What is the uptake rate of breast self-examination in Iranian women? Estimation based on systematic review and meta-analysis.

BACKGROUND: Breast self-examination is a simple, painless, confidential and inexpensive screening method for early diagnosis that does not require specialized tools and equipment. In this study, we have estimated the pooled percentage of breast self-examination (BSE) in Iranian women. METHODS: All the published literatures between 2012 and 2022 have been reviewed. Searches were performed in PubMed, Web of Science, ProQuest, Science Direct, Google Scholar, Scientific Information and Magiran databases. The effect size was the pooled percentage of breast self-examination (BSE). In order to check the heterogeneity, the estimation of the I2 index and extraction of the Galbraith plot were used, and the drivers of heterogeneity have been identified through meta-regression and estimates were made based on subgroups. All the analysis was done in STATA 15. RESULTS: From the initial 294 records, 38 were included in the final analysis in which 9960 women have been studied. The heterogeneity of the studies was high based on the variation in OR (I2 = 98.4%, heterogeneity X2 = 2278.21 (d.f. = 37), p < 0.01). The pooled rate of BSE based on fixed and random methods was obtained as 15.46 (95% CI: 14.83 to 16.09) and 24.74 (95% CI: 19.62 to 29.86) percent, respectively. The highest pooled percentage BSE (39.41%, 95% CI: 30.98 to 47.83) was obtained from studies that investigated the action phase in the Trans theoretical model. The pooled percentage obtained from the studies conducted in the central regions of Iran was higher than other cities (27.47%, 95% CI: 17.38 to 37.55). CONCLUSION: The result from our analysis determined that performing breast self-examination in Iranian women is low. Health policy makers can increase the rate of breast self-examination in Iran by implementing basic educational programs in schools and encouraging and justifying women in social health centers.

Prevalence of externalising disorder comorbidities in adolescents: a systematic review and meta-analysis protocol.

INTRODUCTION: Externalising disorders are some of the most prevalent problems in childhood and particularly during adolescence that can change into more severe psychopathology in adulthood if left unattended. In the research literature, these disorders include attention deficit/hyperactivity disorder, oppositional/defiant disorder, conduct disorder and substance use disorders. The comorbidity prevalence of these disorders is significant and cannot be considered a random factor. The dimensional structure of psychopathology has always been studied by researchers to address disorder comorbidities and aetiology. There has always been controversy over the number of spectra and the lower levels. Currently, the new top-down, Hierarchical Taxonomy of Psychopathology model conceptualising psychopathology is being used, which is a dimensional classification system for the different spectra of psychopathology based on a combination of conceptual modelling and factor analysis of symptoms. This systematic review investigates the comorbidity prevalence of spectra of externalising disorders to provide valuable information and feedback on this model. METHODS AND ANALYSIS: This systematic review will include all the studies conducted from 1/1/1990 to 1/12/2020 to examine the prevalence and comorbidity of each of the externalising disorders in the general population, schools and outpatients using any instrument (questionnaires or interviews). There will be no language restrictions in selecting the studies. The studies are age restricted and must be conducted on adolescents only, but there are no restrictions on the gender and nationality of the participants. ETHICS AND DISSEMINATION: This systematic review is based on previously published articles and therefore will not require ethical approval. The results of the systematic review will be disseminated as publication in a peer-reviewed journal and conference presentation. PROSPERO REGISTRATION NUMBER: CRD42022327629.

Comparison of the effect of lithium plus quetiapine with lithium plus risperidone in children and adolescents with bipolar I disorder: a randomized clinical trial.

Background: In the treatment of bipolar disorder in youths, often more than one medication should be prescribed. In the current study, we compared the efficacy and tolerability of the combination of lithium and quetiapine with lithium and risperidone in the treatment of manic or mixed episodes in children and adolescents. Methods: Thirty patients (aged 10-18 years) who were hospitalized for a manic or mixed episode were recruited from consecutive inpatient admissions to the Child and Adolescent Psychiatric Unit at Razi Psychiatric Hospital (University of Social Welfare and Rehabilitation Sciences, Tehran, Iran) from June 2012 to September. They were randomly treated with lithium (with the usual dose to achieve blood levels 0.8-1) and quetiapine (400-600 mg per day) or risperidone (0.5-6 mg per day). The primary outcome measure with respect to efficacy was the mean decrease in Young Mania Rating Scale (YMRS) score. Side effects were also assessed. The independent t test and two-factor repeated measure analysis of variance (ANOVA) was used for data analysis. P-value of less than 0.05 was considered statistically significant. Results: The reduction in YMRS scores was similar in both groups. The remission rate (YMRS <12) in the group treated with quetiapine was 80% and with risperidone was 66.6%; the difference was not significant. The most common side effect was sedation in both groups. Extrapyramidal side effects were observed only with risperidone. Both drugs caused increased levels of prolactin. Conclusion: Both protocols were effective. Quetiapine in combination with lithium in manic or mixed episodes of bipolar I disorder in children and adolescents was not superior to lithium and risperidone, but was associated with fewer complications.

Evaluation of Knowledge and Attitude of Parents of Attention Deficit/Hyperactivity Disorder Children towards Attention Deficit/Hyperactivity Disorder in Clinical Samples.

Objective: Knowledge and attitude of parents about attention deficit/hyperactivity disorder (ADHD) is an important factor in management of the disorder in children. This study investigates the parents' knowledge and attitude towards ADHD, its symptoms, diagnosis, treatment and prognosis. Method: In this cross-sectional descriptive study, the subjects were 150 parents (120 mother and 30 father) of ADHD children who were referred to a child psychiatry clinic affiliated in university of social welfare and rehabilitation sciences in Tehran. The diagnosis was made by a child psychiatrist according to DSM-IV TR criteria. The parents completed a 40 items questionnaire that was prepared by the authors and assessed their knowledge and attitude towards ADHD and source of their information. Results: The most common source of parent's information about ADHD was TV. The parent's knowledge about the symptoms of the disorder was relatively good. But in regard to diagnosis, treatment and prognosis of the disorder, they have very low knowledge and even incorrect beliefs. The parent's knowledge significantly correlated with their educational level (p=0.01). Conclusion: In general, knowledge of the parents was low and it can lead to misdiagnosis or mismanagement of this common and important disorder and need to further consideration in terms of educating parents about the disorder in media specially TV.