Morteza Hajihosseini received his Ph.D. in Epidemiology with a concentration in the microbiome and spatial single-cell data analysis from the University of Alberta. He completed his MSc degree in biostatistics at Hamadan University of Medical Sciences, Iran. Prior to joining Stanford, Morteza collaborated with the WHO office of NCDs as a biostatistics and epidemiology consultant working on data from the STEPS program, writing R packages and shiny apps for WHO physical activity and cardiovascular risk assessment tools. He worked as an intern at Applied Pharmaceutical Innovation (API) company at the University of Alberta, collaborating on various projects related to the pharmaceutical industry. Morteza is interested in cancer epidemiology and survival studies focusing on cancer progression models and (spatial) gene expression analyses in urologic cancers.
Doctor of Philosophy, University of Alberta, Edmonton, Canada, Epidemiology (2022)
Master of Science, Hamadan University of Medical Science, Hamadan, Iran, Biostatistics (2015)
Bachelor of Science, University of Birjand, Birjand, Iran, Statistics (2013)
Marvin Langston, Postdoctoral Research Mentor
Benjamin Chung, Postdoctoral Faculty Sponsor
Current Research and Scholarly Interests
Renal cell cancer
(Spatial) Single-cell sequencing data analysis
High dimensional data analysis
Administrative data analysis
Exploring educational inequalities in hypertension control, salt knowledge and awareness, and patient advice: insights from the WHO STEPS Surveys of adults from nine eastern European and central Asian countries.
Public health nutrition
To inform strategies aimed at improving blood pressure control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in eastern Europe and central Asia.Data were collected in cross-sectional, population-based nationally-representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories.Nine eastern European and central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan).Nationally-representative samples of 30,455 adults 25-65 years old.HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviors. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction.There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socioeconomically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries.
View details for DOI 10.1017/S1368980023000356
View details for PubMedID 36779266
Infants' gut microbiome data: A Bayesian Marginal Zero-inflated Negative Binomial regression model for multivariate analyses of count data.
Computational and structural biotechnology journal
2023; 21: 1621-1629
The infants' gut microbiome is dynamic in nature. Literature has shown high inter-individual variability of gut microbial composition in the early years of infancy compared to adulthood. Although next-generation sequencing technologies are rapidly evolving, several statistical analysis aspects need to be addressed to capture the variability and dynamic nature of the infants' gut microbiome. In this study, we proposed a Bayesian Marginal Zero-inflated Negative Binomial (BAMZINB) model, addressing complexities associated with zero-inflation and multivariate structure of the infants' gut microbiome data. Here, we simulated 32 scenarios to compare the performance of BAMZINB with glmFit and BhGLM as the two other widely similar methods in the literature in handling zero-inflation, over-dispersion, and multivariate structure of the infants' gut microbiome. Then, we showed the performance of the BAMZINB approach on a real dataset using SKOT cohort (I and II) studies. Our simulation results showed that the BAMZINB model performed as well as those two methods in estimating the average abundance difference and had a better fit for almost all scenarios when the signal and sample size were large. Applying BAMZINB on SKOT cohorts showed remarkable changes in the average absolute abundance of specific bacteria from 9 to 18 months for infants of healthy and obese mothers. In conclusion, we recommend using the BAMZINB approach for infants' gut microbiome data taking zero-inflation and over-dispersion properties into account in multivariate analysis when comparing the average abundance difference.
View details for DOI 10.1016/j.csbj.2023.02.027
View details for PubMedID 36860341
Evaluating the Prevalence and Factors Associated With an Optimal Neurodevelopmental Outcome in 4- to 6-Year-Old Children With Fontan Circulation.
The Canadian journal of cardiology
BACKGROUND: We sought to evaluate the prevalence and factors associated with "optimal" neurodevelopmental outcomes in 4- to 6-year-old children with Fontan circulation.METHODS: Patients followed through the Western Canadian Complex Pediatric Therapies Follow-Up Program, and born between September 1996 and December 2015, were included. Optimal neurodevelopmental outcome was defined as full-scale intelligence quotient; visual-motor integration; adaptive behaviour assessment system-general adaptive composite scores of ≥ 80 each; and the absence of chronic motor disability, permanent hearing loss, visual impairment, and seizure disorder. Multivariable regression models and decision algorithms evaluated variables associated with optimal outcomes.RESULTS: The Fontan procedure was completed on 225 children, with neurodevelopmental outcome data available for 205 (mean [standard deviation]) age at Fontan 3.4 (0.9) years, 37% female). Optimal neurodevelopmental outcome was identified in 55% (112 of 205). Factors independently associated with optimal neurodevelopmental outcome were female sex (odds ratio [OR], 2.1; 95% confidence interval [CI] 1.1-4.1), years of maternal schooling (OR, 1.2 [1.1-1.4]), age at Fontan (years) (OR, 0.97 [0.94-1.0]), need for concomitant atrioventricular valve (AVV) intervention (OR, 0.4 [0.2-1.0]), and time (hours) for lactate to be ≤ 2 mmol/L (OR, 0.9 [0.8-1.0]). Of those with Fontan completion < 3.25 years, without concomitant AVV intervention and lactate normalization within 8 hours post-Fontan, 87% (27 of 31) had optimal neurodevelopmental outcomes.CONCLUSIONS: Optimal neurodevelopmental outcome was present in more than one-half of 4- to 6-year-old children with Fontan circulation in this cohort study, with important associated factors identified, including potentially modifiable factors such as younger age at Fontan surgery and lack of concomitant AVV intervention.
View details for DOI 10.1016/j.cjca.2022.10.022
View details for PubMedID 36544295
Geostatistical Modeling and Heterogeneity Analysis of Tumor Molecular Landscape.
2022; 14 (21)
Intratumor heterogeneity (ITH) is associated with therapeutic resistance and poor prognosis in cancer patients, and attributed to genetic, epigenetic, and microenvironmental factors. We developed a new computational platform, GATHER, for geostatistical modeling of single cell RNA-seq data to synthesize high-resolution and continuous gene expression landscapes of a given tumor sample. Such landscapes allow GATHER to map the enriched regions of pathways of interest in the tumor space and identify genes that have spatial differential expressions at locations representing specific phenotypic contexts using measures based on optimal transport. GATHER provides new applications of spatial entropy measures for quantification and objective characterization of ITH. It includes new tools for insightful visualization of spatial transcriptomic phenomena. We illustrate the capabilities of GATHER using real data from breast cancer tumor to study hallmarks of cancer in the phenotypic contexts defined by cancer associated fibroblasts.
View details for DOI 10.3390/cancers14215235
View details for PubMedID 36358654
An updated reference for age-sex-specific birth weight percentiles stratified for ethnicity based on data from all live birth infants between 2005 and 2014 in Alberta, Canada
CANADIAN JOURNAL OF PUBLIC HEALTH-REVUE CANADIENNE DE SANTE PUBLIQUE
2022; 113 (2): 272-281
This study aims to update the current reference for sex-specific birth weight percentiles by gestational age, overall and for specific ethnic groups, based on data from all singleton live-birth deliveries from 2005 to 2014 in Alberta, Canada.Infant and maternal information were captured in the Alberta Vital Statistics-Births Database for 473,115 singleton infants born to 311,800 women between January 1, 2005 and December 31, 2014. Within each sex, and each sex-ethnic group, birth weights were modelled by gestational age using generalized additive models and natural cubic splines. Crude and corrected estimates for birth weight percentiles including cut-off values for large for gestational age (LGA) and small for gestational age (SGA) were calculated by sex and sex-ethnic group, and gestational age for singleton live births.LGA and SGA cut-offs were lower for females than for males for all gestational ages. The SGA and LGA percentiles were greater for both male and female very preterm infants in Alberta compared to previous national references. Ethnicity-specific LGA and SGA cut-offs for term Chinese and preterm and at-term South Asian infants were consistently lower than those for both the general population in Alberta and the previous national reference. South Asian infants had lower birth weights at almost all gestational ages compared with the other groups.The updated birth weight percentiles presented in this study highlight the differences in SGA and LGA cut-offs among infants from South Asian, Chinese, and the general population, which may be important for clinical perinatal care.
View details for DOI 10.17269/s41997-021-00520-9
View details for Web of Science ID 000670137200001
View details for PubMedID 34231187
View details for PubMedCentralID PMC8975890
Outcomes of Preterm Infants With Congenital Heart Defects After Early Surgery: Defining Risk Factors at Different Time Points During Hospitalization
FRONTIERS IN PEDIATRICS
2021; 8: 616659
Background: Compared with those born at term gestation, infants with complex congenital heart defects (CCHD) who were delivered before 37 weeks gestational age and received neonatal open-heart surgery (OHS) have poorer neurodevelopmental outcomes in early childhood. We aimed to describe the growth, disability, functional, and neurodevelopmental outcomes in early childhood of preterm infants with CCHD after neonatal OHS. Prediction models were evaluated at various timepoints during hospitalization which could be useful in the management of these infants. Study Design: We studied all preterm infants with CCHD who received OHS within 6 weeks of corrected age between 1996 and 2016. The Western Canadian Complex Pediatric Therapies Follow-up Program completed multidisciplinary comprehensive neurodevelopmental assessments at 2-year corrected age at the referral-site follow-up clinics. We collected demographic and acute-care clinical data, standardized age-appropriate outcome measures including physical growth with calculated z-scores; disabilities including cerebral palsy, visual impairment, permanent hearing loss; adaptive function (Adaptive Behavior Assessment System-II); and cognitive, language, and motor skills (Bayley Scales of Infant and Toddler Development-III). Multiple variable logistic or linear regressions determined predictors displayed as Odds Ratio (OR) or Effect Size (ES) with 95% confidence intervals. Results: Of 115 preterm infants (34 ± 2 weeks gestation, 2,339 ± 637 g, 64% males) with CCHD and OHS, there were 11(10%) deaths before first discharge and 21(18%) deaths by 2-years. Seven (6%) neonates had cerebral injuries, 7 had necrotizing enterocolitis; none had retinopathy of prematurity. Among 94 survivors, 9% had cerebral palsy and 6% had permanent hearing loss, with worse outcomes in those with syndromic diagnoses. Significant predictors of mortality included birth weight z-score [OR 0.28(0.11,0.72), P = 0.008], single-ventricle anatomy [OR 5.92(1.31,26.80), P = 0.021], post-operative ventilation days [OR 1.06(1.02,1.09), P = 0.007], and cardiopulmonary resuscitation [OR 11.58 (1.97,68.24), P = 0.007]; for adverse functional outcome in those without syndromic diagnoses, birth weight 2,000-2,499 g [ES -11.60(-18.67, -4.53), P = 0.002], post-conceptual age [ES -0.11(-0.22,0.00), P = 0.044], post-operative lowest pH [ES 6.75(1.25,12.25), P = 0.017], and sepsis [ES -9.70(-17.74, -1.66), P = 0.050]. Conclusions: Our findings suggest preterm neonates with CCHD and early OHS had significant mortality and morbidity at 2-years and were at risk for cerebral palsy and adverse neurodevelopment. This information may be important for management, parental counseling and the decision-making process.
View details for DOI 10.3389/fped.2020.616659
View details for Web of Science ID 000616805700001
View details for PubMedID 33585367
View details for PubMedCentralID PMC7876369
Music Use for Sedation in Critically ill Children (MUSiCC trial): a pilot randomized controlled trial
JOURNAL OF INTENSIVE CARE
2021; 9 (1): 7
To demonstrate feasibility of a music medicine intervention trial in pediatric intensive care and to obtain information on sedation and analgesia dose variation to plan a larger trial.Pilot randomized controlled trial (RCT) was conducted at the Stollery Children's Hospital general and cardiac intensive care units (PICU/PCICU). The study included children 1 month to 16 years of age on mechanical ventilation and receiving sedation drugs. Patients were randomized in a 1:1:1 ratio to music, noise cancellation or control. The music group received classical music for 30 min three times/day using headphones. The noise cancellation group received the same intervention but with no music. The control group received usual care.A total of 60 patients were included. Average enrollment rate was 4.8 patients/month, with a consent rate of 69%. Protocol adherence was achieved with patients receiving > 80% of the interventions. Overall mean (SD) daily Sedation Intensity Score was 52.4 (30.3) with a mean (SD) sedation frequency of 9.75 (7.21) PRN doses per day. There was a small but statistically significant decrease in heart rate at the beginning of the music intervention. There were no study related adverse events. Eighty-eight percent of the parents thought the headphones were comfortable; 73% described their child more settled during the intervention.This pilot RCT has demonstrated the feasibility of a music medicine intervention in critically ill children. The study has also provided the necessary information to plan a larger trial.
View details for DOI 10.1186/s40560-020-00523-7
View details for Web of Science ID 000607177700001
View details for PubMedID 33431051
View details for PubMedCentralID PMC7802123
Health-related quality of life after pediatric heart transplantation in early childhood
2020; 24 (7): e13822
There is limited information about HRQL after pediatric heart transplantation at a young age.Prospective follow-up study of children who received a heart transplant at age ≤4 years. HRQL was assessed using the PedsQLTM 4.0 at age 4.5 years. This cohort was compared with healthy children, children with CHD, and with chronic conditions. Peri-operative factors associated with HRQL were also explored.Of 66 eligible patients, 15 (23%) died prior to the HRQL assessment and 2 (3%) were lost to follow-up, leaving 49 patients. Indication for transplantation was CHD in 27 (55%) and CMP in 22 (45%). Median age (IQR) at transplant was 9 (5-31) months. HRQL was significantly lower in transplanted children compared to population norms (65.3 vs 87.3, P < .0001), children with chronic conditions (65.3 vs 76.1, P = .001), and children with CHD (65.3 vs 81.1, P < .0001). Transplanted children with CHD had lower HRQL than those with a prior diagnosis of CMP (59.5 vs 72.5, P-value = .020). Higher creatinine pretransplant and higher lactate post-operatively were associated with lower HRQL.Children after heart transplant had significantly lower HRQL, as reported by their parents, than the normative population, children with chronic conditions, and children with CHD.
View details for DOI 10.1111/petr.13822
View details for Web of Science ID 000564461200001
View details for PubMedID 32871049
Permafrost Microbial Community Structure Changes Across the Pleistocene-Holocene Boundary
FRONTIERS IN ENVIRONMENTAL SCIENCE
View details for DOI 10.3389/fenvs.2020.00133
View details for Web of Science ID 000566249900001
Reduced myocardial blood flow reserve in kidney transplant candidates may hamper risk stratification
JOURNAL OF NEPHROLOGY
2021; 34 (1): 197-209
Vasodilator nuclear stress testing is frequently ordered for risk stratification prior to kidney transplantation. Since 82Rb-positron emission tomography-computed tomography can measure myocardial blood flow (MBF), the response to vasodilator stress can be verified rendering the results of the scan more reliable.We reviewed the MBF response to dipyridamole infusion in 328 patients with end-stage kidney disease (ESKD) prior to transplant (188 hemodialysis-HD, 120 peritoneal dialysis-PD, and 20 pre-dialysis patients-CKD5) and in 100 controls with normal kidney function. A stress/rest MBF ratio ≥ 2 was considered an adequate response to dipyridamole. Coronary artery calcium (CAC) was measured on CT.Inadequate MBF response was seen in 36%-HD, 21%-PD, 45%-CKD5 vs. 23%-controls (p = 0.006). Univariable predictors of poor MBF response in ESKD patients were age, diabetes mellitus, and CAC (all p < 0.03) while serum hemoglobin was borderline significant (p = 0.052). Multivariable predictors of a poor MBF response were age (p = 0.002) and lower serum hemoglobin (p = 0.014). Ischemia was identified in 8% of ESKD patients and 24% of controls (p < 0.001).ESKD patients are less likely to respond appropriately to vasodilator stress compared to patients with normal renal function and had a lower incidence of ischemia despite a high pre-test probability of disease. Physicians performing vasodilator stress without MBF measurement should be aware of the high probability of a false negative response.
View details for DOI 10.1007/s40620-020-00736-x
View details for Web of Science ID 000524959700002
View details for PubMedID 32277424
Pre-school neurocognitive and functional outcomes after liver transplant in children with early onset urea cycle disorders, maple syrup urine disease, and propionic acidemia: An inception cohort matched-comparison study.
2020; 52 (1): 43-54
BACKGROUND: Urea cycle disorders (UCD) and organic acid disorders classically present in the neonatal period. In those who survive, developmental delay is common with continued risk of regression. Liver transplantation improves the biochemical abnormality and patient survival is good. We report the neurocognitive and functional outcomes post-transplant for nine UCD, three maple syrup urine disease, and one propionic acidemia patient.METHODS: Thirteen inborn errors of metabolism (IEM) patients were individually one-to-two matched to 26 non-IEM patients. All patients received liver transplant. Wilcoxon rank sum test was used to compare full-scale intelligence-quotient (FSIQ) and Adaptive Behavior Assessment System-II General Adaptive Composite (GAC) at age 4.5 years. Dichotomous outcomes were reported as percentages.RESULTS: FSIQ and GAC median [IQR] was 75 [54, 82.5] and 62.0 [47.5, 83] in IEM compared with 94.5 [79.8, 103.5] and 88.0 [74.3, 97.5] in matched patients (P-value <.001), respectively. Of IEM patients, 6 (46%) had intellectual disability (FSIQ and GAC <70), 5 (39%) had autism spectrum disorder, and 1/13 (8%) had cerebral palsy, compared to 1/26 (4%), 0, 0, and 0% of matched patients, respectively. In the subgroup of nine with UCDs, FSIQ (64[54, 79]), and GAC (56[45, 75]) were lower than matched patients (100.5 [98.5, 101] and 95 [86.5, 99.5]), P = .005 and .003, respectively.CONCLUSION: This study evaluated FSIQ and GAC at age 4.5 years through a case-comparison between IEM and matched non-IEM patients post-liver transplantation. The neurocognitive and functional outcomes remained poor in IEM patients, particularly in UCD. This information should be included when counselling parents regarding post-transplant outcome.
View details for DOI 10.1002/jmd2.12095
View details for PubMedID 32154059
Longitudinal linear combination test for gene set analysis
2019; 20 (1): 650
Although microarray studies have greatly contributed to recent genetic advances, lack of replication has been a continuing concern in this area. Complex study designs have the potential to address this concern, though they remain undervalued by investigators due to the lack of proper analysis methods. The primary challenge in the analysis of complex microarray study data is handling the correlation structure within data while also dealing with the combination of large number of genetic measurements and small number of subjects that are ubiquitous even in standard microarray studies. Motivated by the lack of available methods for analysis of repeatedly measured phenotypic or transcriptomic data, herein we develop a longitudinal linear combination test (LLCT).LLCT is a two-step method to analyze multiple longitudinal phenotypes when there is high dimensionality in response and/or explanatory variables. Alternating between calculating within-subjects and between-subjects variations in two steps, LLCT examines if the maximum possible correlation between a linear combination of the time trends and a linear combination of the predictors given by the gene expressions is statistically significant. A generalization of this method can handle family-based study designs when the subjects are not independent. This method is also applicable to time-course microarray, with the ability to identify gene sets that exhibit significantly different expression patterns over time. Based on the results from a simulation study, LLCT outperformed its alternative: pathway analysis via regression. LLCT was shown to be very powerful in the analysis of large gene sets even when the sample size is small.This self-contained pathway analysis method is applicable to a wide range of longitudinal genomics, proteomics, metabolomics (OMICS) data, allows adjusting for potentially time-dependent covariates and works well with unbalanced and incomplete data. An important potential application of this method could be time-course linkage of OMICS, an attractive possibility for future genetic researchers.R package of LLCT is available at: https://github.com/its-likeli-jeff/LLCT.
View details for DOI 10.1186/s12859-019-3221-7
View details for Web of Science ID 000511608800002
View details for PubMedID 31822265
View details for PubMedCentralID PMC6902471
Comparison of artificial neural networks and logistic regression for determination of social-cognitive factors impacting drug abstinence
JOURNAL OF SUBSTANCE USE
2020; 25 (3): 295-300
View details for DOI 10.1080/14659891.2019.1690060
View details for Web of Science ID 000497289600001
Clinical features, treatment, prognosis, and mortality in paraquat poisonings: A hospital-based study in Iran
JOURNAL OF RESEARCH IN PHARMACY PRACTICE
2019; 8 (3): 129-136
The aim of the present study was to evaluate the demographics, clinical characteristics, fatal dose, the efficacy of treatments, and prognosis in paraquat (PQ) poisoning in the Kerman Province of Iran.This analytical cross-sectional study was conducted on 126 PQ poisoned patients who were referred to Afzalipour Hospital during 2006-2015. Demographic variables such as age and gender, signs and symptoms of poisoning, the estimated ingested dosage of PQ, and clinical outcome were extracted from medical records. Patients were compared and categorized into two groups considering the outcome: survivors and nonsurvivors. Patients with nonoral exposures, combined drug exposures, PQ exposures more than 24 h before the presentation, and critical underlying diseases were not included in the study.Our results indicated that the mean dose of PQ used by all patients was 2358 mg, which was reported as 1846 and 2812 mg in females and males, respectively. Moreover, the results showed that the highest mortality rate was in patients with respiratory distress, followed by oral ulceration and excess salivation. In all PQ-poisoned patients, the dose of greater than approximately 2250 mg predicted death with 86.2% specificity and 75.7% sensitivity.Based on the results of the present study, the mortality rate in PQ-poisoned patients depended on the dose of poison, blood sugar level, and aspartate transaminase levels. Our results suggest that these parameters have excellent prognostic value for the prediction of mortality.
View details for DOI 10.4103/jrpp.JRPP_18_71
View details for Web of Science ID 000501861500004
View details for PubMedID 31728343
View details for PubMedCentralID PMC6830018
Determining Risk Factors for Gastric and Esophageal Cancers between 2009-2015 in East-Azarbayjan, Iran Using Parametric Survival Models
Asian Pacific journal of cancer prevention : APJCP
2019; 20 (2): 443-449
Background: Esophageal cancer (EC) and Gastric cancer (GC) have been identified as two of the most commoncancers in the northeastern regions of Iran. The increasing rates of these types of cancers requires attention. This studyaims to assess the potential risk factors for these two cancers and then determine shared risk factors between themin a population of Iranian patients using parametric survival models. Methods: This retrospective cohort study wasconducted using 127 patients with EC and 184 patients with GC in East Azarbaijan, Iran who were diagnosed andregistered during the years 2009-2010 in Irans National Cancer Control Registration Program and were followed forfive years. Parametric survival models were used to find the risk factors of the patients. Akaike Information Criteria wasused to identify the best parametric model in this study. Interaction analysis was used to determine shared risk factorsbetween EC and GC. Results: The mean (±standard deviation) age of diagnoses for EC and GC were 66.92(±11.95) and66.5(±11.5) respectively. The survival time ranges of GC patients was (0.07-70.33) and the survival time ranges werefrom 0.10 to 69.03 months for EC patients. Multivariable Log- logistic model showed that being married (OR=2.25, 95%CI: 1.33 - 3.81) for EC patients and Esophagectomy surgery for EC (OR: 1.62, 95% CI: 1.04 - 2.55) and GC (OR: 1.60,95% CI: 1.02 - 2.53) had significant effects on survival. Age at the time of diagnosis, job status, and Esophagectomysurgery were statistically comparable regarding their magnitude of effect on survival of two cancers (all Ps>0.05).Conclusion: Esophagectomy surgery and being married were important risk factors in EC and GC. The log-logisticmodel was the most appropriate statistical approach to identify significant risk factors on survival of both cancers.
View details for PubMedID 30803206
The Persian Version of Fertility Adjustment Scale: Psychometric Properties
INTERNATIONAL JOURNAL OF FERTILITY & STERILITY
2018; 12 (2): 130-135
Infertility is a common clinical problem. Psychological adjustment to infertility refers to changing the viewpoint and attitude of an infertile person toward infertility problems, treatments and possible outcomes. The present study aims to prepare a valid and reliable scale for assessing the psychological adjustment to infertility, by determining the cultural adaptation, validity and reliability of the Persian version of the Fertility Adjustment Scale.This is a cross-sectional study performed to localize and validate the Fertility Adjustment Scale, in which 40 infertile women and 40 healthy subjects (fertile or having children) were detected by a gynecologist and the subjects who completed the Fertility Adjustment Scale (FAS) questionnaire were recruited. This study had four steps: in the first step, the literature was reviewed, in the second step, the scale was translated, in the third step, the content and construct validity indicators were calculated, and in the fourth step, reliability of the scale was validated.The mean (± SE and range) of fertility adjustment total scores in the infertile group and the control group were 43.2 (1.2 and 27-57) and 42.3 (1.5 and 18-57), respectively (P=0.623). The content validity was good according to Content Validity Index score (0.7-0.8). A two-component structure was extracted from factor analysis which approximately justifies 52.0% of the cumulative variations. A Cronbach's alpha value of 0.68 showed moderate reliability.The results of this study revealed that the infertility adjustment scale is a useful tool for the analysis of psychological reactions towards infertility problems and evaluation of the consequences of treating this social-clinical problem.
View details for DOI 10.22074/ijfs.2018.5219
View details for Web of Science ID 000431560600007
View details for PubMedID 29707929
View details for PubMedCentralID PMC5936610
Prevalence of Pre-hypertension and Risk Factors in an Iranian Population: East of Iran
INTERNATIONAL CARDIOVASCULAR RESEARCH JOURNAL
2018; 12 (1): 34-37
View details for Web of Science ID 000428121800006
Cardiovascular Risk Factors and Atherogenic Indices in an Iranian Population: Birjand East of Iran
CLINICAL MEDICINE INSIGHTS-CARDIOLOGY
2018; 12: 1179546818759286
Introduction: The alteration in serum lipid profile; increase in total cholesterol (TC), triacylglycerol (TAG), and low-density lipoprotein cholesterol (LDL-C); and reduction in high-density lipoprotein cholesterol (HDL-C) are key factors in cardiovascular disease progression. The high prevalence and severity of cardiovascular diseases require new screening tools for better evaluation. Atherogenic index (AI) (LDL-C/HDL-C) and coronary risk index (CRI) (TC/HDL-C) can be strong markers for predicting the risk of atherosclerosis and coronary heart disease and disclose the presence of LDL or TAG in the serum of related patients. To implement this strategy, the AIs and CRIs in our population were assessed. In this study, a total of 5207 subjects were recruited and AIs and CRIs were calculated for all of them. According to our data, age, body mass index, sex, as well as CRI and AI had affirmative correlation with TC, LDL-C, TAG, systolic blood pressure, and diastolic blood pressure. By increasing these factors, AIs and CRIs were augmented. Moreover, in situations where all atherogenic parameters are normal, these parameters may be the alternative screening tool.
View details for DOI 10.1177/1179546818759286
View details for Web of Science ID 000425618100001
View details for PubMedID 29497341
View details for PubMedCentralID PMC5824902
Social cognitive theory as a theoretical framework to predict sustained abstinence 6 months after substance use treatment
JOURNAL OF SUBSTANCE USE
2018; 23 (3): 300-306
View details for DOI 10.1080/14659891.2017.1394382
View details for Web of Science ID 000428785300011
Approach to Chronic Secondary Headache: A Case Report on Unusual Drug Side Effects
IRANIAN JOURNAL OF MEDICAL SCIENCES
2017; 42 (6): 611-614
In this article, we present the case of a 12-year-old female child who complained of bilateral temporal and frontal headache for 2 to 3 months with nausea and vomiting. Physical examination revealed right-sided sixth cranial nerve palsy and papilledema in ophthalmoscopy. To find the cause of increased intracranial pressure, the patient underwent brain imaging and brain MRI showed no abnormality. Ultimately, lumbar puncture (LP) was performed and cerebrospinal fluid (CSF) pressure was 280 mmH2O with normal chemistry. We considered pseudotumor cerebri as the first diagnosis. LP was carried out three times and 30cc of CSF was tapped each time. Finally, patient's headache and papilledema improved and physical examination after 6 months showed no sign of raised intracranial pressure (rICP). The most prominent point in her past medical history was the use of growth hormone (GH) for 2 years. No sign of symptom relapse has been seen after 6 months of drug discontinuation. We must consider the hazard of growth hormone as a potential cause of increased intracranial pressure. When the use of GH is justified, the follow-up must include an ophthalmoscopy examination in each session.
View details for Web of Science ID 000417041400014
View details for PubMedID 29184272
View details for PubMedCentralID PMC5684385
The effect of peer support groups on family adaptation from the perspective of wives of war veterans with posttraumatic stress disorder
PUBLIC HEALTH NURSING
2017; 34 (6): 547-554
The aim of this study was to examine the effect of peer group support on family adaptation of wives of war veterans suffering from post-traumatic stress disorder (PTSD).In this randomized controlled trial, 80 wives of war veterans with PTSD were incorporated, and selected participants were randomly assigned into intervention and control groups (n = 40 per group). The intervention group was divided into four subgroups, with each participating in eight weekly based 1.5-hr peer support group sessions and the control group received no intervention.Demographics form and Family Adaptation Scale (FAS) developed by Antonovsky and Sourani (1988) were applied.The total mean scores of family adaptation increased significantly more in the intervention group than in the control group (p = .033). Furthermore, the time × group interaction effects were significant for internal family fit (p = .013) and a combination of both family fit and family community fit (p = .020) dimensions. Nonetheless family fit dimensions mean scores had no significant increase in the intervention group than the control group over time (p = .948).Peer support group can be a useful tool for health care professionals to enhance family adaptation in spouses of war veterans with PTSD.
View details for DOI 10.1111/phn.12349
View details for Web of Science ID 000414678900007
View details for PubMedID 28833521
Opium, an important risk factor for deep vein thrombosis patients
JOURNAL OF RESEARCH IN MEDICAL SCIENCES
2017; 22: 112
View details for DOI 10.4103/jrms.JRMS_454_17
View details for Web of Science ID 000423018000001
View details for PubMedID 29184570
View details for PubMedCentralID PMC5680652
Hepatitis Awareness Bus: A Model for Finding Unknown Hepatitis B and C Infections
2017; 17 (6)
View details for DOI 10.5812/hepatmon.11719
View details for Web of Science ID 000411093000009
The importance of electrocardiography parameters in healthy Iranian children
2017; 13 (3): 159-160
View details for Web of Science ID 000412433600007
View details for PubMedID 29147124
View details for PubMedCentralID PMC5677331
Prevalence and Determinants of Hypertension among Iranian Adults, Birjand, Iran
INTERNATIONAL JOURNAL OF PREVENTIVE MEDICINE
2017; 8: 36
Hypertension (HTN) is a major cause of noncommunicable diseases. In this study, we report the prevalence rate of HTN in Birjand population.This cross-sectional study was conducted on 1286 individuals in Birjand in 2014. Individuals with systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg were considered as hypertensive. Data were analyzed using Chi-square test, independent t-test, and one-way ANOVA. P < 0.05 was considered as statistically significant.Among the 1286 participants, 659 were women (51.2%). Prevalence of HTN was 20.1% (10.3% systolic HTN and 6.9% diastolic HTN). Prevalence self-reported HTN was 12.3%. SBP and DBP means were higher in men (P < 0.001). Mean scores of SBP and DBP increased by aging and body mass index (P < 0.001). Diabetic individuals had higher SBP scores (P < 0.001). Dyslipidemic patients had greater SBP and DBP (P < 0.001).Prevalence of HTN in our study is high. About one-fifth of the participants had HTN. In addition, BP is higher in men, elderly, and diabetic individual. Therefore, it is necessary to control BP regularly in different groups in society.
View details for DOI 10.4103/ijpvm.IJPVM_103_16
View details for Web of Science ID 000402826600008
View details for PubMedID 28584618
View details for PubMedCentralID PMC5450448
The Effects of Statins on Pulmonary Artery Pressure in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.
Journal of research in pharmacy practice
2017; 6 (1): 27-30
Pulmonary hypertension is a serious complication in patients suffering from chronic obstructive pulmonary disease (COPD). The aim of this study is to investigate the effects of atorvastatin in reducing pulmonary arterial pressure in COPD patients.This double-blind, randomized trial was conducted on 42 known cases of COPD with systolic pulmonary arterial pressure of more than 25 mmHg. The patients were randomly assigned into two groups, 21 patients with atorvastatin treatment (40 mg/daily for 6 months) and 21 patients without receiving atorvastatin. All the patients participated voluntarily and provided written informed consent. The trial was registered in the Iranian Registry of Clinical Trials. Pulmonary pressure was also anticipated by Doppler echocardiography with peak pressure gradient of tricuspid regurgitation. Both groups were tested with echocardiography to measure systolic pulmonary pressure at baseline and posttreatment. Statistical analysis includes Chi-square, Student's t-test, and Wilcoxon test. P < 0.05 was considered statistically significant.The mean age was 65.8 ± 11.5 years for atorvastatin group and 63.7 ± 7.6 years for control group (P = 0.45). Baseline and posttreatment mean systolic pulmonary artery pressure (PAP) levels in the atorvastatin group were 48.9 ± 3.3 and 38.4 ± 1.9 mmHg, respectively (P = 0.007). In the control group, mean systolic PAP levels at baseline and 6 months later were 45.6 ± 3.1 and 38.9 ± 2.4 mmHg, respectively (P = 0.073). The patients treated with atorvastatin showed significant decrease in total cholesterol (P = 0.001) and low-density lipoprotein cholesterol (P = 0.008).A 40 mg dose of atorvastatin daily for 6 months may have beneficial effects in reducing PAP in patients with COPD. Further studies are necessary to find long-term effects of statins in COPD patients.
View details for DOI 10.4103/2279-042X.200985
View details for PubMedID 28331863
View details for PubMedCentralID PMC5348853
Risk Factors of Non-Communicable Diseases in Iranian Children: The 25 x 25 Target
IRANIAN JOURNAL OF PEDIATRICS
2017; 27 (1)
View details for DOI 10.5812/ijp.5787
View details for Web of Science ID 000397334300008
The effect of N-acetyl cysteine (NAC) on aluminum phosphide poisoning inducing cardiovascular toxicity: a case-control study
2016; 5: 1948
Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning.This research was a case-control study to evaluate 63 AlP poisoned patients during 2010-2012. Patients with cardiovascular complications of AlP to be treated with intravenous NAC plus conventional treatment were considered as the case group and compared with patients who did not receive NAC. NAC infusion was administered to the case group at 300 mg/kg for 20 h. The data gathered included age, sex, heart rate, Systolic blood pressure (SBP), creatine phosphokinase (CPK), creatine kinase MB (CK-MB), and ECG at the admission time and 12, 18, and 24 h after admission. Analysis of repeated measures was performed to check the variability of parameters over time.The mean ages in the case and control groups were 26.65 ± 1.06 (19-37 years) and 28.39 ± 1.11 (18-37 years), respectively (P = 0.266). Most of the patients were female (56.5%). CK-MB means were significantly different between the two groups, but no differences between the other variables were observed. Also, CK-MB, CPK, heart rate, and systolic blood pressure means became significantly different over time (0, 12, 18, and 24 h) in both groups (P < 0.001). NAC prevented sharp heart rate fluctuations in AlP patients in the case group. Regarding the outcomes, 17 patients died (10 patients in the control and 7 patients in the case groups). No side-effects of NAC were observed.Our patients could be managed by the positive role of NAC as the biochemical index of cardiotoxicity was found to elevate in both the case and control groups. Therefore, for the management protocol optimization, NAC evaluation should be done in further cases.
View details for DOI 10.1186/s40064-016-3630-2
View details for Web of Science ID 000391817000001
View details for PubMedID 27917341
View details for PubMedCentralID PMC5102994
Multistate Models for Survival Analysis of Cardiovascular Disease Process
REVISTA ESPANOLA DE CARDIOLOGIA
2016; 69 (7): 714-715
View details for DOI 10.1016/j.rec.2016.04.009
View details for Web of Science ID 000378376700020
View details for PubMedID 27236274
Survival Analysis of Breast Cancer Patients after Surgery with an Intermediate Event: Application of Illness-Death Model
IRANIAN JOURNAL OF PUBLIC HEALTH
2015; 44 (12): 1677-1684
Breast cancer (BC) is the second most commonly diagnosed cancer after lung cancer. Survival of BC patients is affected by intermediate events. This study was aimed to investigate the disease course of primary nonmetastatic BC patients with first recurrence of the tumor (FRT) as the intermediate event using the illness- death model.This retrospective cohort study was conducted on 529 Iranian females with BC underwent surgery, from 1995 to 2013. Patients, tumor and treatment characteristics were collected from medical records of the patients. The illness-death model were used to investigate the relationship between these factors and survival time. Data were analyzed using version 3.1.1 of R software.The risk of FRT in patients who had tumors size in the range of 2-5 cm and >5 cm was 1.3 and 3.5 times higher than that of patients with tumor size ≤2 cm, respectively (P<0.001). Furthermore, risk of death in patients aged ≥50 years was 1.6 times higher compared to patients aged less than 50 years (P =0.012). Risk of death after metastasis in patients with tumor size >5 cm was 2.1 times higher than patients with tumor size ≤2 cm (P =0.019).The stage of the disease and tumor size have statistically significant effects on patients' survival before occurrence of the FRT. Furthermore, illness-death model was found to be a useful tool in modeling the disease course of BC patients.
View details for Web of Science ID 000367351200012
View details for PubMedID 26811819
View details for PubMedCentralID PMC4724741