes in the prevalence of CLU across provinces

Decreases in Community Viral Load Are Accompanied by Reductions in New HIV Infections in San Francisco

BACKGROUND: At the individual level, higher HIV viral load predicts sexual transmission risk. We evaluated San Francisco's community viral load (CVL) as a population level marker of HIV transmission risk. We hypothesized that the decrease in CVL in San Francisco from 2004-2008, corresponding with increased rates of HIV testing, antiretroviral therapy (ART) coverage and effectiveness, and population-level virologic suppression, would be associated with a reduction in new HIV infections. METHODOLOGY/PRINCIPAL FINDINGS: We used San Francisco's HIV/AIDS surveillance system to examine the trends in CVL. Mean CVL was calculated as the mean of the most recent viral load of all reported HIV-positive individuals in a particular community. Total CVL was defined as the sum of the most recent viral loads of all HIV-positive individuals in a particular community. We used Poisson models with robust standard errors to assess the relationships between the mean and total CVL and the primary outcome: annual numbers of newly diagnosed HIV cases. Both mean and total CVL decreased from 2004-2008 and were accompanied by decreases in new HIV diagnoses from 798 (2004) to 434 (2008). The mean (p = 0.003) and total CVL (p = 0.002) were significantly associated with new HIV cases from 2004-2008. CONCLUSIONS/SIGNIFICANCE: Reductions in CVL are associated with decreased HIV infections. Results suggest that wide-scale ART could reduce HIV transmission at the population level. Because CVL is temporally upstream of new HIV infections, jurisdictions should consider adding CVL to routine HIV surveillance to track the epidemic, allocate resources, and to evaluate the effectiveness of HIV prevention and treatment efforts

Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

A cost-effectiveness study by Sue Goldie and colleagues finds that better family planning, provision of safe abortion, and improved intrapartum and emergency obstetrical care could reduce maternal mortality in India by 75% in 5 years

Is Prone Position One of the Symptoms of Childhood Gastroesophageal Reflux Disease?

Abstract: Background & Aims: The aim of the present study was to find whether prone position is one of the symptoms of childhood gastroesophageal reflux disease or not. Method: In this prospective case-control study, 200 children with gastroesophgeal reflux disease (case group) and 210 healthy children (control group) were studied between 21 march 2009 and 21 march 2011. Data gathering was performed by a questionnaire including variables of sex, age, main complaint, sleeping position, endoscopic and pathologic findings. The questionnaires were filled out by face to face interviews with children’s mothers. The patient group underwent upper endoscopy with pediatric video-endoscope. Pathologic reflux was approved in histological studies. Results: Mean age of case and control groups were 5.0 ± 3.2, and 5.2±3.0 years respectively. The most common symptoms were abdominal pain (46.5%), and vomiting (34.8%). The majority of cases with esophagitis (73%) lied in prone position in night that had significant difference (P<0.0001) with the corresponding value in the control group (37.1%). In present study sensitivity and specificity of prone position for gastroesophagal reflux disease were respectively, 73% and 62.9%. Conclusion: According to the results, during taking history, prone position should be questioned. Keywords: Gastroesophageal reflux, Prone position, Esophagitis, Iran, Chil

Screening for Celiac Disease in Growth Retarded Children with or without Chronic Diarrhea: a Study on Children in Kerman/Iran

Abstract: Background & Aims: The aim of this study was to determine the yield of screening for celiac disease in children with failure to thrive and with or without chronic diarrhea. Methods: In this prospective study, 144 children aged 1-14 years and weighed below the fifth percentile with or without chronic diarrhea were studied during six months in 2010. Sample collection was done in the private office of one of the researchers, health care clinics, schools, and subspecialty clinic of Afzalipour Hospital, Kerman/ Iran. Screening was done by measuring anti-tissue transglutaminase IgG antibody test (tTG test). All positive cases underwent upper endoscopy with pediatric Pentax video endoscope. Definitive diagnosis was made by doing small intestine biopsy and histological study. Results: Mean weight and age of children were respectively 14 ± 4.2kg and 6 ± 3.3 years. One third of subjects had diarrhea. Positive tTG test was observed in 11.1% of children. Celiac was confirmed in all seropositive subjects by intestinal biopsy. Therefore, the predictive value of tTG test was 100%. There was no significant relationship between the prevalence of celiac and variables of age (p=0.445), sex (p=0.859) and chronic diarrhea (p=0.137). Conclusion: Regarding the relatively high prevalence of celiac disease in growth retarded children (11.1%), and high sensitivity (100%) of tTG test found in the present study, screening of growth retarded children with or without chronic diarrhea for celiac disease seems logical. Keywords: Celiac disease, Chronic diarrhea, Serology, Failure to thriv