Development and psychometric testing of a Gastric Cancer Behavioural Risk Assessment Inventory (GC-BRAI)

Background: Gastric cancer (GC) is one of the most common cancers worldwide. There is no disease-specific tool for GC risk assessment in research and practice settings within the Iranian sociocultural context.Aims: To develop and assess the psychometric properties of the Gastric Cancer Behavioral Risk Assessment Inventory (GC-BRAI) in GC patients in Northwest Islamic Republic of Iran.Methods: Face-to-face interviews were performed on a convenient sample of 175 GC patients and a purposive sample of 350 matched non-GC patients as a control group. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to appraise the structure validity of GC-BRAI and examine its possible latent constructs.Results: The designed instrument with its 5 latent factors indicated acceptable internal consistency (0.72), reliability (0.99) and fit indices (χ2/degrees of freedom = 2.24, root mean square error of approximation = 0.049, adjusted goodness of fit index = 0.91 and root mean square residual = 0.085). The identified components were specific nutritional behaviours, typical daily diet, routine heartburn-causing behaviours or foods in diet, daily use of rice and smoked foods, and tobacco smoking/alcohol consumption, which all indicated a significant association (P= 0.0001) with high-risk of GC.Conclusions: GC-BRAI can be considered a feasible tool to measure individual GC risk and a reliable data collection instrument in tailor-made risk reduction interventional programmes.

Effects of nonpharmacological interventions on reducing fatigue after hematopoietic stem cell transplantation.

Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation.

Effect of late vs early clamping of the umbilical cord (on haemoglobin level) in full-term neonates.

Sixty term infants delivered vaginally were assigned randomly to one of the two management groups; early cord clamping (ECC) or delayed cord clamping (DCC). Six months after delivery, the children in both groups were called back for follow-up. Blood samples were obtained for measuring haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), serum iron (SI), transferrin saturation (TS) and serum ferritin (SF) levels. The mean Hb, HCT, SI and TS at 6 months were significantly higher in the DCC group (95% confidence interval (CI); p<0.001, p<0.001, p<0.024 and p<0.009). The mean SF at 6 months was also higher in the DCC group but it was not significant (p<0.071). Polycythaemia, jaundice and other undesirable side-effects of DCC were not seen.

L-asparaginase induced hyperlipidaemia in acute lymphoblastic leukaemia.

OBJECTIVE: To evaluate hyperlipidaemia in patients with acute lymphoblastic leukaemia (ALL) receiving L-asparaginase. METHODS: A case-control study carried out between October 2007 and October 2010 with 77 patients undergoing chemotherapy at a teaching children's hospital in Babol, Iran. Patients were treated with anti-leukaemic agents according to the protocols for standard-risk and high-risk ALL. Those patients who received asparaginase represented the cases and those who did not receive it were the controls. Biochemical markers were checked during the induction phase chemotherapy. Lipid profile of patients was recorded. Data was analysed using SPSS 16. RESULTS: Of the 77 patients, 37 (48.05%) received asparaginase therapy and 40 (51.94%) patients did not.The mean peak triglyceride and cholesterol levels during asparaginase therapy in the first group were significantly higher than the levels in the second group. CONCLUSION: Severe hyperlipidaemia may be the cause of some morbidity in children receiving asparaginase. Asparaginase-induced hyperlipidaemia should be monitored in ALL patients during the induction phase of treatment.

Acute Lymphoblastic Leukemia with Eosinophilia and Strongyloides stercoralis Hyperinfection.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Bone pain is an important symptom that can be severe. Eosinophilia without any other abnormal laboratory findings is rare in ALL. Strongyloides stercoralis in ALL causes disseminated fatal disease. CASE PRESENTATION: This 9-year-old girl presented with bone pain in lumbar region. Bone pain was the only symptom. The patient didn't have organomegaly. The BM samples were studied by flow cytometry, which showed pre-B cell ALL. Larva of Strongyloides stercoralis was found in fecal examination. Plain chest x ray showed bilateral para-cardiac infiltration. Strongyloidiasis was treated before starting chemotherapy. After two days treatment with Mebendazol the patient developed cough, dyspnea, respiratory distress and fever. The treatment changed to Ivermectin for 2 days. Chemotherapy started five days after diagnosis of leukemia. CONCLUSION: The patient complained merely of bone pain in lumbar region without any other signs and symptoms. Peripheral blood smear showed eosinophilia without any other abnormality. Stool examination showed Strongyloides stercoralis larvae. We suggest that all patients diagnosed as ALL in tropical and subtropical regions should be evaluated for parasitic infection especially with Strongyloides stercoralis.

Correlation of splenectomy with portal vein thrombosis in beta-thalassemia major.

OBJECTIVE: To evaluate the correlation of portal vein thrombosis and splenectomy in beta-thalassemia major patients visiting Babol Medical University, Iran. METHODS: This cohort study was done from 1997 to 2008. In our study, major beta-thalassemic patients visiting for transfusion at least once a month at Amirkola Children's Hospital were selected. Portal vein thrombosis was diagnosed through Doppler ultrasound in symptomatic patients. Cases were 160 beta-thalassemia major patients who underwent splenectomy and 160 remaining thalassemic patients without splenectomy were controls. Statistical comparison with Fisher exact test was performed. RESULTS: Five cases had suffered from portal vein thrombosis (P = 0.03). Majority patients with portal vein thrombosis had their symptoms after first month of the operation. CONCLUSION: Correlation of splenectomy with portal vein thrombosis is statistically significant among beta-thalassemic children from Iran.