mohammad amin pourhoseingholi

This study aimed to identify the risk factors of metabolic (dysfunction)-associated fatty liver disease (MAFLD) among adults in northeastern Iran.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and hepatic manifestation of metabolic syndrome that threatens global public health. Recently, MAFLD has been proposed as a new terminology updated from NAFLD and diagnosed based on modified criteria.

A nested case-control study was performed on the participants of the first phase of the Persian Sabzevar Cohort Study (PSCS), a survey that was conducted in northeastern Iran and enrolled 4,242 participants aged 35-70 years. In total, 968 MAFLD cases and 964 controls adjusted for age and sex were recruited. Data including demographic, lifestyle, anthropometric, biochemical, sleep pattern, and dietary intake information was collected. Results The mean (SD [standard deviation]) age of participants was 49.2 (8.8) years, and 39.9% of the participants were males. The prevalence of MAFLD was 22.8% (95% CI [confidence interval] 19.2 – 26.3%). Increased body mass index (BMI) (OR [odds ratios] 5.51, 95% CI 2.73 – 11.10), waist circumference (WC) (OR 1.85, 95% CI 1.44 – 2.38), blood concentrations of triglycerides (TG) (OR 1.10, 95% CI 1.06 – 1.15), total cholesterol (TC) (OR 1.02, 95% CI 1.003 – 1.04), and alanine aminotransferase (AST) (OR 1.10, 95% CI 1.05 – 1.16) were significantly associated with an increased risk of the MAFLD (p-value <0.05). Furthermore, the odds of MAFLD risk was 43% higher in subjects who slept ≤ 5 hrs/day than those with ≥ 7 hrs per day of sleep (OR 1.43; 95% CI 1.07 – 1.92, p-value = 0.01).

In this study, it was found that MAFLD was best predicted by BMI, WC, and serum levels of TG, total cholesterol, and AST. Sleeping ≤ 5hrs/day compared to ≥ 7hrs/day was associated with an increased risk of MAFLD.

Childbearing is an important biological and social event in the life of most women. It is a voluntary behavior that can be affected by many factors. Behavioral theories are a potential path way to study and influence childbearing behavior. The present study was conducted to determine the effect of an educational intervention based on the theory of planned behavior (TPB) on childbearing intentions in women presenting to premarital counseling centers in Tehran.

This randomized controlled quasi‑experimental study was conducted on 150 women aged 20–35 years presenting to premarital counseling centers. The participating women were randomly divided into an intervention (n = 75) and a control (n = 75) group using randomized sampling in Excel. The intervention group received two 90‑min sessions of training. The effect of training was assessed 6 weeks after the intervention using the researcher‑made questionnaire based on the components of the TPB. The questionnaires included subjects’ demographic details, knowledge (11 items), attitude (13 items), subjective norms (10 items), perceived behavioral control (8 items), and behavioral intention (4 items). Data were analyzed by SPSS software (version 22) and independent t‑test, Chi‑square, Mann–Whitney U‑test, and Wilcoxon test. P <0.05 was considered statistically significant.

There were significant differences between the intervention and control group after the intervention in the Mean ± SD scores of knowledge (6.73 ± 2.63 vs. 4.73 ± 2.85, P = 0.001), attitude (48.23 ± 7.19 vs. 40.13 ± 5.80, P = 0.001), perceived behavioral control (33.19 ± 5.28 vs. 23.59 ± 3.47, P = 0.001), and behavioral intention (13.84 ± 2.95 vs. 11.77 ± 2.12, P = 0.027).

The findings showed that an education based on the TPB increased women’s childbearing intentions by affecting their knowledge, attitude, perceived behavioral control, and intention. It is therefore essential to implement better public policies, create a more conducive educational setting for women of different age groups, and build a social support system.

The main aim of the present study was to map the real high risk regions of gastric cancer (GC) using corrected data for misclassification error in all Iranian provinces.

In this cross-sectional study, the data were extracted from the reports of Ministry of Health and Medical Education and previous studies on correcting GC registered data including 30 provinces in 2008. The information about socioeconomic factors was extracted from the statistical centers of Iran. To estimate the model parameters, the Bayesian approach was used with regards to spatial correlation due to adjacent effects.

The southern and northern provinces were introduced as high-risk regions and the central provinces were introduced as low-risk regions. The mean household income was inversely associated with the risk of GC.

The real high-risk regions of GC in Iran are the north and south border provinces which should be considered by health policy makers. It is also necessary to correct misclassified registered data which can lead to seduction in health service allocation.

Present study aimed to evaluate association between serum levels of interleukin (IL)-1, IL-6, IL-8, IL-15 genes and interferon (IFN)-? and the risk of celiac disease (CD).

The role of serum cytokine levels in the pathophysiology of CD is still an open field to be explored.

This case-control study was performed on 110 patients with CD and 46 healthy controls referred to Taleghani Hospital, Tehran, Iran. Expression levels of IL-1, IL-6, IL-8, IL-15 and IFN-? were assessed by enzyme-linked immunosorbent assay (ELISA) kits.

The Bayesian intervention odds ratio (OR) and Highest Posterior Density (HPD) interval were 1.133 (95% credible interval 1.018- 1.269), 0.947 (95% credible interval 0.898 - 0.996) and 1.004 (95% credible interval 1.001- 1.009) for IL-1, IL-6, and IL-8 respectively.

Serum levels of IL-15 and IFN-? have no effect on the risk of CD and its symptoms, but given the OR and the HPD interval obtained for serum levels of IL-1, IL-6 and IL-8, one unit increase in IL-1 serum, the risk of CD 1.13 times more likely and one unit increase in IL-6 serum reduces risk of CD by 15% and about IL-8, the risk of CD increases 0.004 times with a unit increase in IL-8 serum.

We used mixture cure mode to separately investigate the risk factors for long-term and short-term survival of colorectal cancer patients.

Colorectal cancer (CRC) is the second most common cancer worldwide. In cancer studies, patients’ survival is the most important indicator of patients’ status. Classical methods in analyzing the survival data usually apply Cox proportional hazard regression.

The study was performed on 1121 patients diagnosed with colorectal cancer. Mixture cure model with Weibull distribution and logit link function was fitted to data.

Odds of long-term survival for rectum cancer patients were lower than for colon cancer patients (OR=0.29(0.09, 0.9)). Also, patients with the advanced stage of the disease had lower odds of long-term survival compared to early-stage patients (OR=0.24(0.06, 0.86)).In the short-term, the hazard of death for people with normal BMI was lower than the underweight group (HR=0.4(0.21, 0.76)). The short-term hazard of death for rectum cancer was about half of the short-term hazard for colon cancer (HR=0.49(0.29, 0.81)). Further, people with moderately (HR=2.11(1.26, 3.55)) and poorly (HR=4.04(2.03, 8.03)) differentiated tumor grade had a higher short-term hazard of death compared to people with well-differentiated grade.

Predictive variables of colorectal cancer survival showed different effects in short- and long -terms. Site topography was a prognosis for both long-term and short-term survival; BMI and tumor grade were short-term predictors of survival while stage was a long-term predictor of survival.Keywords: Mixture cure model, Colorectal cancer, Survival.(Please cite as: Amanpour F, Akbari S, Azizmohammad Looha M, Abdehagh M, Pourhoseingholi MA. Mixture cure model for estimating short-term and long-term colorectal cancer survival. Gastroenterol Hepatol Bed Bench 2019;12(Suppl.1):S37-S43).

Colorectal cancer (CRC) is one of the most important causes of morbidity and mortality worldwide. This study aimed to determine the effect of measurement error of risk factors on the cure fraction of CRC patients.

This study was conducted using the medical records of 346 patients with CRC, who were followed up between 2006 and 2017 in Shiraz, Iran. In our data, lymph node ratio (LNR) was a characteristic measuring with error. This variable was used in the model with 0.04 and 0.8 of error variance. Nonmixture nonparametric cure rate model and its corrected forms, simulation-extrapolation (SIMEX) and corrected score (CS), were applied to the data.

In noncured cases, the mean survival time was 1115.45 (95% confidence interval, 1043.60-1187.30) days. The 1-, 3-, and 5-year survival rates were 0.93, 0.71, and 0.65, respectively. The proportion of cured patients was 65.2%. The SIMEX method did not change the effect of LNR substantially on cure fraction as compared with the naive method when the variance of measurement error was 0.04 and 0.80. The CS method changed the effect of LNR on cure fraction even when the variance of measurement error was 0.04.

The best method to assess the effect of LNR on cure fraction was the naive method, and the CS method was not deemed to be a valid method to correct the measurement error in LNR.

Some errors may occur in the disease registry system. One of them is misclassification error in cancer registration. It occurs because some of the patients from deprived provinces travel to their adjacent provinces to receive better healthcare without mentioning their permanent residence. The aim of this study was to re-estimate the incidence of gastric cancer using the Bayesian correction for misclassification across Iranian provinces.

Data of gastric cancer incidence were adapted from the Iranian national cancer registration reports from 2004 to 2008. Bayesian analysis was performed to estimate the misclassification rate with a beta prior distribution for misclassification parameter. Parameters of beta distribution were selected according to the expected coverage of new cancer cases in each medical university of the country.

There was a remarkable misclassification with reference to the registration of cancer cases across the provinces of the country. The average estimated misclassification rate was between 15% and 68%, and higher rates were estimated for more deprived provinces.

Misclassification error reduces the accuracy of the registry data, in turn causing underestimation and overestimation in the assessment of the risk of cancer in different areas. In conclusion, correcting the regional misclassification in cancer registry data is essential for discerning high-risk regions and making plans for cancer control and prevention.

Different procedures can be used to develop predictive models for medical data with binary response. In this study, we aimed to probe the process of developing common predictive models, including decision tree (DT) and logistic regression (LR). Also, we investigated how to set the model parameters, how to develop accurate models efficiently, and how to determine the prediction efficiency.

The main purpose of this study was to find the prevalence and risk factors associated with functional dyspepsia (FD) and gastroesophageal reflux disease (GRED) in a sample of the Iranian population.

This cross-sectional study was conducted in Tehran, from May 2016 to December 2017, on 18,180 participants who were selected randomly and interviewed using a reliable questionnaire.

The areas under the ROC curve (AUC) of DT and LR were 0.93 and 0.94 for GERD and 0.98 and 0.95 for FD, respectively. Generally, 63.8% and 37.2% of the participants had FD and GRED, respectively. The results of multiple logistic regression analysis showed that men had a higher risk of FD than women. The prevalence of FD increased with increasing age.

This study showed a low rate of FD and GERD among urban people of Tehran. Also, the prediction results of both models were approximately similar. Therefore, when we deal with multiple independent variables and a binary response variable in data from a large sample, more statistical techniques and strategies should be considered in developing a prediction model.

The first-degree relatives (FDRs) of patients with colorectal cancer (CRC) are at a 2 to 3-fold increased risk of developing the disease compared with the general population. This study aimed to determine the relationship between the lifestyle of colorectal cancer patients’ FDRs and their compliance in colonoscopy screening test. This cross-sectional study conducted on FDRs of patients with colorectal cancer in one educational hospital, Tehran, Iran in duration 2018. A total of 114 patients’ FDRs were consulted face to face by preventive medicine specialist and data collecting forms were fully completed. Three months later the FDRs were followed for undergoing colonoscopy screening test or decision to do it soon. Next, the relationship between lifestyle [BMI (body mass index), cigarette smoking, diet, physical activity], socioeconomic status (job, income, health insurance), and comorbidities with a tendency to participate in colonoscopy screening program assessed. In multivariable logistic regression analysis, predictor factors for colonoscopy screening in FDRs were investigated. The data were analyzed using SPSS V. 18 software and the significance statistically was P < 0.05 in the all tests. Overall, 57% of FDRs undergone colonoscopy tests up to time of study or they were tended to do it soon. In multivariable logistic regression, age < 50 years old (P = 0.01, OR = 1.08, 95%CI: 1.01 - 1.8), higher income (equal and more than 20 million Rials) (P < 0.001, OR = 2.5, 95%CI: 1.8 - 11), appropriate physical activity (≥ 150 minutes weekly) (P < 0.001, OR = 5.2, 95%CI: 4.6 - 17.5) and normal diet (intake of carbohydrate, fat, protein, fruit and vegetables) (P = 0.006, OR = 3.02, 95%CI: 2.9 - 6.6) were the predictor factors to compliance the FDRs for participation in colonoscopy screening program. Although in this study there was an association between lifestyle of FDRs and the compliance rate of colonoscopy screening test but according to the vulnerability of the relatives, more research in this field should be carried out

We designed this study to evaluate the effectiveness of the combination of topical rectal therapy with biofeedback in treatment of solitary rectal ulcer compared to single biofeedback therapy. Biofeedback therapy is an appropriate treatment for patients with solitary rectal ulcer syndrome (SRUS) but it seems that it is not effective alone. Topical medical therapies are supposed to have an additive role to biofeedback. This randomized, controlled trial was conducted on 63 patients with SRUS. Patients were randomly enrolled into two groups of combination and single therapy. The patients in combination group (n=31) received biofeedback plus a topical therapy (an enema contained dexamethasone, sulfasalazine and bismuth) and the patients in single therapy group (n=32) were treated with biofeedback alone. Endoscopic responses to treatment in the combination and single groups were 80% and 50%, respectively (P<0.05).  Clinical improvement in symptoms such as difficulty to evacuate, digitation to evacuate, feeling of incomplete evacuation, time to need to evacuation and life style alternation were significantly better in treated group by combination therapy than single therapy. Regarding to the mean total score based on all subjective parameters, the results were also significantly better in the treated group by combination therapy. Topical anti-inflammatory therapies in combination with biofeedback is an efficient treatment for patients with SRUS.Keywords: Biofeedback, SRUS, Endoscopic responses.(Please cite as: Abdi S, Tavakolikia N, Yamini M, Bagheri M, Sadeghi A, Pourhoseingholi MA, et al. Solitary rectal ulcer syndrome: addition of rectal therapies to biofeedback is more effective than biofeedback alone. Gastroenterol Hepatol Bed Bench 2019;12(3):197-202).

The aim of this study was to identify the esophageal cancer (EC) high risk regions to evaluate changes of relative risks (RRs) for both genders by time in Iranian provinces. EC is one of the public health problems in Iran. In spite of this fact, there is not comprehensive study estimating RRs across the Iranian provinces. In this cross-sectional study the data for EC cases were extracted from Ministry of Health and Medical Education (MOHME) including 30 provinces from 2004 to 2010. For estimating the model parameters, we used Bayesian approach by regarding spatial correlations of adjacent provinces. The Northern half of Iran has high risk and other half has low risk. During the time, the range of RRs has decreased for both gender and also the dispersion of EC is decreasing for women but nearly is fixed for men. While RR has declined during the study, focusing on the Northern half of Iran as high risk regions is a considerable fact for policymakers.

Colorectal cancer (CRC) is a heterogeneous disease that occurs in different parts of the gastrointestinal system. This study aimed at analyzing the effects of risk factors on survival and cure fraction of patients with CRC in a population of Iranian patients, using parametric non-mixture cure rate model. This retrospective cohort study was conducted at Shiraz University of Medical Sciences on 512 patients with CRC. Patients were followed-up for 8 years, from January 2009 until February 2017. Stepwise selection and parametric non-mixture cure rate model were used to find the risk factors of survival in patients with CRC. Akaike information criteria was used to identify the best parametric non-mixture cure rate model in this study. Staging III (OR = 0.41, 95% CI: 0.19 - 0.90, P = 0.026), staging IV (OR = 0.15, 95% CI: 0.04 - 0.50, P = 0.002), Perineural invasion (OR = 0.41, 95% CI: 0.21 - 0.92, P = 0.007), and lymph node ratio (OR = 0.94, 95% CI: 0.51 - 0.82, P = 0.002) had significant effects on cure fraction and survival of patients with CRC. Perineural invasion, Lymph node ratio, and American Joint Committee on Cancer (AJCC) staging should be assessed as an important factor in modeling survival analysis of patients with CRC. Patients who were in advanced stages of CRC should have received treatment and appropriate therapies given their shorter survival rates.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in children that creates problems in parents-children relationships. Improving familial and social interactions of these children needs mental and social interventions, and parents’ management training (PMT) program is one of these interventions. The present study aimed at determining the effectiveness of PMT program on parent-child relationship of parents with ADHD children. Through an experimental research, 40 parents with ADHD children were selected based on purposeful sampling. A total of 20 parents were randomly placed in intervention group and received 8 sessions of intervention course (60 minutes per session) and the other 20 parents were grouped in the control group and received no training intervention. Research tools included a researcher-designed demographics questionnaire and Parker’s Bonding Instrument (PBI). Data were collected at pretest, posttest, and follow- up stages and analyzed using descriptive and covariance analysis. The results revealed that PMT program was significantly effective in reducing excessive support and increasing parent care index in parents with ADHD children (p<0.05). The results of the present study supported the effectiveness of PMT program on parent-child relationship of the parents with ADHD children.

The decline in fertility and childbearing tendency in Iran is due tovarious demographic, economic, social, and cultural variables. The present research wasconducted to review studies carried out on factors affecting the decline in childbearing. This systematic review searched for articles published from 2011 to 2017in all the available Iranian and foreign databases, including SID, Magiran, Irandoc,Medlib, Pubmed, Google Scholar, Science Direct, and Proquest using the followingkeywords, “childbearing”, “fertility”, “fertility decline” and “population decline”. Thesearch ultimately led to the inclusion of 53 studies. The main factors affecting the decline in childbearing discussed in the 53reviewed articles were divided to three general categories: 1. Personal and familyfactors, including aging, older age at marriage, current number of children, theduration of marriage, the mean birth spacing, gender preferences, hopefulness, maritalsatisfaction, and quality of life, 2. Socioeconomic factors, including social support,education, occupation and social participation, especially of females, place of residenceand the effect of social networks, 3. Cultural factors, including modernity, urbanizationand industrialization, attitude change towards the value of children, changes in familyvalues and religion. To intervene in the decline in childbearing and to increase the successrate of the designed plans and strategies, policy-makers and planners should providestrategies to deal with all the three noted groups of factors affecting childbearing.

Posttraumatic growth resulting from a stressful factor such as the diagnosis and treatment of cancer can positively affect various aspects of a mother’s life as the child’s main caregiver. The present study aims to determine the level of posttraumatic growth in the mothers of the children with cancer.
In the present descriptive study, the statistical population consisted of the mothers of the children with cancer referring to oncology clinics or hospitalized in the oncology departments of selected hospitals from June 2016 to October 2016. The samples included 180 eligible mothers selected by convenient sampling. The data were collected using “Posttraumatic Growth Inventory” (PTGI) that determines the psychological growth following exposure to traumatic events with 21 items in 5 domains of new possibilities, relationship with others, appreciation of life, personal strength, and spiritual changes and scored by 6-point Likert scale, ranging from 0 to 105; the higher scores indicate greater growth. The data were analyzed in SPSS-20 using descriptive and inferential statistical tests.
The mean age of the participating mothers was 34±5.3, 83.3% of whom were housewives. The majority of the children suffered from leukemia, and cancer onset age was between 3 and 6 in 33.9% of the children. The mothers’ mean score of posttraumatic growth was 62.4±18.9, and the highest percentage of scores in various dimensions belonged to “spiritual change” (3.59), “appreciation of life” (3.04), and “relating to others” (3.02).
Results showed that the experience of having a child with cancer can lead to posttraumatic growth in mothers.

BackgroundThe most common cause of death during neonatal period is prematurity. Nutritional tolerance is very important in this period. If during this period the problems of feeding the preterm infant are not resolved, chronic disorder occurs in normal growth.
Materials and MethodsIn this randomized controlledclinical trial we selected 60 preterm infants in the neonatal intensive care unit of Motahhari Hospital in Urmia, Iran, and randomly assigned to control and intervention groups. The infants were touched using Field technique by olive oil in two steps in the morning and evening, with a time of 15 minutes by first researcher. Nutritional tolerance was evaluated using the "Daily Observation Chart" and by gavage milk volume, abdominal circumference, the frequency of defecations and gastric residual volume. The data were collected during 4 consecutive days and the results were compared on the fourth day, with the first day. Data were analyzed using SPSS software version 17.0.
ResultsAccording to the results, the abdominal circumference after touch was less in the intervention group (1.77±1.38) compared to the control group (1.43±1.22) (p ConclusionAccording the results,touching in premature infants using Field technique in two steps in the morning and evening, with a time of 15 minutes can improve nutritional tolerance of premature infants.

The assessment of health-related quality of life has become an important primary or secondary outcome measure in clinical and epidemiologic studies. The aim of this study was to validate a Persian version of Celiac Disease Questionnaire (CDQ) for Celiac disease (CD) among Iranian patients. The English version of the CDQ adapted to the Persian language by a forward-backward translation by 3 professional bilingual translators (1 medical, 2 nonmedical). The content validity of translated questionnaire were studied by 5 experts who complete the validity form regarding the questionnaire. Then in a pilot study, translated CDQ completed by 81 CD patients who referred to Taleghani Hospital, Tehran. For assessing the validity and reliability of the questionnaire, confirmatory factor analysis and Cronbach’s alpha coefficient have been done, using Lisrel and SPSS software. Of 81 CD patients entered to this study with mean age of 30.54 years old, 71.6% were female. Also, 56.8% were married and 45.7% were high educated. The mean of CDQ total score was 119.18±34. The calculated Cronbach’s alpha coefficient for CDQ questionnaire was 0.9. Also, for each subgroups the Cronbach’s alpha coefficient were calculated as the following; emotion: 0.92, Social: 0.89, Worries: 0.73, Gastrointestinal: 0.78. Confirmatory factor analysis indicated that all questions could be remain in questionnaire respectively. The reliability of the Persian version of CDQ was excellent with Cronbach’s alpha coefficients and Persian version of CDQ retains the psychometric properties of the original instrument and should be useful to assess outcome in studies and clinical trials involving Iranian patients with CD.

Colorectal cancer is a highly prevalent cancer across the world, which is associated with significant mortality. Therefore, special attention must be paid to the prevention and care of this fatal disease. The present study aimed to evaluate the effective methods to prolong the survival of colorectal cancer patients and determine the influential factors in their longevity using the exponentiated Weibull statistical model.
Medical records of 446 colorectal cancer patients referring to Taleghani Hospital in Tehran, Iran during 1985 - 2013 were reviewed. The exponentiated Weibull model is an extended version of the Weibull model, which is used to investigate the survival of colorectal cancer patients and assess the influential factors in their survival and longevity. We also compared the model with the Weibull-exponential model for better practice.
Mean survival rate of the patients was 4.52 ± 0.182 years. According to the exponentiated Weibull model, age at diagnosis was the only significant influential factor in the survival of colorectal cancer patients (P = 0.002). Other factors such as gender, tumor size, family history of colorectal cancer, tumor site, and body mass index had no significant effects on the survival of these patients. The proposed model was considered superior to the Weibull-exponential model due to the lower Akaike’s information criterion.
According to the results, age of colorectal cancer patients at the time of diagnosis is the most important influential factor in increasing their survival and reducing the mortality rate. Therefore, it is recommended that proper care be provided for the elderly patients with colorectal cancer, especially at the onset of the disease.

Aim: The aim of this study was to investigate the impact of diabetes and hypertension on colorectal cancer (CRC) mortality.
One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias.
One of the methodology in epidemiological studies is to use self-report questionnaires to gather data, this is the easiest and cheapest method but involves with misclassification bias. We use robust Bayesian adjustment to correct this bias.
The effect size with ignorance misclassification bias was 0.78 for diabetes and 0.94 for hypertension respectively which both of them were not significant. After adjusting the misclassification and performing the robust Bayesian analysis, we arrived at region (0.27, 3.4) for OR of diabetes and (0.21, 2.31) for hypertension.
our study demonstrated that diabetes and hypertension increase the risk of mortality in CRC patients, using robust Bayesian analysis and misclassification in diagnosis these two exposure could change or confound the results of this association.

Aim: The aim of this study was to obtain more accurate estimates of the liver cancer incidence rate after correcting for misclassification error in cancer registry across Iranian provinces.
Nowadays having a thorough knowledge of geographic distribution of disease incidence has become essential for identifying the influential factors on cancer incidence.
Data of liver cancer incidence was extracted from Iranian annual of national cancer registration report 2008. Expected coverage of cancer cases for each province was calculated. Patients of each province that had covered fewer cancer cases than 100% of its expectation, were supposed to be registered at an adjacent province which had observed more cancer cases than 100% of its expected coverage. For estimating the rate of misclassification in registering cancer incidence, a Bayesian method was implemented. Beta distribution was considered for misclassified parameter since its expectation converges to the misclassification rate. Parameters of beta distribution were selected based on the expected coverage of cancer cases in each province. After obtaining the misclassification rate, the incidence rates were re-estimated.
There was misclassification error in registering new cancer cases across the provinces of Iran. Provinces with more medical facilities such as Tehran which is the capital of the country, Mazandaran in north of the Iran, East Azerbaijan in north-west, Razavi Khorasan in north-east, Isfahan in central part, and Fars and Khozestan in south of Iran had significantly higher rates of liver cancer than their neighboring provinces. On the other hand, their neighboring provinces with low medical facilities such as Ardebil, West Azerbaijan, Golestan, South and north Khorasans, Qazvin, Markazi, Arak, Sistan & balouchestan, Kigilouye & boyerahmad, Bushehr, Ilam and Hormozgan, had observed fewer cancer cases than their expectation.
Accounting and correcting the regional misclassification are necessary for identifying high risk areas of the country and effective policy making to cope with cancer.

Social supports have a key role in nurses’ quality of working life. The present study aimed to measure the quality of working life and social support and examine their relationship in neonatal intensive care unit nurses.

In the present descriptive-correlational study, statistical population consisted of nurses working in neonatal intensive care units of selected hospitals affiliated to Ahwaz University of Medical Sciences, selected by census. Tools used included Zimet et al. Social Support Scale and Brooks' Quality of Working Life of Nurses questionnaire. Validity of this questionnaire was confirmed by 12 experts, and its reliability was confirmed by Cronbach's alpha coefficient. Data were analyzed in SPSS-20.ResultsThe highest mean value in social support pertained to "family" dimension (5.190) and the lowest to "friends" (4.505), and overall mean social support value was 4.785. The quality of working life had the highest mean value in "working life" dimension (3.672) and the lowest in "personal life" (3.350), and overall mean value of quality of working life was 3.550 in nurses. The results obtained showed a significant relationship and a positive correlation between social support and the quality of working life in nurses (P=0.012, r=0.251).Discussion and

The results obtained showed a significant and positive relationship between social support and the quality of working life in nurses. But, the relationship between subscales of these two variables was mildly confirmed. Generally, the present study results concur with the results of previous studies.

Aim: The aim of this study was to estimate the economic burden of celiac disease (CD) in Iran.
The assessment of burden of CD has become an important primary or secondary outcome measure in clinical and epidemiologic studies.
Information regarding medical costs and gluten free diet (GFD) costs were gathered using questionnaire and checklists offered to the selected patients with CD. The data included the direct medical cost (including Doctor Visit, hospitalization, clinical test examinations, endoscopies, etc.), GFD cost and loss productivity cost (as the indirect cost) for CD patient were estimated. The factors used for cost estimation included frequency of health resource utilization and gluten free diet basket. Purchasing Power Parity Dollar (PPP$) was used in order to make inter-country comparisons.
Total of 213 celiac patients entered to this study. The mean (standard deviation) of total cost per patient per year was 3377 (1853) PPP$. This total cost including direct medical cost, GFD costs and loss productivity cost per patients per year. Also the mean and standard deviation of medical cost and GFD cost were 195 (128) PPP$ and 932 (734) PPP$ respectively. The total costs of CD were significantly higher for male. Also GFD cost and total cost were higher for unmarried patients.
In conclusion, our estimation of CD economic burden is indicating that CD patients face substantial expense that might not be affordable for a good number of these patients. The estimated economic burden may put these patients at high risk for dietary neglect resulting in increasing the risk of long term complications.

Painful nipple fissure is a troublesome problem for breastfeeding mothers. This study was conducted to evaluate the effect of saqez (Pistacia atlantica) ointment on the improvement of nipple fissure in breastfeeding women during one-month follow-up.
This randomized controlled clinical trial was conducted on 100 eligible women who visited the selected health centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, from July 2015 to December 2015 during their postpartum period. A total of 100 subjects were randomly divided into two equal groups of 50 women grouped as saqez ointment group and breast milk group, and followed-up for one month. Both groups received face-to-face instructions on breastfeeding techniques. For severity of nipple fissure, Storr scale and to measure the intensity of pain, visual analog scale (VAS) were used.
The results showed that the two groups were matched in terms of demographic and obstetric characteristics. Mean of nipple fissure severity in ointment group (42.62) was lower than that of the control group (48.02), that was significantly different between the two groups (p=0.047). In addition, Mean nipple pain intensity in ointment group (40.57) was lower than that of the control group (49.81), but there was no significant difference between the two groups (p=0.056).
The present study showed that saqez ointment was more effective than breast milk in healing and controlling nipple fissures during one-month follow-up, without resulting in any side effects.

Colorectal cancer is one of the important causes of death due to cancer worldwide. Survival time in this cancer should be controlled to decrease the risk of mortality. In this study survival time and factors that could affect it are evaluated.
In the present study, the files of 446 patients afflicted with colorectal cancer who had referred to Taleghani Hospital, Tehran from 1985 to 2013 were chosen as the study group. The exponential model was used here, for the purpose of investigating the survival of patients with colorectal cancer and finding proper variables affecting this survival and longevity.
In this study, the subjects had the mean (standard deviation) survival time 4.52 (0.182) year. The patients’ age at the time of diagnosis (P = 0.002) and tumor size (P = 0.032) were the only significant variables affecting the survival of patients in the exponential model. Sex, the family history of colorectal cancer, the tumor site, and body mass index had no significant effect on the survival time of the patients with colorectal cancer.
The results of the study show that to improve the survival chance of the patients with colorectal cancer or decrease the mortality rate, due attention should be paid to the age of the patient at the time of diagnosis.