Journal of Research in Medical Sciences1735-1995142200904276977ENTehran University of Medical SciencesTehran University of Medical SciencesTehran University of Medical SciencesTehran University of Medical SciencesTehran University of Medical Sciences200810252009010320081209<ul><li><strong>BACKGROUND</strong>: Strengths and difficulties questionnaire (SDQ) is a widely used instrument for screening mental problems in children and adolescents. The main aim of this study was to evaluate the validity and psychometric properties of this questionnaire in comparison with the children behavior checklist (CBCL) and psychiatric interview.</li><li><strong>METHODS</strong>: The study was done in two stages. At stage one, 600 children aged between 6 and 12 were evaluated using the parent and teacher versions of SDQ and CBCL. At stage two, 25 children with the scores above the cut point reported by the developer of SDQ and 27 children with the score below this point were selected to be interviewed by a child and adolescent psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) classification and by another clinician using the K-SADS-PL (Schedule or Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version) as a semi structured interview.</li><li><strong>RESULTS</strong>: The mean scores of SDQ subscales found in this study were comparable to what found in other studies in other countries. The cut-off points of SDQ were almost similar to that of other researches. The internal consistency and concurrent validity of this questionnaire was good.</li><li><strong>CONCLUSIONS</strong>: The current study showed that both parent and teacher versions of SDQ in Persian language can be used as a valid tool in screening the mental problems in children and adolescents.</li><li><strong>KEYWORDS</strong>: SDQ, CBCL, mental problems, children, K-SADS.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2532http://jrms.mui.ac.ir/index.php/jrms/article/download/2532/1626

Journal of Research in Medical Sciences1735-1995142200904277987ENAssociate Professor,Tehran's University of Medical Sciences.Assistant Professor, Legal Medicine Organization of Iran.200809272009011020090106<ul><li><strong>BACKGROUND</strong>: Drowning is a preventable cause of morbidity and&nbsp; ortality. We studied drowning deaths in Isfahan province, focusing on the activity victims were involved in and the setting of the incident.</li><li><strong>METHODS</strong>: Retrospective analysis was done on all drowning deaths&nbsp; eferred to Legal Medicine Organization of Isfahan province over a period of 5 years from 1 January 2002 to 31 December 2006.</li><li><strong>RESULTS</strong>: During these 5 years, 355 persons suffered fatal drowning in Isfahan province. The annual incidence rate was 1.6 per 100000 population (2.6 & 0.4 for males and females, respectively). Mean age was 21.99 &plusmn; 14.86 and M/F ratio was 6.5:1. Most victims were 15-24 and 5-14 years of age (172 and 62 decedents, 3.0 and 1.8 per 100000 population/ year, respectively). Most incidents occurred in natural settings, of which rivers, canals, lakes and ponds were the most common sites, respectively. The most frequently connected activity was swimming and wading, followed by accidental fall into water. The manner of death was found as following: 85.1% accidental, 1.7% suicidal, 0.3% homicidal and 12.9% undetermined.</li><li><strong>CONCLUSIONS</strong>: Although the drowning related mortality in Isfahan province is comparable to developed countries, effective prevention of drowning with better programming and policies might reduce its rate.</li><li><strong>KEYWORDS</strong>: Drowning, epidemiology, public health, Isfahan province, Iran.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2341http://jrms.mui.ac.ir/index.php/jrms/article/download/2341/1627

Journal of Research in Medical Sciences1735-19951422009042789103ENDepartment of Electrical EngineeringDepartment of Electrical EngineeringDepartment of Linguistics, Ferdowsi University of MashhadHealth Research Center, Baqiyatallah University of Medical Sciences200809092008123120081122<ul><li><strong>BACKGROUND</strong>: Aphasia diagnosis is particularly challenging due to the linguistic uncertainty and vagueness, inconsistencies in the definition of aphasic syndromes, large number of measurements with&nbsp; mprecision, natural diversity and subjectivity in test objects as well as in opinions of experts who diagnose the disease.</li><li><strong>METHODS</strong>: Fuzzy probability is proposed here as the basic framework for handling the uncertainties in medical diagnosis and particularly aphasia diagnosis. To efficiently construct this fuzzy probabilistic mapping, statistical analysis is performed that constructs input membership functions as well as determines an effective set of input features.</li><li><strong>RESULTS</strong>: Considering the high sensitivity of performance measures to different distribution of testing/training sets, a statistical t-test of significance is applied to compare fuzzy approach results with NN&nbsp; esults as well as author&rsquo;s earlier work using fuzzy logic. The proposed fuzzy probability estimator approach clearly provides better diagnosis for both classes of data sets. Specifically, for the first and second type of fuzzy probability classifiers, i.e. spontaneous speech and comprehensive model, P-values are 2.24E-08 and 0.0059, espectively, strongly rejecting the null hypothesis.</li><li><strong>CONCLUSIONS</strong>: The technique is applied and compared on both comprehensive and spontaneous speech test data for diagnosis of four Aphasia types: Anomic, Broca, Global and Wernicke. Statistical analysis confirms that the proposed approach can significantly improve accuracy using fewer Aphasia features.</li><li><strong>KEYWORDS</strong>: Aphasia, fuzzy probability, fuzzy logic, medical diagnosis, fuzzy rules.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2287http://jrms.mui.ac.ir/index.php/jrms/article/download/2287/1650

Journal of Research in Medical Sciences1735-199514220090427105110ENIsfahan University of Medical SciencesDepartment of Biostatistics and Epidemiology, Faculty of Health, Isfahan University and Medical Sciences, IsfahanIsfahan Endocrinology and Metabolism Research Center, Isfahan University and Medical Sciences, Isfahan,200809192009031020081117<ul><li><strong>BACKGROUND</strong>: The purpose of this study was to develop a simple risk score as screening tool for retinopathy in type II diabetic patients.</li><li><strong>METHODS</strong>: A cross-sectional study was carried out recruiting 3734&nbsp; atients with type II diabetes in an outpatient clinic in Isfahan ndocrinology and Metabolism Research Center (IEMRC), Iran. The logistic regression was used as a model to predict diabetic retinopathy. The cut-off value for the risk score was determined using the Receiver&nbsp; perating Characteristic (ROC) curve procedure.</li><li><strong>RESULTS</strong>: According to final models, being male, having lower body mass index (BMI), being older, longer duration of diabetes and higher HbA1c were correlated with increased risk of diabetic retinopathy. Area under the Curve (ROC) was 0.704 (95% CI: 0.685-0.723). A value ; 52.5 had the optimum sensitivity (60%) and specificity (69%) for determining diabetic retinopathy.</li><li><strong>CONCLUSIONS</strong>: The results indicated that risk factors for retinopathy were sex, BMI, age, duration of diabetes and HbA1c levels. In onclusion, applying developed retinopathy risk score is a practical way to identify patients who are at high risk for developing diabetic retinopathy for an early treatment.</li><li><strong>KEYWORDS</strong>: Retinopathy risk score, sensitivity, specificity, receiver operating characteristic curve.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2307http://jrms.mui.ac.ir/index.php/jrms/article/download/2307/1623

Journal of Research in Medical Sciences1735-199514220090427111116ENAssistant Professor of Pediatrics, Pediatric Hematologist, Pediatric Hematology Department, Al-Zahra Hospital, Isfahan, Iran.MD, Department of Pediatrics, Isfahan University of Medical SciencesProfessor of Pediatrics, Pediatric Endocrinologist, Department of Pediatric, Al-Zahra Hospital, Isfahan, Iran.PhD in statistics and Measurements, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran.Assistant Professor of Pediatrics, Department of Pediatric, Al-Zahra Hospital, Isfahan, Iran.Associate Professor of Pediatrics, Pediatric Hematologist, Pediatric Hematology Department, Saied Al-Shohada Hospital, Isfahan, Iran.200810282009011720090106<ul><li><strong>BACKGROUND</strong>: To determine the prevalence of metabolic syndrome in survivors of childhood leukemia in Isfahan, Iran.</li><li><strong>METHODS</strong>: During a 4-year period (2003 to 2007), 55 children (33 male and 22 female) diagnosed with ALL at Unit of Hematology/ Oncology, Department of Pediatrics, Isfahan University of Medical Science, were enrolled in this crosssectional study. Metabolic syndrome was defined using the modified version of Adult Treatment Panel (ATP III) criteria. Insulin resistance was defined based on the homeostasis model assessment index (HOMA-IR).</li><li><strong>RESULTS</strong>: The mean age of participates was 10.4 years (range 6-19 years) and the mean interval since completion of chemotherapy was 35 months. Twenty percent (11/55) of survivors (10 male, 1 female) met criteria for diagnosis of metabolic syndrome. Obesity was observed in one forth of patients and nearly 3/4 of obese patients had metabolic syndrome. High serum insulin levels were found in 16% of participants and in 63% of obese survivors. The mean insulin levels in survivors with metabolic syndrome was three-times more than those without (28.3 mu/l vs. 9.57 mu/l, p = 0.004). Insulin resistance was detected in 72.7% of survivors with metabolic syndrome and it was&nbsp; ositively correlated with serum triglycerides (0.543, p < 0.001), systolic and diastolic BP (0.348, p = 0.01 and 0.368, p = 006 respectively), insulin levels (0.914, p < 0.001) and blood sugar (0.398, p = 003).</li><li><strong>CONCLUSIONS</strong>: The prevalence of metabolic syndrome in survivors of childhood leukemia in Iran is higher than developed countries. Nearly all of the obese patients had metabolic syndrome. Weight control and regular physical exercise are recommended to the survivors.</li><li><strong>KEYWORDS</strong>: Acute lymphoblastic leukemia, metabolic syndrome, obesity, children.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2554http://jrms.mui.ac.ir/index.php/jrms/article/download/2554/1628

Journal of Research in Medical Sciences1735-199514220090427117122ENDepartment of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.200808282009010720090107<ul><li><strong>BACKGROUND</strong>: The prevalence of carotid artery stenosis (CAS) in the&nbsp; eneral population is not high enough to justify screening programs. This study was done to determine the prevalence of asymptomatic carotid artery stenosis (ACAS) among patients with severe peripheral vascular disease (PVD).</li><li><strong>METHODS</strong>: Between March 2005 and February 2006, 54 consecutive&nbsp; atients with severe PVD admitted at a vascular surgery unit and underwent carotid duplex scanning in a prospective study. A&nbsp; uestionnaire was used to collect data concerning known risk factors. Significant CAS was defined as a stenosis of 70% or greater.</li><li><strong>RESULTS</strong>: The mean age was 62.5 years (51-72). Out of 54 patients, 2 (3.7%) had an occluded internal carotid artery. Significant CAS was found in 9 (16.7%) and its presence was correlated with diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, coronary artery disease, severity of symptoms, ankle-brachial index, and carotid bruit. On multivariate analysis, only hypercholesterolemia and carotid bruit seemed to have independent influence.</li><li><strong>CONCLUSION</strong>: The prevalence of significant ACAS is higher among&nbsp; atients with severe PVD. This patient population may indicate a&nbsp; uitable subgroup for screening of ACAS, especially when hypercholesterolemia and carotid bruit are present.</li><li><strong>KEYWORDS</strong>: Carotid artery stenosis, duplex ultrasound scanning, peripheral vascular disease, carotid endarterectomy,</li><li>cerebrovascular accident.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2260http://jrms.mui.ac.ir/index.php/jrms/article/download/2260/1620

Journal of Research in Medical Sciences1735-199514220090427123127ENConsultant cardiologist, Cardiology Department, Shahid Gangalal National Heart Centre, Kathmandu ,NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, NepalDepartment of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal200809292009010920081222<ul><li><strong>BACKGROUND</strong>: Acute myocardial infarction (AMI) is complicated by cardiogenic shock in 7~10% of patients. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Large thrombolytic trials demonstrate 60% mortality with most effective thrombolytic agent.</li><li><strong>METHODS</strong>: In between September 2005 to August 2008 total PCI in Shahid Gangalal National Heart Center (SGNHC) in Nepal was 452. Among them primary PCI (PPCI) in AMI with cardiogenic shock was done in only 16 patients (3.5%).</li><li><strong>RESULTS</strong>: This study showed in-hospital mortality of 50% (n = 8). Of 50% (n = 8) alive patients with cardiogenic shock who underwent PPCI, 6&nbsp; atients are in routine follow-up over 12 months and 2 were doing well in subsequent 6 months but not in follow up after that.</li><li><strong>CONCLUSION</strong>: Primary PCI in AMI complicated by cardiogenic shock has lower mortality and improved outcome. High cost, high in-hospital ortality and lack of trained personnel are major limitations.</li><li><strong>KEY WORDS:</strong> Primary percutaneous coronary intervention, acute myocardial infarction, cardiogenic shock, SGNHC (Shahid Gangalal National Heart Center).</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2353http://jrms.mui.ac.ir/index.php/jrms/article/download/2353/1625

Journal of Research in Medical Sciences1735-199514220090427129133ENDepartment of Anthropology, Vidyasagar University, Midnapore, West BengalDepartment of Anthropology, Dinabandhu Mahavidyalaya, Bongoan, West Bengal2008090820081201<ul><li><strong>BACKGROUND</strong>: To assess the prevalence of thinness among 5-10 year old school children of Nandigram, Purba Medinipur District of West Bengal, India.</li><li><strong>METHODS</strong>: A total of 596 students (323 boys and 288 girls) aged 5-10 years were included in this cross-sectional study. Height and weight were measured and the body mass index (BMI) was computed. The new&nbsp; nternational BMI-based classification cut-off points proposed by Cole et al were utilized to identify thinness.</li><li><strong>RESULTS</strong>: The overall (age-combined) mean BMI among boys and girls were 13.9 kg/m2 (SD = 1.4) and 13.8 kg/m2 (SD = 1.2), respectively. In general, mean BMI increased with age in both sexes. There was no&nbsp; ignificant sex difference in mean BMI. The overall (age-combined) prevalence of thinness was 62.9% and 61.6% in boys and girls,&nbsp; espectively.</li><li><strong>CONCLUSIONS</strong>: The present study clearly indicated that the nutritional situation of these children was unsatisfactory.</li><li><strong>KEYWORDS</strong>: Body mass index, undernutrition, thinness, IOTF cut off points, nandigram, West Bengal.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/2278http://jrms.mui.ac.ir/index.php/jrms/article/download/2278/1624

Journal of Research in Medical Sciences1735-199514220090427135138ENMD. Assistant professor of orthopaedic surgery. Iran University of Medical Sciences, Tehran, Iran.MD. Assistant professor of orthopaedic surgery. Iran University of Medical Sciences, Tehran, Iran.Department of orthopaedic surgery. Shafa Yahyaian rehabilitation center, Iran University of Medical Sciences, Tehran, Iran.MD. Orthopaedic Surgeon. Iran University of Medical Sciences, Tehran, Iran.2008050820080720<ul><li>Osteoblastoma is rarely found in the hand or wrist. Review of literature&nbsp; evealed that only five cases of osteoblastoma have been reported in scaphoid bone. This paper presents a rare case of scaphoid steoblastoma with unusual course ina young patient and its treatment process. </li><li><strong>KEYWORDS</strong>: Hand, osteoblastoma, scaphoid, wrist.</li></ul>http://jrms.mui.ac.ir/index.php/jrms/article/view/1897http://jrms.mui.ac.ir/index.php/jrms/article/download/1897/1619

Journal of Research in Medical Sciences1735-199514220090427139140ENGastroenterohepatology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences/Department of Biostatistics, Lorestan University of Medical SciencesGastroenterohepatology Research Center, Department of Pathology, Nemazee Hospital, Shiraz University of Medical SciencesGastroenterohepatology Research Center, Shiraz University of Medical SciencesDepartment of Surgery, Shiraz University of Medical SciencesGastroenterohepatology Research Center, Nemazee Hospital, Shiraz University of Medical SciencesOffice of Vice Chancellor for Health Affairs, Shiraz University of Medical SciencesOffice of Vice Chancellor for Health Affairs, Shiraz University of Medical Sciences2008103020090103Background: Lung cancer is one of the fatal cancers in Iran while 12% of the mortalities are related to this cancer in the country. This active hospital-based study was undertaken to determine the occurrence of lung cancer in Fars Province, southern Iran. Methods: Data including face-to-face interview with patients and a survey of their medical and demographic records in relation to all invasive cancers were actively collected from 2002 to 2007 from four university hospitals. Results: Among 10800 cancer cases registered during this period, 238 cases were lung cancer, including 76.1% male and 23.9% female patients. 66.1% of the lung cancer cases were smokers. The mean age at the time of diagnosis was 58.3 years which was higher in males compared to females (pv<0.001). There were also more smokers among males than females (74.6% vs 38.7%, pv<0.001). The most common histological type of lung cancer was squamous cell carcinoma followed by adenocarcinoma. Conclusion: Our results showed a higher prevalence of lung cancer in males, age group of 46-65, smokers and moderate and low socioeconomic classes while the most common type was squamous cell carcinoma. It seems that these findings may play a key role for authorities in health planning programs.http://jrms.mui.ac.ir/index.php/jrms/article/view/2560http://jrms.mui.ac.ir/index.php/jrms/article/download/2560/1621