Validity and reliability of the Persian version of Violence Risk Screening-10 Instrument (V-Risk-10) in admitted patients to the psychiatric ward.

Background: Violence Risk Screening Tool-10 (V-Risk-10) is one of the few instruments available for violence risk assessment in patients with a psychiatric diagnosis. The present study aimed to validate the Persian version of this instrument in patients admitted to the psychiatric ward. Materials and Methods: Eighty patients referred to a psychiatric hospital were enrolled in this cross-sectional methodological study. In the initial phase, seven senior psychiatry residents rated 20 cases independently at the time of their admission and total scale and subscale reliability were examined. Intraclass correlation coefficients were used to assess the inter-rater reliability. After initial confirmation of V-RISK-10 reliability, a senior psychiatry resident assessed 80 patients with V-RISK-10 in the emergency room. The incident of violent behaviors was recorded during the patients' admission period. The receiver operator characteristics curve (ROC-curve) analysis was used to measure the predictive accuracy of the instrument. The convergent validity was assessed by comparing V-RISK-10 scores between the three risk categories and the three outcome recommendations according to clinicians' overall clinical judgment. Results: A Cronbach's alpha coefficient was 0.99 for the total scale. During the research period, 47.5% of patients demonstrated various degrees of aggression and violent behavior. The ROC area under the curve was 0.89 (P < 0.001) with 87% sensitivity, 69% specificity, 72% positive predictive value, and 85% negative predictive value at the cutoff point of 8.5. Conclusion: Results indicate that the Persian version of V-Risk-10 is a reliable and valid screening tool for violence risk in patients who are admitted into psychiatric wards.

Validity and reliability of the Persian version of the Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire.

OBJECTIVE: The Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) is one of the most widely used questionnaires for assessing typical gastro-oesophageal reflux disease (GORD) symptoms. It is simple, concise, and treatment responsive, yet it has not been validated in the Persian language. This study aimed to translate the GERD-HRQL questionnaire into Persian and assess its validity and reliability. DESIGN: In this cross-sectional validation study, a team of gastroenterologists, general surgeons, and professional translators conducted the forward-backward translation. A gastroenterologist interviewed 10 patients with GORD to insure understandability of the questionnaire. Fifty-four patients with GORD and 60 patients with gastrointestinal complaints other than GORD were enrolled using convenience sampling method. To assess concurrent validity, patients with GORD completed the Persian GERD-HRQL and the WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaires. To assess discriminant validity, GERD-HRQL scores were compared between GORD and non-GORD patients. After 2 weeks, the patients with GORD completed the GERD-HRQL questionnaire again to assess test-retest reliability. The internal consistency was measured using Cronbach's alpha. RESULTS: The mean age of the GORD participants was 36.90±10.44, and the majority were women (78%). All GERD-HRQL domains and total scores exhibited significant negative correlations with WHOQOL-BREF domains (ranging from -0.28 to -0.97). The GERD-HRQL scores were significantly different in GORD and non-GORD patients (p<0.001). Test and retest scores did not show any significant differences (p=0.49). Cronbach's alpha was 0.85. CONCLUSION: The Persian GERD-HRQL questionnaire is valid and reliable and can effectively assess the GORD symptoms in Persian-speaking individuals.

Upper Gastrointestinal Endoscopic Screening in Bariatric Surgery Candidates: Correlating the Findings with GERD symptoms.

INTRODUCTION: The role of routine preoperative esophagogastroduodenoscopy (EGD) in bariatric surgery candidates is controversial. This study compares preoperative EGD outcomes with patient-reported gastroesophageal reflux disease (GERD) symptoms to determine if a case-based EGD is appropriate. PATIENTS AND METHODS: A prospective cohort study was conducted from April 2022 through September 2023 in Mashhad, Iran. All patients underwent EGD. To assess GERD symptoms, we used the GERD-Health Related Quality of Life questionnaire. Patients were categorized into two groups: the asymptomatic group (GERD-HRQL = 0) and the symptomatic group (GERD-HRQL > 0). RESULTS: A total of 165 patients were included, out of which 133 (80.6%) were in the symptomatic group and 32 (19.4%) were in the asymptomatic group. Esophagitis was present in 41 (24.8%) patients. There was no significant difference in the frequency of esophagitis (18.8% vs. 26.3%, p-value = 0.37), hiatal hernia (18.8% vs. 18.8%, p-value = 1.00), gastritis (56.3% vs. 63.9%, p-value = 0.42), and H. pylori infection (9.4% vs. 12.0%, p-value = 1.00) between the asymptomatic and symptomatic groups, respectively. None of the demographic factors or comorbidities of asymptomatic patients were associated with esophagitis, except for hiatal hernia (OR = 7.67, 95% CI 3.01-19.53, p-value < 0.001). Receiver operating characteristic (ROC) analysis showed that the GERD-HRQL total scores, as well as the heartburn and regurgitation subscales, were poor predictors of esophagitis (AUC 0.57, 0.51, and 0.56, respectively). CONCLUSION: EGD findings were not associated with GERD symptoms in candidates for bariatric surgery.

Epilepsy and quality of life in Iranian epileptic patients.

BACKGROUND: Epilepsy is one of the most common neurological disorders with physical, emotional, and social consequences. Previous studies indicate that epilepsy symptoms can highly affect the epileptic patients' satisfaction in life. The aim of the present study is to investigate the QOL of People with Epilepsy (PWE) in Khorasan Razavi province, Iran. METHODS: In this study, 100 patients were randomly selected. After confirmation of the diagnosis of epilepsy by neurologists and fulfilling the entrance criteria, patients completed the Quality of Life in Epilepsy-31 inventory (QOLIE-31) questionnaire. Finally, data was analyzed statistically by SPSS software. RESULTS: The study sample comprised 100 PWE, aged 18-74 years (34 ± 13), of whom 58 (58%) were females. Tonic-colonic seizure was the most common (60%) type of seizure. The obtained score of each subscale and the range of the QOLIE-31 total score was 16.40-79.18 with the mean of 50 (SD = 16). The energy-fatigue subscale score was significantly higher in patients younger than 35 (p = 0.018). The data analysis showed that the seizure worry subscale was significantly higher in single patients (p = 0.04). Duration of epilepsy had a positive correlation with QOLIE-31 total score (p = 0.038), and a negative relationship with energy-fatigue subscale (p = 0.018). In contrast with previous studies, which reported the frequency of the epileptic episodes as the most important predictor of QOL, our results showed no significant correlation between the number of the episodes and overall QOL score (p = 0.063). However, the number of episodes was significantly correlated with emotional well-being and cognition subscales. Furthermore, the results indicated that poor QOL score is correlated with depressed mood. CONCLUSION: In fact, the ultimate and preferred outcome of all treatments and care interventions is the patient's QOL. Thus, improvement of the QOL by means of obtaining more information about its contributing factors, in PWE should be one of the main goals in the patients' treatment.

A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review.

INTRODUCTION: There are some randomized trials which have already evaluated different calcineurin inhibitors (CNIs), especially comparing Tacrolimus and Cyclosporine, as immunosuppressant agents in children. However, their findings have been occasionally conflicting and thus debatable. Therefore, the evidence on safety and efficacy of immunosuppressive therapy after kidney transplantation in children has been inconclusive and argued to date. This study was aimed to compare the benefits and disadvantages of tacrolimus versus cyclosporine as the primary immunosuppression after renal transplantation in children. METHODS: A systematic review and meta-analysis was done. An electronic literature review was conducted to identify appropriate studies. The outcomes were presented as relative risk, with 95% confidence intervals. RESULTS: Five qualified randomized controlled trials were included in this systematic review. Tacrolimus was insignificantly superior to cyclosporine considering the total effect size of graft loss (RR = 0.67, 95% CI: 0.40 - 1.11; P > .05) and acute rejection (RR = 0.79, 95% CI: 0.59 - 1.05; P > .05). On the contrary, cyclosporine seemed to be insignificantly superior to tacrolimus regarding mortality rate (RR = 1.06, 95% CI: 0.59 - 1.90; P > .05). CONCLUSION: Admitting the study limitations mainly because of the nature and case study size of the included trials, it can be concluded from our systematic review results that Tacrolimus seems insignificantly superior to Cyclosporine respecting graft loss and acute rejection. However, Cyclosporine was shown to be insignificantly superior regarding mortality rate. However additional studies with a larger sample size are highly recommended.

Sexual Function in Iranian Female Multiple Sclerosis Patients.

BACKGROUND: One of the typical complaints in females with multiple sclerosis (MS) is Sexual dysfunction (SD). AIM: This study aimed to compare the sexual function of women with and without MS and to recognise factors that possibly related to sexual dysfunction of women with MS. MATERIAL AND METHODS: Sexual function of 64 women with MS as a case study group were compared to a group of control comprised of 64 women. Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI) were used accordingly to assess sexual function and severity of depression of case and control groups. Functional status of MS Patients was assessed by the Expanded Disability Status Scale (EDSS). The data were analysed using chi-square, independent Samples t, Pearson's correlation coefficients, and multiple linear regression tests. RESULTS: There were no differences in the Total FSFI and 4 FSFI subscale scores (i.e. sexual desire, arousal, lubrication and satisfaction) between women with MS and controls. The only significant difference between the two groups was the dimension of orgasm (p = 0.016). Multivariate analysis demonstrated that only BDI and FSFI total scores have significantly related (B = -0.436, P < 0.001). In women with MS, a significant negative correlation was found between FSFI and EDSS scores (rho = -0.35, P = 0.032), as well as between FSFI scores and disease duration (rho = -0.25, P = 0.01). CONCLUSION: Depression was associated to sexual dysfunction in women. It could be advantageous to evaluate and treat depression in women with MS who suffer from sexual dysfunction.

Effect of Low Dose Imipramine in Patients with Nocturnal Enuresis, A Randomized Clinical Trial.

INTRODUCTION: Nocturnal enuresis is a condition, which can affectthe quality of life in children. The present study was designed toinvestigate the efficacy of low-dose imipramine combined withdesmopressin on treatment of patients with primary nocturnalenuresis who were defined as desmopressin non-responders. METHODS: A randomized clinical trial was carried out on patientswith primary nocturnal enuresis. Forty children with enuresisranging from 5 to 12 years old were randomly divided into theintervention (n = 20) and control groups (n = 20). The subjects inthe intervention group were treated with desmopressin combinedwith 5 mg imipramine at bedtime, and those in the control groupwere given desmopressin alone. The patients were followed upweekly for one month. The number of wet nights was recorded. RESULTS: Two individuals in the intervention and three individualsin the control group were excluded from the study. Our findingsindicated that the age and gender showed no significant difference.Furthermore, a significant better recovery in the enuresis wasobserved in 18 of 20 patients who were treated with combinationtherapy after 1 month (P < .05). In addition, the frequency ofrecovery was significantly higher (83.3%) in the intervention group,compared with the control group (29.4%). CONCLUSION: The analysis showed that low-dose imipramine is welltolerated in clinical practice and may represent a good short-termtreatment option in combination therapy where desmopressinalone is not efficient enough.

Mothers' preferences toward breaking bad news about their children cancer.

BACKGROUND: The responsibility of breaking bad news (BBN) to patients is one of the most difficult tasks of a medical profession. AIM: The current study aimed to investigate the preferences of mothers of children with cancer about BBN. MATERIALS AND METHODS: In this cross-sectional study was conducted in Mashhad during years of 2016, 62 mothers of children with cancer at Dr-Sheikh hospital were recruited by convenience sampling and completed a questionnaire including demographic data and 20 questions about the mothers' preferences to BBN. Data displayed as percent by SPSS V20 software. RESULTS: Mothers preferred that BBN conducted by their child's doctor (93.5%), with an emotional and compassionate way (83.9%), and in a private setting (90.3%). Be told completely about the process of diagnosis (98.4%), meet people with similar conditions (83.9%), receive psychological (85.5%), and religious (79%) support after getting bad news, being in touch with a close relative (82.3%) and applying another term-like malignancy instead of cancer (95.5%). CONCLUSION: We tried providing helpful information for developing national guidelines about how to breaking news in Iran, by doing this study.

Evaluation of physicians' skills in breaking bad news to cancer patients.

BACKGROUND: Delivering bad news to patients is one of the most difficult tasks of physicians that play a big role in the process of treatment and cooperation of patients. The objective of this study is to evaluate the ability and skills of physicians in delivery bad news to cancer patients. METHODS: This study is a cross-sectional study performed on 70 specialist physicians in two hospitals of Mashhad in 2016. Data were collected by Persian questionnaire of SPIKES included 16 questions and were analyzed by SPSS software. RESULTS: In this study, among the questionnaire items, the most prevalent item was not giving the bad news by phone (100%) and the least prevalent item was putting the hand on the shoulder (24.3%). This study showed that 81.4% of doctors agreed on giving the bad news in private, 72.9% agreed on giving relative hope to patients and 67.1% agreed on evaluating patients knowledge of his/her disease when giving bad news. CONCLUSION: The results of this study show that the ability of physicians in giving bad news is not enough in some aspects. Therefore, holding educational courses during physicians' education and after graduation are recommended to increase patients' trust and decreasing worries and inconvenience of physicians in difficult situations of delivering bad news.

Effect of Stem Cell Therapy on Patients' Quality of Life in Heart Failure with Reduced Ejection Fraction.

Introduction: Heart failure with reduced ejection fraction (HFrEF) is a debilitating disease in which Left Ventricular Ejection Fraction (LVEF) is ≤ 40%, and it involves various organs. Regarding the novelty of stem cell therapy in HF, we aimed at studying the effect of stem cell therapy on the QoL of patients with HFrEF. Materials and Methods: In a prospective study, 30 patients diagnosed with HFrEF who had undergone stem cell injection (study group) and 30 patients with HFrEF receiving guideline-directed medical therapy (control group) were recruited by convenience sampling during 2016 in Mashhad, Iran. Patients' quality of life, left ventricular ejection fraction and their disability degree were studied twice with a 3-month interval. For data analysis, paired t-test, chi2 and multivariate linear regression were used. Results: The mean age of study and control groups was 61.3±10.24 and 60.93±7.88 years respectively. Ninety percent of the cases and 56.7% of the controls were male (P=0.003). A significant difference in QoL was observed before and after treatment in each group (P<0.05). However, the QoL score showed no statistical difference between the two groups following treatment (P=0.13). The same result was achieved for LVEF (P=0.18); whereas the NYHA function class showed a significant difference between the two groups following treatment (P=0.017). Conclusions: According to the results, it seems that the treatment of HFrEF patients with stem cells is as effective as conventional therapies in improving the LVEF and QoL and more efficient than conventional treatments in increasing the patients' general satisfaction with life.

Corrigendum to "Data on insulin therapy refusal among type II diabetes mellitus patients in Mashhad, Iran" [Data in Brief 18 (2018) 2047-2050].

[This corrects the article DOI: 10.1016/j.dib.2018.04.136.].

Using Modified Direct Observation of Procedural Skills (DOPS) to assess undergraduate medical students.

INTRODUCTION: Nowadays according to competency based curriculum, selecting an appropriate assessment method is inevitable. This study aimed to investigate application of Direct Observation of Procedural Skills (DOPS) in undergraduate medical students. METHODS: This is a cross sectional study conducted during emergency ward rotation in last year medical students using consensus sampling method. Each student performed 2 procedures at least twice under the observation of 2 assessors using modified DOPS rating scales designed for each procedure simultaneously. Correlation between DOPS score and final routine exam was measured. Face and content validity was determined by the panel of experts. Moreover, through the test-retest and inter-rater reliability, the correlation of each score and total score was investigated. The spent time was calculated too. The statistical analysis was carried out using SPSS version 18. RESULTS: Totally 60 students did 240 procedures under DOPS. The face and content validity confirmed by an expert panel. The findings showed that there was a significant correlation between the scores of each test and the total DOPS score (r1=0.736**, r2=0.793**, r3=0.564**, r4=0.685**; p<0.001). There was a significant correlation between the first and second scores of doing the same procedure (Pearson Cor.=0.74, p<0.001) and also between the scores of the two individual examiners when observing the same procedure (Pearson Cor.=0.84-0.94 p<0.001). The results showed that there was no correlation (Pearson Correlation =0.018, p<0.89) between the scores of this test and the final routine ward exam scores. The average time for doing DOPS test and the average time for providing feedback were 11.17 Max and 9.2 4.5 Min, respectively. CONCLUSION: The use of novel performance assessment methods such as DOPS is highly beneficial in order to ensure the adequacy of learning in medical students and assess their readiness for accepting professional responsibilities. DOPS as a practical and reliable test with acceptable validation can be used to assess clinical skills of undergraduate medical students.

The data on health locus of control and its relationship with quality of life in HIV-positive patients.

Locus of control is a concept defined based on social learning theory, and focuses on individuals' beliefs regarding factors that influence their health status. Health Locus of Control (HLC) and its relationship with Quality of Life (QOL) in HIV positive patients in local population were studied. This was a cross-sectional study on 80 HIV-positive patients. Multidimensional Health Locus of Control (MHLC) Scale and Medical Outcome Study Short-Form Health Survey (MOS-SF-36) used to measure patients' HLC and QOL, respectively. Internal, external, and chance HLC mean ± SD scores were 30.31±3.87, 24.17±5.03, and 32.01±4.49, respectively. Positive correlation was found between internal HLC scores and both physical (p <0.001, r = 0.53) and mental quality of life (p <0.001, r = 0.48). Multiple regression analysis showed that internal HLC was the only significant predictor of quality of life. HIV-positive patients who believe their health is mostly influenced by individual's actions and behaviors (internal HLC) showed a higher quality of life. These findings suggest that modifying health locus of control beliefs, hypothetically could influence patients' quality of life.

Data on insulin therapy refusal among type II diabetes mellitus patients in Mashhad, Iran.

Insulin has been considered as a therapy option of last resort in type 2 diabetes (T2DM) management. Delay in insulin therapy is common in these patients. This study collected the data on the factors associated with insulin refusal in poorly controlled T2DM patients prior to insulin therapy. The data collected from two endocrinology outpatient clinics affiliated by Islamic Azad University of Mashhad, Iran (IAUM) from January 2016 to September 2017. Study population was adults with non-insulin-using type 2 diabetes mellitus who refused insulin therapy. A 17-items researcher made questionnaire was used to obtain demographic data and information toward causes of insulin refusal. Data were analyzed using SPPS V.16 with descriptive and analytical tests such as multiple logistic regressions. The data of 110 patients with T2DM was recorded in this study. The most prevalent cause of insulin therapy refusal was reported to be painful insulin injection (78.2%) followed by this item "I'm afraid of injecting myself with a needle" (74.5%). Regression analysis revealed that education level had a significant association with the item of "Injecting insulin is painful" (P=0.033, OR=0.357). Also age (P=0.025, OR=1.076) and disease duration (P=0.024, OR=0.231) were significantly associated with the question "taking insulin makes life less flexible". Several causes have been found regarding misconceptions about insulin therapy in T2DM patients. Specialized educational interventions are recommended for initiating successful insulin therapy in these patients.

Perception of educational environment among undergraduate students of health disciplines in an Iranian university.

OBJECTIVES: This paper seeks to determine the perception of Medical, Nursing and Midwifery students about their educational environment and compare their perceptions in terms of disciplines, demographic attributes and academic level. METHODS: In this cross-sectional study, Medical, Nursing and Midwifery students in Islamic Azad University, Mashhad, Iran, were selected using stratified random sampling method (N=378). They completed the standard Persian version of Dundee Ready Education Environment Measure (DREEM) questionnaire. Descriptive statistics, t-test and analysis of variance (ANOVA) were used to analyze data. RESULTS: The mean score of DREEM was 106 ± 24.6. The mean scores in five domains of DREEM questionnaire including students' perception of learning, perception of teachers, scientific abilities, students' perception of educational environment and students' perception of social conditions were 23±8, 23.4±6, 18±5.5, 25.5±7.7 and 15.8±4, respectively. In the first four domains (p=0.000, F=27.35), (p=0.000, F=9.9), (p=0.000, F=18.5), (p=0.000, t=18.7) and for total scores (p=0.000, F=22.77), the three disciplines were significantly different. Also, there was a significant difference between mean total score (p=0.021, t=2.3) and scores of students' perception of learning (p=0.008, t=2.65) and social conditions (p=0.022, t=2.3) with respect to gender. CONCLUSIONS: According to these results, students tend to have a positive attitude towards their educational environment. The findings of this study are useful to identify areas in need of improvement by employing more specialized tools and planning for improvement.

Quality of life in patients with Parkinson's disease: Translation and psychometric evaluation of the Iranian version of PDQ-39.

BACKGROUND: Health related quality of life is an important outcome measure in studies involving patients with chronic neurological conditions. Disease specific patient reported outcome measures (PROMs) are increasingly used as primary end points in clinical trials. The most widely used disease specific PROM is the 39 item Parkinson's Disease Questionnaire (PDQ-39). The aim of this study was to determine validity and reliability of Persian PDQ-39. METHODS: Two hundred Parkinson's disease patients attending neurologic clinics of teaching hospitals were recruited. PD patients completed a translated version of the PDQ-39. Internal consistency reliability of the questionnaire was assessed by Cronbach's alpha coefficient. Reproducibility was assessed across the 3-week interval using the intraclass correlation coefficient. To assess convergent validity, results on the PDQ-39 were correlated with those gained on the SF-36. Discriminate validity of questionnaire was assessed by comparing PDQ-39 scores and the severity and the duration of disease. RESULTS: A value of 0.93 (Cronbach's α) was gained for the summary score (PDQ-SI), indicating high levels of internal reliability. Alpha value of seven domains was greater than 0.70. The intraclass correlation coefficient ranged from 0.47 to 0.90. The range of correlation coefficients between domains of SF-36 and PDQ-SI was from -0.40 to -0.61. There was a statistically significant difference between severity of disease and mean scores of PDSI. CONCLUSIONS: This study provides evidence that the Persian version of PDQ-39 is a valid and reliable measure of quality of life in PD.

experiential comparison of levetiracetam efficacy in migraine headache with sodium valproate

Background: Migraine and other recurrent headaches are considered a major public health concern. Levetiracetam, a broad spectrum anti-epileptic have been used in migraine prophylaxis

Objectives: Assessment the efficacy of levetiracetam on migraine in comparison to sodium valproate

Materials and Methods: This randomized double blind clinical trial was performed on patients with migraine headache, diagnosed based on ICDH-version B criteria. One group received levetiracetam and the other group received valproate sodium. The number of migraine attacks per month, the mean duration of attacks and the intensity of pain [VAS] and disability due to headache [MIDAS] were assessed at first and after four weeks of treatment. Data were analyzed in SPSS 20 by Mann-Whitney-U and Chi-square tests. The significance level was set<0.05

Results: Thirty patients [28 women and 2 men, mean age of 35.14 +/- 7.3 years] remained in the valproate group and 33 patients [31women and 2 men, mean age of 36.33 +/- 6.7 years] in the levetiracetam group. The patients in both groups showed a statistically significant reduction in the frequency of headache [p=0.0001]; intensity of headache [p=0.004]; mean duration of attacks [p=0.0001] and MIDAS score of disability [p=0.004] compared to baseline. There was also a statistically significant difference between the two groups in terms of frequency of attacks [p=0.0001], intensity of pain [p=0.0001]; and MIDAS score [p=0.0001], by the end of the treatment with superiority of levetiracetam

Conclusion: Levetiracetam, compared to valproate, yielded better results in prophylaxis of migraine headache