A correlated frailty model for analysing risk factors in bilateral corneal graft rejection for Keratoconus: a Bayesian approach

There are many unknown causes that increase the rate of corneal graft rejection. In bilateral cases, some of these unknown causes are common, and some are individual factors. In this paper, we use a correlated frailty model to analyse risk factors for bilateral corneal graft in Keratoconus. Applying the piecewise constant baseline hazard model, we have performed a Bayesian analysis of the correlated frailty model using the Markov chain Monte Carlo method. The correlated frailty model and the shared frailty model are compared by deviance information criterion. The results show more accurate and better fit for the correlated frailty model. Copyright (C) 2005 John Wiley & Sons, Ltd

Explanation the experiences of mothers with gestational diabetes about the factors affecting self-care: A qualitative study

Background and aims: Diabetes is the most common medical complication of pregnancy. This disease is a growing health problem in the world. Self-care is the most important factor in the control of chronic diseases such as diabetes. Several factors include biological factors, psychological, economic, social, cultural and health care system. Community Treatment is effective directly and indirectly on self-care behaviors in patients with diabetes.The aim of this study was to assess mothers, experiences with gestational diabetes on the factors influencing self-care. Methods: This study is a qualitative conventional content analysis research. In this study, data were collected by semi-structured individual interviews. Interviews were performed based on interview guidance. Participants were pregnant women diagnosed with gestational diabetes in 24th-36th week of pregnancy who referred to the clinics affiliated to Shahid Beheshti University of Medical Sciences. After 12 interviews with participants, data were saturated. Conventional content analysis was done for data analysis. To assess the accuracy and reliability of data, four criteria provided by Lincoln and Guba, including dependability, credibility, confirmability and transferability were used. For the analysis of qualitative data in this study, the conventional qualitative content analysis methods and software MAXQDA 10 was used. Results: Perception of pregnant women led to the extraction of two themes: barriers and facilitators to self-care. The former was featured with four main categories: insolvency, perceived problems, admission disease and support from others. 13 sub- categories were also classified in the main form. Results showed that mothers for self- care actions, need to get further information via health-care provider and get more support from their relatives. It was also found barriers and facilitators to take care of mothers in most societies is almost the same. Conclusion: According to the results of this study, it is needed to do appropriate proceedings to promoting culture, providing appropriate information and higher quality services, and promoting healthlevel and self-care of mothers with gestational diabetes

The prevalence of adulthood overweight and obesity in Tehran: Findings from Urban HEART-2 study

Background: To estimate and compare prevalence of overweight and obesity among adult people across the 22 districts of Tehran in 2011. Methods: This was a cross-sectional study using data on 47,406 women and 47,525 men aged� 15 years from a large population-based survey (Urban HEART-2). Age-standardized prevalence (ASP) of overweight (25�BMI<30) and obesity (BMI�30) were estimated for the Tehran's districts. Pearson Chi2 tests and logistic regression were used to examine any significant differences in prevalence of these disorders across sociodemographic groups. Results: ASPs of overweight were 36.5 and 32.0 among men and women, respectively (p<0.001). These figures for obesity were 10.7 and 15.3 among men and women, respectively (p<0.001). Crude prevalence of overweight and obesity rose with age up to the age of 54 years and decreased thereafter. Across education groups, the lowest prevalence of overweight/obesity was seen among most educated people. The results showed that being young, single and student were associated with lower odds of overweight/obesity. Conclusion: This study showed a high prevalence of overweight and obesity among adult in Tehran. There were significant associations between sociodemographic characteristics and prevalence of overweight/obesity among adults in Tehran. The results of this study might be used in identifying high risk groups of overweight and obesity in Tehran

Dialysis adequacy of chronic hemodialysis patients in Zanjan-Iran, 2016

Background: Dialysis adequacy is one of the most important factors in determining the survival rate and mortality of dialysis patients. Objectives: The aim of this study was to determine the dialysis adequacy of patients undergoing chronic hemodialysis at dialysis centers located in the province of Zanjan, located in northwest Iran. Methods: This descriptive cross-sectional study was performed on 257 patients undergoing chronic hemodialysis with an available sampling method in 6 dialysis centers in the province of Zanjan. The hemodialysis sessions were performed for 3 to 4 hours using via synthetic filters and bicarbonate dialysate. To determine the adequacy of dialysis, serum BUN levels were assessed before and after dialysis. The standard software provided by the Ministry of Health was used to calculate the adequacy of dialysis and Kt/V was considered to be at least 1.2. Results: The most common underlying causes of chronic dialysis were hypertension (41.2%) and diabetes mellitus (35.8%), respectively. Mean Kt/V and URR were 1.26±0.34 and 63.55±9.5%, respectively. The difference among these indexes was significant between men and women (p<0.05). Also, dialysis adequacy was significantly associated with increased dialysis frequency, blood flow rate, interdialytic weight gain, vascular access and dialysis shift (p<0.05). Conclusion: Despite the relatively favorable dialysis adequacy among patients, this index is highly variable based on patient gender, the dialysis center, location, frequency of dialysis, blood flow rate, interdialytic weight gain, type of vascular access and dialysis shift. Therefore, serious attention and greater caution are recommended among the dialysis centers of the province

A new biomechanical method for objective measurement of spasticity: A preliminary study

The assessment of the various impairments in brain damage including spasticity is important. The purpose of this study was to develop a new biomechanical method based on quantification of velocity reduction (VR) suitable for clinical use. A highly reliable system was developed to apply a constant torque perturbation at the elbow. This system was used to measure the VR in 30 healthy adults and 10 hemiplegic patients. In healthy subjects, the mean VR was 3.02 (SE (standard error) = 0.29). In hemiplegic patients, the mean VR in the impaired arm (81.47, SE= 2.87) was significantly higher than the VR () either in the nonimpaired arm (9.86, SE= 0.92) (WSRT (Wilcoxon Signed Ranks Test): Z = -12.74; p<0.001), or the normal (3.02) p<0.001). The interaction between the associated reaction (AR) and the asymmetrical tonic neck reflex (ATNR) with head away from the impaired arm made a significant higher VR (90.41, SE=3.43) (p<0.001). The correlation between the VR () and the Modified Ashworth Scale scores was significant (Spearman�s rho = 0.77, p<0.001). It is concluded that the quantification of velocity reduction may be used as an objective method of measuring spasticity in neurological conditions. © MA Healthcare Limited 2014