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BACKGROUND: There are important differences regarding cancer disclosure in various geographical populations (Europeans, Western Asia, Eastern Asia), depending on multiple sociocultural factors, and therefore, there is no standard protocol on this issue, especially in Iran. OBJECTIVES: To evaluate the amount of information that Iranian patients have and their preference for the disclosure of the cancer diagnosis. PATIENTS AND METHODS: In this cross sectional descriptive research, patients admitted in the oncology departments of 3 referral medical centers, Imam Hussein, Shohada-e-Tajrish and Modarres, in Tehran, from March 2007 to April 2008, were questioned about their awareness and knowledge regarding their diagnosis. Two different structured questionnaires were designed for the people who know and who didn't know their diagnosis. For the former, the survey concerned their psychological reactions to their situations, whether they would prefer to know about their diagnosis and by whom they are preferred to be informed .For the latter, the questionnaire included their preference whether to know the diagnosis and their current emotional state. Descriptive statistics and chi square test was applied to analyze gathering Data, using SPSS version 14. RESULTS: 60.3% of the patients knew their diagnosis. Among the subjects who did not know their diagnosis, 88% preferred to be more informed about their diagnosis and 68% had some psychological reaction to their situations. Among the subjects who knew their diagnosis, 92.1 % preferred to know their diagnosis, 73.6% preferred to be informed directly by their physicians. Following the diagnostic disclosure, 81.5% reported that they had felt nervous, anxious and worried. CONCLUSIONS: The majority of Iranian patients with malignancy want to know the truth and they prefer to be informed directly by their doctors.
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OBJECTIVE: The aim of this research was to perform a systematic review to identify all randomized controlled trials (RCTs) evaluating the efficacy and safety of add-on celecoxib for treatment of depressive mood episodes. METHODS: Four electronic databases were systematically searched from their inception to 8 August 2013: PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials), Scopus, and PsychINFO. Pooled difference in means of Hamilton Depression Rating Scale score, pooled odds ratio (OR) of treatment response, and pooled OR of remission were calculated as the main effect size. A random-effects model was used to pool the data across studies. RESULTS: Five RCTs (four unipolar depression studies and one bipolar depression study) were included in the systematic review for qualitative data synthesis. Moreover, quantitative results of four RCTs (unipolar depression studies) were meta-analyzed. The add-on celecoxib group had a statistically significant decrease in means of the Hamilton Depression Rating Scale score at week 4 (pooled difference in means=3.3, 95%CI [1.2-5.3], p=0.002) and week 6 (pooled difference in means=3.43, 95%CI [1.9-4.9], p<0.0001). The add-on celecoxib group also showed higher response (pooled OR=6.6, 95%CI [2.5-17], p<0.0001) and remission rates (pooled OR=6.6, 95%CI [2.7-15.9], p<0.0001) compared with the placebo group. CONCLUSIONS: Celecoxib can be considered as an effective add-on treatment for unipolar depressive patients. Making conclusion regarding the efficacy and safety for longer duration warrants further studies with a larger sample size and longer follow-up duration.
