Publications by authors named "Ghodratollah Roshanaei"

73 Publications

Generalized linear mixed hidden semi-Markov models in longitudinal settings: A Bayesian approach.

Stat Med 2021 Feb 15. Epub 2021 Feb 15.

Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Hidden Markov and semi-Markov models (H(S)MMs) constitute useful tools for modeling observations subject to certain dependency structures. The hidden states render these models very flexible and allow them to capture many different types of latent patterns and dynamics present in the data. This has led to the increased popularity of these models, which have been applied to a variety of problems in various domains and settings, including longitudinal data. In many longitudinal studies, the response variable is categorical or count-type. Generalized linear mixed models (GLMMs) can be used to analyze a wide range of variables, including categorical and count. The present study proposes a model that combines HSMMs with GLMMs, leading to generalized linear mixed hidden semi-Markov models (GLM-HSMMs). These models can account for time-varying unobserved heterogeneity and handle different response types. Parameter estimation is achieved using a Monte Carlo Newton-Raphson (MCNR)-like algorithm. In our proposed model, the distribution of the random effects depends on hidden states. We illustrate the applicability of GLM-HSMMs with an example in the field of occupational health, where the response variable consists of count values. Furthermore, we assess the performance of our MCNR-like algorithm through a simulation study.
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http://dx.doi.org/10.1002/sim.8908DOI Listing
February 2021

Joint modelling of colorectal cancer recurrence and death after resection using multi-state model with cured fraction.

Sci Rep 2021 Jan 13;11(1):1016. Epub 2021 Jan 13.

Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

Curing of colorectal cancer (CRC) occurs at the time of resection but it is not immediately observable. If the cancer is not completely eliminated, the patient will not be cured of cancer and will experience recurrence as the tumor has regrown to a detectable size. The main propose of the present study was to assess the effects of different covariates on the probability of being cured as well as the time-to-recurrence, and time-to-death in CRC patients by using multi-state cure model. The information of 283 patients with CRC, who underwent resection, from 2000 to 2015 in Imam Khomeini Hospital of Hamadan, Iran, were analyzed. The results of multi-state cure model reveal that females and who experience metastasis were more likely to be apparently cured. It has been shown that sex has a significant effect on the time-to-recurrence given patient was in the not cured group. The survival time of patients of the not cured group was affected by the stage of disease. However, the survival of the apparently cured patients were affected by age at diagnosis and metastasis status. The multi-state cure model provided a flexible framework to study the effects of prognostic factors simultaneously on the transition between different states and the probability of being apparently cured of CRC.
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http://dx.doi.org/10.1038/s41598-020-79969-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806811PMC
January 2021

The Impact of Control Measures and Holiday Seasons on Incidence and Mortality Rate of COVID-19 in Iran.

J Res Health Sci 2020 Dec 6;20(4):e00500. Epub 2020 Dec 6.

Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Preventive measures on the COVID-19 pandemic is an effective way to control its spread. We aimed to investigate the effect of control measures and holiday seasons on the incidence and mortality rate of COVID-19 in Iran.

Study Design: An observational study.

Methods: The daily data of confirmed new cases and deaths in Iran were taken from the Johns Hopkins University COVID-19 database. We calculated weekly data from 19 Feb to 6 Oct 2020. To estimate the impact of control measures and holiday seasons on the incidence rate of new cases and deaths, an autoregressive hidden Markov model (ARHMM) with two hidden states fitted the data. The hidden states of the fitted model can distinguish the peak period from the non-peak period.

Results: The control measures with a delay of one-week and two-week had a decreasing effect on the new cases in the peak and non-peak periods, respectively (P=0.005). The holiday season with a two-week delay increased the total number of new cases in the peak periods (P=0.031). The peak period for the occurrence of COVID-19 was estimated at 3 weeks. In the peak period of mortality, the control measures with a three-week delay decreased the COVID-19 mortality (P=0.010). The expected duration of staying in the peak period of mortality was around 6 weeks.

Conclusion: When an increasing trend was seen in the country, the control measures could decline the incidence and mortality related to COVID-19. Implementation of official restrictions on holiday seasons could prevent an upward trend of incidence for COVID-19 during the peak period.
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http://dx.doi.org/10.34172/jrhs.2020.35DOI Listing
December 2020

Effect of photo core, LuxaCore, and core max II core building materials on fracture resistance of endodontically-treated teeth restored with fiber-reinforced composite posts and ParaPosts.

Dent Res J (Isfahan) 2020 Jul-Aug;17(4):244-250. Epub 2020 Aug 14.

Dentist, Private Practice, Tehran, Iran.

Background: Post and core treatment is commonly performed for endodontically treated teeth to replace the lost tooth structure and reinforce and protect the remaining dental tissue. This study aimed to compare the effect of three-core building materials on fracture resistance of endodontically-treated teeth restored with fiber-reinforced composite (FRC) posts and ParaPosts.

Materials And Methods: This , experimental study evaluated 108 sound, single-rooted mandibular first premolars extracted for orthodontic purposes. The teeth were randomly divided into nine groups ( = 12) of control (no endodontic or restorative treatment), FRC + Photo Core (Group 2), FRC + LuxaCore (Group 3), FRC + Core Max II with bonding agent (Group 4), FRC + Core Max II without bonding agent (Group 5), ParaPost + Photo Core (Group 6), ParaPost + LuxaCore (Group 7), ParaPost + Core Max II with bonding agent (Group 8), and ParaPost + Core Max II without bonding agent (Group 9). The fracture resistance was measured by applying the load at 45° angle relative to the longitudinal axis of the tooth with a crosshead speed of 1 mm/min using a universal testing machine. Data were through descriptive statistics, Tukey's test, and one-way analysis of variance (α = 0.05).

Results: The mean fracture resistance was 454.0 ± 62.7, 410.8 ± 48.3, 365.1 ± 42.1, 423.7 ± 111.7, 392.4 ± 90.0, 292.3 ± 83.9, 242.3 ± 73.4, 278.2 ± 67.9, and 247.3 ± 49.6 N in Groups 1-9, respectively. Group 4 showed the highest fracture resistance, which was significantly higher than this study the value in all ParaPost and control groups ( < 0.05) but had no significant difference with the fracture resistance of other groups ( > 0.05).

Conclusion: Fracture resistance is independent of the type of core building material used, and the tested products had no superiority over each other. The mean fracture resistance of FRC post groups were significantly higher than that of ParaPost groups. Furthermore, Core Max II + bonding agent yielded insignificantly higher fracture resistance than Core Max II without bonding agent.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7688039PMC
August 2020

Factors affecting the survival of patients with colorectal cancer using random survival forest.

J Gastrointest Cancer 2020 Nov 10. Epub 2020 Nov 10.

Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

Purpose: Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to develop and validate a random survival forest (RSF) to identify important risk factors on mortality in colorectal patients based on their demographic and clinical-related variables.

Methods: In this retrospective cohort study, the information of 317 patients with colorectal cancer who were referred to Imam Khomeini Clinic of Hamadan during the years of 2002 to 2017 were examined. Patient survival was calculated from the time of diagnosis to death. In the present study, the RSF model was used to identify factors affecting patient survival. Also, the results of the RSF model were compared with the Cox model. The data were analyzed using R software (version 3.6.1) and survival packages.

Results: One-, 2-, 3-, 4-, 5-, and 10-year survival rates of included patients were 81.4%, 63%, 57%, 52%, 45%, and 34%, respectively, and the median survival was obtained to be 53 months. The number of 150 patients was died at this time period. The four most important predictors of survival included metastasis to other organs, WBC count, disease stage, and number of lymphomas involved. RSF method predicted survival better than the conventional Cox proportional hazard model.

Conclusion: We found that metastasis to other organs, WBC count, disease stage, and number of lymphomas involved were the most four most important predictors of low survival for colorectal cancer patients.
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http://dx.doi.org/10.1007/s12029-020-00544-3DOI Listing
November 2020

Developing and Testing an Instrument to Measure the Factors Affecting the Salt Restriction Behaviors among Women.

J Res Health Sci 2020 Sep 30;20(3):e00489. Epub 2020 Sep 30.

Department of Public Health, School of Health, Ilam University of Medical Sciences, Ilam, Iran.

Background: High salt intake is considered as one of the most important causes of hypertension and cardiovascular diseases. Measuring and identifying factors contributing to people's salt intake behaviors is important to evaluate effectiveness of interventions focusing on salt reduction behaviors. The purpose of this study was to develop and test a new theory of planned behavior (TPB)- based instrument to measure factors influencing three different salt intake behaviors (adding salt during cooking, at the table, purchasing salty food) among women.

Study Design: A mixed-method study.

Methods: After the face and content validity of developed instrument were established, a representative sample of women (N= 300, age (SD):42.82(12.10)) were recruited to assess the construct validity using Partial Least Square confirmatory factor analysis. Coefficient alpha and composite reliability (CR) were used to establish reliability of instrument. The content validity index (CVI) and content validity ratio (CVR) were used to assess the content validity.

Results: Assessing validity and reliability of instrument led to 56-item questionnaire. CVI was more than 0.70 and CVR more than 0.56. Internal consistency as assessed by Cronbach's alpha was acceptable. Convergent and discriminant validity were established. The GOF index for behavior one was 0.250, for behavior two was 0.414 and behavior three was 0.374. The results of confirmatory factor analysis indicate that TPB model has an acceptable fit with data.

Conclusion: Our instrument provides a validated and reliable tool for assessing different aspects of salt intake behaviors in women to evaluate effectiveness of interventions focusing on salt reduction behaviors.
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http://dx.doi.org/10.34172/jrhs.2020.26DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585764PMC
September 2020

Dimensions of aberrant driving behaviors and their association with road traffic injuries among drivers.

PLoS One 2020 9;15(9):e0238728. Epub 2020 Sep 9.

Department of Public Health, School of Public Health and Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.

Objective: Road traffic injuries (RTIs) are recognized as one of the most important causes of morbidity and mortality throughout the world, especially in developing countries. Human behavior is reportedly one of the critical factors in the occurrence of such injuries. The purpose of this study is to evaluate the correlation of abnormal driving behaviors with the frequency and severity of RTIs among drivers in Hamadan, west of Iran.

Methods: The present cross-sectional study was conducted on 800 people driving, who were selected by multistage cluster sampling technique. Data were collected using a three-part self-administered questionnaire including demographic, social and driving characteristics; the Manchester driver behavior questionnaire (DBQ); as well as information on a history of the occurrence of the injuries caused by the crashes and the severity of them. Data were statistically analyzed using numerical indices, linear regression analysis, Pearson correlation, ordinal logistic regression model and multinomial logistic regression.

Results: The highest and lowest mean percentages of abnormal driving behavior were related to unintentional violations (19.13) and Lapses (16.44), respectively. "Changing radio stations and listening to music while driving", "overtaking a driver who drives slowly", and "unintentionally exceeding the speed limit" were the three highest behaviors associated with road traffic injuries, with the mean and standard deviation of (1.93 ± 1.4), (1.90±1.4), (1.58±1.3), respectively. Age, gender, educational level, driving experience and driving hours during the day were significantly associated with DBQ dimensions and severity of road traffic injuries.

Conclusions: The results of this study showed that socio-demographic characteristics were significantly correlated with driving behavior. In addition, driving behaviors were correlated with traffic crashes and the resulting injuries. The findings of this study can be utilized to develop driving behavior interventions among the drivers.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238728PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7486081PMC
November 2020

Prediction of Serum Creatinine in Hemodialysis Patients Using a Kernel Approach for Longitudinal Data.

Healthc Inform Res 2020 Apr 30;26(2):112-118. Epub 2020 Apr 30.

Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Objectives: Longitudinal data are prevalent in clinical research; due to their correlated nature, special analysis must be used for this type of data. Creatinine is an important marker in predicting end-stage renal disease, and it is recorded longitudinally. This study compared the prediction performance of linear regression (LR), linear mixed-effects model (LMM), least-squares support vector regression (LS-SVR), and mixed-effects least-squares support vector regression (MLS-SVR) methods to predict serum creatinine as a longitudinal outcome.

Methods: We used a longitudinal dataset of hemodialysis patients in Hamadan city between 2013 and 2016. To evaluate the performance of the methods in serum creatinine prediction, the data was divided into two sets of training and testing samples. Then LR, LMM, LS-SVR, and MLS-SVR were fitted. The prediction performance was assessed and compared in terms of mean squared error (MSE), mean absolute error (MAE), mean absolute prediction error (MAPE), and determination coefficient (). Variable importance was calculated using the best model to select the most important predictors.

Results: The MLS-SVR outperformed the other methods in terms of the least prediction error; MSE = 1.280, MAE = 0.833, and MAPE = 0.129 for the training set and MSE = 3.275, MAE = 1.319, and MAPE = 0.159 for the testing set. Also, the MLS-SVR had the highest , 0.805 and 0.654 for both the training and testing samples, respectively. Blood urea nitrogen was the most important factor in the prediction of creatinine.

Conclusions: The MLS-SVR achieved the best serum creatinine prediction performance in comparison to LR, LMM, and LS-SVR.
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http://dx.doi.org/10.4258/hir.2020.26.2.112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278511PMC
April 2020

Application of group smoothly clipped absolute deviation method in identifying correlates of psychiatric distress among college students.

BMC Psychiatry 2020 05 4;20(1):198. Epub 2020 May 4.

Department of Psychiatry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: College students are at an increased risk of psychiatric distress. So, identifying its important correlates using more reliable statistical models, instead of inefficient traditional variable selection methods like stepwise regression, is of great importance. The objective of this study was to investigate correlates of psychiatric distress among college students in Iran; using group smoothly clipped absolute deviation method (SCAD).

Methods: A number of 1259 voluntary college students participated in this cross-sectional study (Jan-May 2016) at Hamadan University of Medical Sciences, Iran. The data were collected using a self-administered questionnaire consisting of demographic information, a behavioral risk factors checklist and the GHQ-28 questionnaire (with a cut-off of 23 to measure psychiatric distress, recommended by the Iranian version of the questionnaire). Penalized logistic regression with a group-SCAD regularization method was used to analyze the data (α = 0.05).

Results: The majority of students were aged 18-25 (87.61%), and 60.76% of them were female. About 41% of students had psychiatric distress. Significant correlates of psychiatric distress among college students selected by group-SCAD included the average grade, educational level, being optimistic about future, having a boy/girlfriend, having an emotional breakup, the average daily number of cigarettes, substance abusing during previous month and having suicidal thoughts ever (P < 0.05).

Conclusions: Penalized logistic regression methods such as group-SCAD and group-Adaptive-LASSO should be considered as plausible alternatives to stepwise regression for identifying correlates of a binary response. Several behavioral variables were associated with psychological distress which highlights the necessity of designing multiple factors and behavioral changes in interventional programs.
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http://dx.doi.org/10.1186/s12888-020-02591-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199302PMC
May 2020

The Effect of an Anti-Bullying Intervention on Male Students' Bullying-victimization Behaviors and Social Competence: A Randomized Controlled Trial in Deprived Urban Areas.

J Res Health Sci 2019 Oct 21;19(4):e00461. Epub 2019 Oct 21.

Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Violence among adolescents is a global public health concern. There is limited evidence on the effectiveness of anti-bullying interventions in Iran. Weaimed to examine the effectiveness of social cognitive theory (SCT)-based intervention on reducing bullying and victimization in elementary school students.

Study Design: A randomized controlled trial.

Methods: Eight elementary schools (consisted of 280 students in 5th and 6th grade) from deprived and semi-deprived areas of Kermanshah (west of Iran) were randomly assigned to intervention and control group from 2018 to 2019. Anti-bullying training content appropriate for SCT and sociocultural characteristics were provided to the intervention group including students, parents, teachers and school staff. The measures included SCT constructs, bullying, victimization, and social competence of students.

Results: At baseline participants of two groups were homogenous in terms of demographic factors except for the type of living with the parent (P=0.040) and outcome variables including SCT constructs and bullying behaviors. The interventions significantly improved SCT constructs, reduced bullying and victimization and increased social competence in the intervention group compared to the control group (P<0.001). The difference between outcome expectations in both groups was not significant (P=0.137).

Conclusion: Interventions based on sociocultural characteristics and focuses on SCT theory reduce bullying and victimization behavior. Given the effectiveness and feasibility of these interventions, this theory can be effective to break the bullying cycle and improve social competence.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183563PMC
October 2019

Circulating IFN-γ producing CD4+ T cells and IL-17A producing CD4+ T cells, HLA-shared epitope and ACPA may characterize the clinical response to therapy in rheumatoid arthritis patients.

Hum Immunol 2020 May 24;81(5):228-236. Epub 2020 Feb 24.

Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

This study analyzed the association between peripheral distributions of helper T cell subsets, HLA shared-epitope (SE), anti-cyclic citrullinated peptide antibody (ACPA) and clinical response to therapy in rheumatoid arthritis (RA) patients. Frequencies of IFN-γ-producing CD4+T (Th1) and IL-17A-producing CD4+T (Th17) cells were determined by flow cytometry in 167 patients (114 cases with good-response (GR) and 53 poor-response (PR) based on DAS28). HLA-DRB1 alleles for patients and 150 healthy controls were determined by PCR-SSP. We observed that 65.2% of RA patients were SE, 63.4%ACPA, 43.7%SEACPA and 14.9% were SEACPA. Higher significantly proportions of Th1 and Th17 cells were found in RA patients than controls (P < 0.05) as well as in the SE or ACPARA patients compared to SE and ACPA patients. Increased frequencies of both Th subsets were found in SEACPA versus SEACPA patients (P < 0.001) and in the PR versus GR group (P < 0.001). We showed significant differences for Th cells frequencies between SE and SE patients in both groups, and between ACPA and ACPA cases in the PR group. Our findings suggest a close link between Th1 and Th17 cells proportions and HLA-SE/ACPA in the RA patients and remarkably in the PR group which could be indicative for the importance of immune monitoring for evaluation of response to therapy.
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http://dx.doi.org/10.1016/j.humimm.2020.02.008DOI Listing
May 2020

Identification of hemolysin encoding genes and their association with antimicrobial resistance pattern among clinical isolates of coagulase-negative Staphylococci.

BMC Res Notes 2020 Feb 10;13(1):68. Epub 2020 Feb 10.

Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Park Mardome, Hamadan, IR, Iran.

Objective: Coagulase-negative staphylococci (CoNS) are as considered opportunistic pathogens which capable of producing several toxins, enzymes and resistance genes. The current study aimed to determine the occurrence of different hemolysins genes and patterns of antibiotic resistance among CoNS species.

Results: The highest frequency of antibiotic resistance was observed against cefoxitin in 49 isolates (53.8%), and the lowest resistance was against novobiocin in 5 isolates (5.5%). None of the isolates was resistant to vancomycin. The prevalence of hla, hla_yidD, hld, and hlb genes was: 87.9%, 62.6%, 56%, and 47.3%, respectively. The hla/yidD and hld genes were detected in 69.4% of S. epidermidis and the hla gene in 94.6% of S. haemolyticus isolates; the hlb gene was detected in 53.1% of the S. epidermidis isolates. The mecA gene was identified in 50 (55%) of the CoNS isolates. In conclusion, the results of statistical analysis showed that the hld gene had a significant association with resistance to levofloxacin and erythromycin antibiotics, the hlb with clindamycin resistance and the hla/yidD with rifampicin and novobiocin resistance. The results of this study showed that there is a significant relationship between hemolysin encoding genes and antibiotic resistance patterns; therefore, detection of virulence factors associated with antibiotic resistance has become a significant issue of concern.
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http://dx.doi.org/10.1186/s13104-020-4938-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011549PMC
February 2020

Relationship Between Parental Stress and their Attitudes Towards Cochlear Implantation Outcomes in Children Referred to Besat Cochlear Implant Center in Hamadan 2018.

J Pediatr Nurs 2020 Jul - Aug;53:e1-e5. Epub 2019 Nov 28.

Mother and Child Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

Purpose: This study aimed to investigate the relationship between parental stress and their attitudes towards post-cochlear implantation outcomes in children referred to Besat cochlear implant center in Hamadan during 2018.

Design And Methods: In this descriptive cross-sectional study, 100 parents of children with cochlear implantation were selected from Besat cochlear implant center in Hamadan through census method from April to October 2018. The data were collected using a demographic characteristic questionnaire, parental stress scale developed by Berry and Jones, and Parental Attitudes of Various Aspects of Cochlear Implantation. The data were analyzed using SPSS software (version 16) through correlation coefficient, one-way ANOVA, and t-test. P-value <0.05 was considered statistically significant.

Results: The results of this study indicated that parental stress negatively correlated with their attitudes towards the outcomes of cochlear implantation (r = -0.420), including the aspects of communication (r = -0.462), educational (r = -0.398), and social skills (r = -0.445), as well as services provided by the health care centers (r = -0.277), and the efficiencies of cochlear implantation center (r = -0.118) (P < 0.05).

Conclusion: According to the results, parents with more positive attitudes towards the areas of communication, educational, and social skills, as well as services provided by the health care centers, and the efficiencies of cochlear implantation center experienced lower levels of stress.

Practice Implications: Nurses can measure the stress and attitudes towards cochlear implantation outcomes in children to accurately assess the needs of the family in order to improve their nursing process and advance the child's rehabilitation program.
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http://dx.doi.org/10.1016/j.pedn.2019.11.004DOI Listing
November 2019

Polymorphisms in Promoter Region of the Interferon-Gamma Receptor-1 Gene and its Relation with Susceptibility to Brucellosis.

Iran J Pathol 2019 1;14(3):206-211. Epub 2019 Aug 1.

Department of Biostatistics and Epidemiology, Hamadan University of Health Sciences, Hamadan, Iran.

Background & Objective: Brucellosis is one of the most prevalent bacterial zoonotic diseases which afflicts both humans and animals. Genetic factors play an important role in susceptibility to brucellosis. One of these factors is interferon-gamma (IFN-), which is vital in the defense mechanism against infectious diseases such as brucellosis. The purpose of this study was to evaluate the relationship between two single nucleotide polymorphisms (SNPs) at positions -611 and -56 within the promoter region of interferon-gamma receptor-1 gene (IFN- R1) and brucellosis.

Methods: In this research, the genomic DNA was collected from 60 peripheral blood samples infected with brucellosis and 68 healthy volunteers. DNA was extracted by salting out method. Then, DNA genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP).

Results: The results showed that there is a significant difference in -611 SNP frequencies between control and patient groups. At position -611, CC genotype was related to patient group (=0.024) and TT genotype was related to the control group. According to the results, males had a higher frequency of infection.

Conclusion: The presence of C allele in position -611 in IFNγ R1 gene promoter was related to a higher risk of disease and susceptibility to brucellosis. Moreover, the presence of T allele in position γ.
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http://dx.doi.org/10.30699/ijp.2019.91536.1888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742735PMC
August 2019

Doxycycline-encapsulated solid lipid nanoparticles as promising tool against enclosed in macrophage: a pharmacodynamics study on J774A.1 cell line.

Antimicrob Resist Infect Control 2019 3;8:62. Epub 2019 Apr 3.

1Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid fahmideh street, Park Mardome, Hamadan, IR Iran.

Background: Brucellosis is a zoonotic disease caused by species. It has been estimated that more than 500,000 new cases of Brucellosis occur annually all around the world. Relapse of the disease is one of the most important challenges. The most important reason for the relapse of brucellosis is the survival of the bacteria inside the macrophages, which makes them safe from the immune system and disrupts drug delivery mechanism.

Objectives: The present study was performed to assess the effects of Doxycycline-loaded Solid Lipid Nanoparticles (DOX-SLN) on the inside macrophages.

Methods: DOX-SLN was prepared using double emulsion method. The technological characterization of DOX-SLN, including particle size, zeta potential, polydispersity index (PDI), drug loading and encapsulation efficiency were used. Fourier-transform infrared spectroscopy (FTIR) and Differential scanning calorimetry (DSC) were used to assess the interactions between Nanoparticles (NPs) components and crystalline form of doxycycline. Moreover, the effect of DOX-SLN on the bacteria were compared with that of the doxycycline using various methods, including well diffusion, Minimum Inhibitory Concentration (MIC), and investigation of their effects on murine macrophage-like cells cell line J774A.1.

Results: The means of particle size, zeta potential, PDI, drug loading and encapsulation efficiency were 299 ± 34 nm, - 28.7 ± 3.2 mV, 0.29 ± 0.027, 11.2 ± 1.3%, and 94.9 ± 3.2%, respectively. The morphology of NPs were spherical with a smooth surface. No chemical reaction was occurred between the components. Doxycycline was located within NP matrix in its molecular form. The DOX-SLN significantly decreased the microbial loading within macrophages (3.5 Log) in comparison with the free doxycycline.

Conclusions: Since the DOX-SLN showed better effects on enclosed in macrophages than the free doxycycline, it is recommended to use it for treating brucellosis and preventing relapse.
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http://dx.doi.org/10.1186/s13756-019-0504-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448226PMC
May 2020

Aggression and its predictors among elementary students.

J Inj Violence Res 2019 Jul 14;11(2):159-170. Epub 2019 Apr 14.

Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Aggression is the most significant psychopathological risk factor. It is a multifaceted construct and can affect students' social, mental and physical health. The present study was conducted to investigate factors associated with aggression among elementary school girls and boys using the theoretical framework of Social Cognitive Theory in Kermanshah city, Iran.

Methods: The cross-sectional study was conducted on 900 students, including 445 girls and 455 boys, 563 parents and 104 elementary school teachers in the fourth, fifth and sixth educational grades in Kermanshah city in 2018. The proportionate stratified random sampling was used. The Adolescent Peer Relations Instrument (APRI) was used to measure aggression. To measure the variables of social cognitive theory, a researcher-made questionnaire was used. Data analysis was conducted using descriptive and inferential statistics via the SPSS software.

Results: It was showed that 29% and 10% of the students had moderate and high levels of aggression, respectively. Also, 30.6% of them were moderate victims and 45.6% were intense victims. Self-efficacy (p less than 0.001), perceived social norms (p=0.011), observational learning (p less than 0.001), outcome expectations (p=0.027), outcome expectancies (p=0.028) and per-ceived situational (p less than 0.001) were reported as the significant predictors of aggressive behaviors in the students based on the Social Cognitive Theory constructs. In total, they explained for 37.3% of changes in aggressive behaviors. Parents' knowledge (p=0.005), parents' attitude (p=0.012), teachers' attitude (p less than 0.001), and teachers' self-efficacy (p=0.021) had statistically significant relationships with aggression in the students.

Conclusions: Aggression among children and adolescents is getting alarmingly prevalent. The Social Cogni-tive Theory is the appropriate framework for the prediction of aggression behaviors in children and adolescents. Therefore, designing and implementing educational interventions based on this theory can help with the management of aggression in children and adolescents.
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http://dx.doi.org/10.5249/jivr.v11i2.1102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646832PMC
July 2019

Improved antibacterial function of Rifampicin-loaded solid lipid nanoparticles on Brucella abortus.

Artif Cells Nanomed Biotechnol 2019 Dec;47(1):1181-1193

d Department of Biochemistry , Hamadan University of Medical Sciences , Hamadan , Iran.

The objective of this study was to assess the antibacterial activity of Rifampicin-loaded solid lipid nanoparticles on Brucella abortus 544. Rifampicin-loaded solid lipid nanoparticles were prepared by a modified microemulsion/sonication method and characterized. The results showed the average size about 319.7 nm, PI about 0.20 and zeta potential about 18.4 mv, encapsulation efficacy and drug-loading were equal to 95.78 and 34.2%, respectively, with a spherical shape. Drug release lasted for 5 days. The antibacterial activity was statistically significant with p < .05 in bacterial and cell culture media compared to free Rifampicin. It can be concluded that solid lipid nanoparticles can be considered as a promising delivery system for improving the antibacterial activity of Rifampicin against Brucella abortus.
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http://dx.doi.org/10.1080/21691401.2019.1593858DOI Listing
December 2019

Unintentional Injuries among the Elderly in Rural Areas and Their Related Behaviors.

Korean J Fam Med 2019 Mar 28;40(2):80-86. Epub 2019 Feb 28.

Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Although the role of unintentional injuries as a cause of death in adults is known, there is limited knowledge about such adults' behaviors. This study aims to investigate the frequency of and factors affecting unintentional injuries among the elderly living in rural areas and their related behaviors.

Methods: A cross-sectional study was carried out in the rural areas of Hamadan County, Iran, in 2016. The sample consists of randomly selected 445 adults aged 60-75 years. Data collection was conducted through face-to-face interviews, using questionnaires.

Results: One hundred and forty-three participants (34.7%) experienced 166 injury occurrences. The injuries occurred more in females than in males. There were more mild and severe injuries (48.2% and 31.3%, respectively) than moderate ones (20.5%). The most frequent mechanism of injuries was accidental falls (64.5%). There was a significant relationship between using aid devices and injuries (P=0.001). Among the most applied injury preventive measures as reported by the elderly, crossing streets safely and the use of proper lighting at night had the highest percentages (81.5% and 69.7%, respectively). However, the use of protective handles and plastic flooring in bathrooms in order to prevent slipping had the lowest percentages (less than 1.0%).

Conclusion: The injuries among the elderly in this study were important health concerns. Injury-related factors should be considered in the development of injury prevention programs.
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http://dx.doi.org/10.4082/kjfm.17.0124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6444085PMC
March 2019

Evaluation of dimensional accuracy of dental bridges manufactured with conventional casting technique and CAD/CAM system with Ceramill Sintron blocks using CMM.

J Dent Res Dent Clin Dent Prospects 2018 19;12(4):264-271. Epub 2018 Dec 19.

Department of Prosthodontic Dentistry, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.

Recently, non-presintered chromium-cobalt (Cr-Co) blocks with the commercial name of Ceramill Sintron were introduced to the market. However, comprehensive studies on the dimensional accuracy and fit of multi-unit frameworks made of these blocks using the coordinate measuring machine (CMM) are lacking. This study aimed to assess and compare the dimensional changes and fit of conventional casting and milled frameworks using Ceramill Sintron. A metal model was designed and scanned and 5-unit frameworks were fabricated using two techniques: (I) the conventional casting method (n=20): the wax model was designed, milled in the CAD/CAM machine, flasked and invested; (II) the milling method using Ceramill Sintron blocks (n=20): the wax patterns of group 1 were used; Ceramill Sintron blocks were milled and sintered. Measurements were made on the original reference model and the fabricated frameworks using the CMM in all the three spatial dimensions, and dimensional changes were recorded in a checklist. Data were analyzed with descriptive statistics, and the two groups were compared using one-way ANOVA and Tukey test (α=0.05). The fabricated frameworks in both groups showed significant dimensional changes in all the three dimensions. Comparison of dimensional changes between the two groups revealed no significant differences (P>0.05) except for transverse changes (arch) that were significantly greater in Ceramill Sintron frameworks (P<0.05). The two manufacturing processes were the same regarding dimensional changes and the magnitude of marginal gaps and both processes resulted in significant dimensional changes in frameworks. Ceramill Sintron frameworks showed significantly greater transverse changes than the conventional frameworks.
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http://dx.doi.org/10.15171/joddd.2018.041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368946PMC
December 2018

The effectiveness of group counseling on prenatal care knowledge and performance of pregnant adolescents in a Kurdish region of Iran.

Int J Adolesc Med Health 2018 Dec 4. Epub 2018 Dec 4.

Hamadan University of Medical Sciences, Modeling of Noncommunicable Diseases Research Center, Hamadan, Iran (Islamic Republic of).

Background Prenatal care in adolescents is one of the most important challenges worldwide, especially in the regions with a specific culture and traditions. The purpose of this study was to investigate the effectiveness of group counseling on knowledge and performance of pregnant adolescents in prenatal care in a Kurdish region in Iran. Methods This quasi-experimental study was conducted on pregnant adolescents attending in the health centers of Mahabad, a Kurdish city in Iran. Using a multi-stage cluster sampling method, after random selection of four health centers as the intervention and the control, primigravida adolescents with gestational age of 16-20 weeks filled out the demographic and midwifery characteristics questionnaire, as well as a prenatal care knowledge and performance of pregnant adolescents' questionnaire. Then 102 pregnant adolescents (51 people in the control centers and 51 people in the intervention centers), who responded correctly to <50% of the questionnaire items were included in the study. Six sessions of group counseling about prenatal care were held for the intervention group. The control group received the routine prenatal care. Knowledge and performance of pregnant adolescents about prenatal care were compared inter and intra two groups 1 month after the end of the sessions through descriptive-analytic tests including chi-square, independent T and paired T tests. Results In contrast to the control group, the mean scores of adolescents' knowledge about prenatal care increased after the intervention (from 17.51 ± 5.93 to 24.67 ± 5.79) and showed significant difference to the control group (p < 0.05). In addition, the mean scores of adolescent care performance in the intervention group increased (from 5.80 ± 2.19 to 10.33 ± 2.55) and showed significant difference to the control group (p < 0.05). Conclusion The results of the present study show the positive effects of prenatal care counseling on increasing knowledge and improving the performance of pregnant adolescents.
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http://dx.doi.org/10.1515/ijamh-2018-0108DOI Listing
December 2018

Comparative Study of Dimensional Accuracy in Three Dental Implant Impression Techniques: Open Tray, Closed Tray with Impression Coping, and Snap Cap.

J Contemp Dent Pract 2018 Aug 1;19(8):974-981. Epub 2018 Aug 1.

Department of Prosthodontics, Faculty of Dentistry, Hamadan University of Medical Science, Hamadan, Islamic Republic of Iran, Phone: +989188185838, e-mail:

Aim: Several impression techniques have been proposed to result passive fitness between the prosthesis and osseointe-grated implant. The aim of the study was to compare dimensional accuracy of three impression methods: Open tray, closed tray with impression coping, and closed tray with snap cap.

Materials And Methods: In this experimental study, a mandibular acrylic model was prepared with a milling machine to place three holes for dental implant analogs (Dio SM) with the dimension of 3.8 × 10 mm into the intended sites (one in midline and two others on the side at a distance of 10 mm) parallel with each other and perpendicular to the plane. Twenty-seven casts were prepared with impression material of polyvinyl siloxane (PVS) and dental stone type IV and divided into three groups. Implant situations were measured by coordinate measuring machine (CMM) and results were analyzed with Kruskal-Wallis and Mann-Whitney test to perform pairwise comparison among the groups.

Results: The mean ΔR values for open tray, closed tray with impression coping, and closed tray with snap cap were respectively, 0.070 ± 0.088, 0.173 ± 0.205, and 0.142 ± 0.044. There were statistically significant differences between open tray and closed tray as well as open tray and snap cap methods (p < 0.05), but there was no statistically significant difference between closed tray and snap cap method (p = 0.1).

Conclusion: Regarding the results, open tray impression technique had the highest dimensional accuracy compared with the other two methods. There were no statically significant differences between closed tray with snap cap and closed tray with impression coping technique.

Clinical Significance: Snap cap technique is less time consuming with similar dimensional accuracy in comparison with open tray impression technique.
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August 2018

Effect of Nd:YAG and Diode Lasers on Apical Seal of Root Canals Filled with AH Plus and Mineral Trioxide Aggregate-Based Sealers.

J Dent (Tehran) 2018 Jan;15(1):30-40

Assistant Professor, Department of Endodontics, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran.

Objectives: Laser irradiation, as an adjunct to root canal preparation, may increase the success rate of endodontic treatments. This study aimed to assess the effect of neodymium-doped yttrium aluminum garnet (Nd:YAG) and diode lasers on the apical seal of the root canals filled with AH Plus® and mineral trioxide aggregate (MTA)-based sealers.

Materials And Methods: This in-vitro experimental study was conducted on 96 single-rooted, single-canal extracted human teeth with closed apices. The root canals were prepared by using ProTaper® rotary instruments and were randomly divided into six groups (n=16): 940-nm diode laser and AH Plus® sealer (group 1), Nd:YAG laser and AH Plus® sealer (group 2), AH Plus® sealer (group 3), 940-nm diode laser and MTA-based sealer (group 4), Nd:YAG laser and MTA-based sealer (group 5), MTA-based sealer (group 6), as well as positive and negative control groups. A bacterial leakage model was used for microleakage assessment. Qualitative assessment was done by using a scanning electron microscope (SEM). Data were analyzed by two-way analysis of variance (ANOVA) at the significance level of 0.05.

Results: There were statistically significant differences between the experimental and control groups (P=0.002). The laser-treated groups showed a lower apical microleakage compared to the non-laser-treated groups, although the difference was not statistically significant (P>0.05). No significant differences were noted between the two lasers in terms of the apical microleakage, irrespective of the type of sealer (P>0.05).

Conclusions: Laser irradiation, as an adjunct to root canal preparation, has no significant effect on the level of apical microleakage.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026104PMC
January 2018

The Effect of Canal Preparation with Four Different Rotary Systems on Formation of Dentinal Cracks: An In Vitro Evaluation.

Iran Endod J 2018 ;13(2):163-168

Dental Center, Urmia Seyedoshohada Hospital, Urmia University of Medical Sciences, Urmia, Iran.

Introduction: Endodontic rotary systems may result in dentinal cracks. They may propagate to vertical root fracture that compromises the outcome of endodontic treatment. This study aimed to compare Neolix and Reciproc (single-file systems), Mtwo and ProTaper (conventional rotary systems) in terms of dentinal crack formation in root canal walls.

Methods And Materials: This study was conducted on 110 extracted human single-rooted teeth. The teeth were randomly divided into four experimental groups (=25) for root canal preparation with Neolix, Reciproc, Mtwo and ProTaper systems and two control groups (=5). The first control group underwent root canal instrumentation with hand files while the second control group received no preparation and was only irrigated. After instrumentation, root canals were horizontally sectioned at 3, 6 and 9 mm from the apex and inspected under a stereomicroscope under 12× magnification for detection of cracks. The data were analyzed using GEE test and Bonferroni tests (<0.05).

Results: No crack was found in the control groups. All rotary systems caused dentinal cracks. ProTaper, Reciproc, Mtwo and Neolix caused cracks in 92%, 80%, 68% and 48% of samples. ProTaper caused significantly more cracks than Neolix and Mtwo (<0.05). No significant differences were noted between other groups (>0.05).

Conclusion: All rotary systems cause dentinal cracks and it is significantly different in apical, middle and coronal third of the root. Neolix appears to be a suitable alternative to other rotary systems since use of this single-file system saves time and cost and minimizes trauma to dentinal walls.
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http://dx.doi.org/10.22037/iej.v13i2.16416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911288PMC
January 2018

The relationship between general health and coping style with perceived stress in primigravida healthy pregnant women: Using the PATH model.

Women Health 2019 01 24;59(1):41-54. Epub 2018 Jul 24.

d Department of Biostatistics, School of Public Health, Modeling of Non Communicable Diseases Research Center , Hamadan University of Medical Sciences , Hamadan , Iran.

The aim of this study was to analyze relationships among general health, coping style, and perceived stress in healthy primigravida pregnant women. A cross-sectional study was conducted at public health clinics in Hamadan city, Iran between July and December 2015. In total, 380 pregnant women were selected through stratified random sampling. Data were collected using the Revised Prenatal Coping Inventory and General Health Questionnaire. Perceived stress was assessed through an interview comprised of open-ended questions. The final PATH model fit well; general health (β = 0.02) as well as anxiety and sleep disorders (β = 0.03) were slightly directly associated with perceived stress, and only planning-preparation was related to perceived stress through general health (β = 0.09). The findings enhance the knowledge gained from previous perinatal stress research. General health status was directly related to stress, and coping style was indirectly related to stress. Coping styles may mediate the relationship between general health status and perceived stress, suggesting that midwives should attempt to improve the general health of women to reduce stress and its consequences during pregnancy by teaching patients appropriate coping styles. Further studies on the effect of coping style interventions on stress are warranted.
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http://dx.doi.org/10.1080/03630242.2018.1434587DOI Listing
January 2019

The burden of pure anisometropic amblyopia: a cross-sectional study on 2800 Iranians.

Int Ophthalmol 2018 Feb 13;38(1):29-34. Epub 2017 Dec 13.

Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Purpose: To assess the proportion of pure anisometropic amblyopia in a sample Iranian (white) population.

Methods: A total of 2800 consecutive individuals who presented at a referral eye clinic for any reason were examined for the presence of pure anisometropic amblyopia. Anisometropia was reported when a spherical equivalent refraction difference of at least 1.0 D with or without a cylinder refraction difference of at least 1.0 D was present between the two eyes. Amblyopia was defined as the best-corrected visual acuity of 20/30 or worse or a two-line interocular visual acuity difference between eyes that could not be attributed to any structural ocular pathology or visual pathway abnormality.

Results: Subjects were 1528 females and 1272 males with a mean age of 30.25 ± 14.93 years (range, 5-65). Amblyopia was diagnosed in 192 cases (6.9%), significantly more frequent among females (7.9 vs. 5.7%, p = 0.02). Pure anisometropic amblyopia was present in 6.1% of the study population, significantly more common in patients with spherical hyperopic anisometropia (37.7%) compared to patients with spherical myopic anisometropia (21.3%), cylindrical myopic anisometropia (4.1%), and cylindrical hyperopic anisometropia (15%) (p < 0.001).

Conclusions: Pure anisometropic amblyopia is a common finding in Caucasians seeking eye care, particularly when anisometropia is of spherical hyperopic subtype.
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http://dx.doi.org/10.1007/s10792-017-0784-zDOI Listing
February 2018

Fatigue Fracture Strength of Implant-Supported Full Contour Zirconia and Metal Ceramic Fixed Partial Dentures.

J Dent (Tehran) 2017 May;14(3):165-172

Associate Professor, Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Hamedan University of Medical Sciences, Hamedan, Iran.

Objectives: Zirconia restorations have been suggested as a more durable and more appealing alternative to metal restorations. However, their mechanical properties may be negatively affected by fatigue due to superficial stresses or low temperature degradation. This study aimed to assess the fatigue fracture strength of three-unit implant-supported full contour zirconia and pre-sintered cobalt-chromium (Co-Cr) alloy posterior fixed partial dentures (FPDs).

Materials And Methods: In this in-vitro experimental study, 28 posterior three-unit implant-supported FPDs were fabricated of full contour zirconia and pre-sintered Co-Cr alloy, and were cemented on implant abutments. To simulate the oral environment, FPDs were subjected to 10,000 thermal cycles between 5-55°C for 30 seconds, and were then transferred to a chewing simulator (100,000 cycles, 50 N, 0.5 Hz). Afterwards, fatigue fracture strength was measured using a universal testing machine. Data were analyzed by Mann-Whitney U test.

Results: The mean and standard deviation of fracture strength were 2108.6±440.1 N in full contour zirconia, and 3499.9±1106.5 N in pre-sintered Co-Cr alloy. According to Mann-Whitney U test, the difference in this respect was statistically significant between the two groups (P=0.007).

Conclusions: Since the fracture strength values obtained in the two groups were significantly higher than the maximum mean masticatory load in the oral environment, both materials can be used for fabrication of posterior three-unit FPDs, depending on the esthetic demands of patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694850PMC
May 2017

Down-regulation of TYK2, CBLB and LMP7 genes expression in relapsing-remitting multiple sclerosis patients treated with interferon-beta.

J Neuroimmunol 2018 01 8;314:24-29. Epub 2017 Nov 8.

Department of Immunology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Molecular Immunology Research Group, Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

This study aimed to examine the expression of TYK2, CBLB and LMP7 genes at both mRNA and protein levels in relapsing-remitting MS (RRMS) patients in compare with healthy controls. Seventy-eight RRMS patients treated with IFNβ-1a and 79 age- and ethnic-matched healthy subjects were studied. The mRNA expression levels of TYK2, CBLB and LMP7 in PBMCs were quantified by real-time PCR and plasma concentrations of three molecules were measured by ELISA. Results were compared between patients and controls, IFNβ-responders and non-responders. Forty-nine of 78 patients were classified as IFNβ-responders and 29 cases were non-responders. Significantly down-regulated expression of TYK2, CBLB and LMP7 genes was found in the patients group versus controls (P<0.001). Decreased plasma levels of three molecules were observed in patients compared to controls (P<0.001). IFNβ-responders had significantly higher expressions for CBLB (P=0.001) and LMP7 (P=0.02) than non-responders. Also, we observed increased expressions of LMP7 (P=0.39) and CBLB (P=0.02) genes in patients under 30y and increased expression of TYK2 in patients >40years (P=0.002). Our results suggest that expression analysis of TYK2, CBLB and LMP7 genes could be useful for evaluation of T cells immunity and clinical response to IFNβ-therapy in RRMS patients.
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http://dx.doi.org/10.1016/j.jneuroim.2017.11.004DOI Listing
January 2018

The Effect of Educational Program on Quality of Life in Menopausal Women: A Clinical Trial.

J Menopausal Med 2017 Aug 31;23(2):91-95. Epub 2017 Aug 31.

Modeling of Non-Communicable Diseases Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Objectives: This study aimed to investigate the effect of Educational program on quality of life (QOL) in menopausal women in 2016 in Hamadan, Iran.

Methods: In this clinical trial study, 100 postmenopausal women were randomly selected and allocated to case and control group (50 per group). Data collection tool included questionnaires of demographic information and Menopause QOL, which were completed by the samples before the intervention. In the case group, education program was run during 5 sessions for 45 to 60 minutes. Immediately and Three months after intervention, information were collected using questionnaire in both groups and they were analyzed using SPSS 16 software.

Results: The menopause women in both intervention and control groups had similar demographics. There was not a significant difference in the QOL mean scores in before of the intervention between the two groups of intervention and control in all dimension of QOL. There was a significantly difference in the mean of QOL scores between the two groups in immediately after the intervention and 3 months after the intervention in dimension of vasomotor, psychosocial, sexual and physical ( < 0.001).

Conclusions: This study recommend that a unit in health and treatment centers be established for training menopausal women about health care by holding didactic classes.
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http://dx.doi.org/10.6118/jmm.2017.23.2.91DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606915PMC
August 2017

The limbo of motherhood: Women's experiences of major challenges to cope with the first pregnancy.

Midwifery 2017 Dec 30;55:38-44. Epub 2017 Aug 30.

Department of Biostatistics, Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

Introduction: pregnancy is a unique health experience which is influenced by various factors, particularly culture and social context.

Aim Of Study: to explore women's perception regarding major challenges of adaptation with first pregnancy based on culture and social context.

Design: a qualitative content analysis was used for data gathering and analysis. Data were collected through unstructured in-depth interviews.

Setting: the study was conducted in public health clinics in Hamadan city, an urban area in southwest of Iran from July to December 2016.

Participants: nineteen healthy primigravidas were recruited using a purposive sampling method and interviewed in the third trimester of pregnancy.

Findings: the two main categories extracted: imposing the motherhood role on oneself and negative feelings toward pregnancy. The feeling of being in limbo during pregnancy suggests that the everyday experiences of the participants were filled with challenges and short-term tensions, fears, and limitations of pregnancy overwhelmed the participants with negative feelings. As a result, they experienced doubt due to their inexperience in the acceptance of the responsibility of pregnancy and motherhood.

Key Conclusions And Implications For Practice: one of the challenges of adaptation to pregnancy is the experience of negative feelings toward physiological changes and sense of uncertainty toward accepting motherhood responsibilities. Thus, the provision of suitable interventions during the prenatal period to reduce negative feelings and improve women's self-sufficiency in adaptation to pregnancy seems necessary.
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http://dx.doi.org/10.1016/j.midw.2017.08.009DOI Listing
December 2017

Efficacy of Sodium Hypochlorite Activated With Laser in Intracanal Smear Layer Removal: An SEM Study.

J Lasers Med Sci 2017 8;8(1):36-41. Epub 2017 Jan 8.

Department of Endodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.

The purpose of the present study was to evaluate the different concentrations of sodium hypochlorite activated with laser in removing of the smear layer in the apical, middle, and coronal segments of root canal walls by scanning electron microscopy analysis. Sixty single-rooted human mandibular teeth were decoronated to a standardized length. The samples were prepared by using Race rotary system to size 40, 0.04 taper and divided into 4 equal groups (n = 15). Group 1, irrigated with EDTA 17% and 5.25% NaOCl, groups 2, 3 and 4, 1%, 2.5%, and 5% NaOCl activated with Nd:YAG laser, respectively. Teeth were split longitudinally and subjected to scanning electron microscope (SEM). Data were analyzed by Kruskal-Wallis, Mann-Whitney tests. value of <0.05 was considered statistically significant. Five percent NaOCl LAI (laser-activated irrigation) showed best smear layer removal in test groups and the difference was statistically significant ( < 0.001). Control group (EDTA 17% and 5.25% NaOCl irrigation) showed significantly better outcomes in comparative with test groups ( < 0.001). In the apical third, compared to coronal and middle third, the canal walls were often contaminated by inorganic debris and smear layer. All different concentrations of sodium hypochlorite activated with laser have a positive effect on removing of smear layer. Sodium hypochlorite activated with laser removed smear layer more effectively at the coronal and middle third compared to the apical third.
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http://dx.doi.org/10.15171/jlms.2017.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420363PMC
January 2017