[Evaluation of lumbosacral manipulation on motoneuronal activity in patients with low back pain]

Spinal manipulation is a manual technique commonly used for the treatment of low back pain. The physiologic mechanisms of spinal manipulation are largely unknown. One basic physiologic response to spinal manipulation [SM] is alternation in Moto neuronal activity, as assessed by the Hoffmann reflex [H-reflex] technique. The purpose of this study was to determine the effect of spinal manipulation on amplitude and onset latency of H-reflexes and on H/M amplitude ratio in patients with low back pain. It was a clinical trial with IRCT201203069222N1 Registration code. Ffifty eight patients with low back pain aged between 20-60 years were included. Tibial nerve H reflex and M wave were recorded before and after Lumbosacral spinal manipulation. The data was analyzed by SPSS 16. Lumbosacral manipulation significantly decrease amplitude of H reflex and H/M amplitude ratio [P<0.05]. It had not significantly effect on H reflex latency or M wave amplitude and latency [P>0.05]. Lumbosacral manipulation produces attenuation of alpha motoneuronal excitability. These findings support of this theory that manual spinal therapy can lead to reduction in muscle tone.

[Eosinophilic granuloma in tenth thoracic vertebra: a case report]

Eosinophilic granuloma is a rare disease that more occurs in children especially bays. It usually presents in flat and long bones. Sometimes skull and vertebral spine is affected. The Case was a 6 years old boy that had back pain from 20 days ago. In physical exam we found a local tenderness on tenth thoracic vertebra. Imaging study includes X-ray and MRI revealed vertebra plana on tenth thoracic vertebra without any periostic reaction or bone formation. Bone scintigraphy showed increased radiotracer uptake only in the tenth thoracic vertebra. With attention to age, gender, clinical features, lab data and imaging study we suspected an eosinophilic granuloma for this patient that histological examination confirmed it. With considering to patient's signs, conservative treatment include thoracolumbosacral brace and long term follow up was used. One of the differentional diagnosis of backpain in children specially in boys is Eosinophilic granuloma

[Serum folate levels in major beta Thalassemia patients]

Beta major thalassemia is a variant of beta thalassemia syndrome which could be treated with bone marrow transplantation or if not available, regular blood transfusion. In the latter case, supportive therapy is the mainstay of treatment because of low folate intake or absorption. But the main cause of insufficient supportive therapy is the increasing need of bone marrow for ineffective erythropoiesis in the absence of regular blood transfusion. The purpose of regular blood transfusion in beta major thalassemia patients is to maintain the range of hemoglobin level between 9 and 11 gr/dl to stop insufficient erythropoiesis completely. Therefore, by regular blood transfusion, supportive therapy with folic acid would not be needed. The aim of this study is to determine serum folate level in regular transfused [3 major thalassemia patients in Mofid Children's Hospital during 2006. This is a cross sectional descriptive-analytic study performed on 100 beta major thalassemia patients receiving regular blood transfusion and desferal. Post-storage leukodepleted blood is used for transfusion. Patients' data is achieved from information data sheets. Serum folate level is determined with Electrochemiluminescence method in one of the most reliable laboratory centers. Normal serum folate level was 3-17.5 ng/ml in this laboratory with the sensitivity of 0.6 ng. Data analysis is performed with SPSS analysis software, and with chi squared, T-test and Spearman test. 56 [56%] girls and 44 [44%] boys entered this study with a median age of 156 [ +/- 71.2] months and an age range of 14-288 months. Patients' median hemoglobin level was 9.5 [ +/- 0.87] g/dl, with minimum of 7.5 and maximum of 11.9 g/dl. Mean MCV was 84.2 [ +/- 4.20] fl, with the range of 73.4 -95.3 fl. Seaim folate level was in the range of 1-19 ng/ml and median of 9 [ +/- 4.9] ng/ml. Serum folate was less than 3 ng/ml in 3% of evaluated patients. Hemoglobin level was equal or more than 9 g/dl in 73% of patients. It seems that if major [3 thalassemia patients receive regular blood transfusion, their serum folate level would be in normal range and supplementation therapy with folate will not be necessary