[ effect of combined training [hip abductor and external rotators strengthening + balance] on pain and performance in the patients with patellofemoral pain syndrome]

Background and Aim: patellofemoral pain syndrome [PFPS] is an orthopedic disorder of the knee joint which results in pain and impairment of performance. The purpose of this study was to investigate the effect of combined exercise [hip abductor and external rotators strengthening + balance] on pain and performance in the patients with PFPS

Materials and Methods: in this semi experimental study, 20 men with PFPS were selected by purposeful sampling and then randomly assigned to two groups, i.e. experimental [n=10] and control [n=10] groups. The experimental group performed a training program which consisted of hip abductor and external rotators strengthening and balance exercises, 3 sessions per week for eighth weeks. Pain and physical performance in the patients were assessed by Visual Analogue Scale [VAS] and WOMAC respectively, before and after exercise. Repeated measures ANOVA was used to analyze the data. P

Results: the results indicated that the changes and interactions of the two variables of pain [F=14/2 and p=0/001] and physical performance [F=60/2 and p=0/001] were significant in the experimental group [P < 0.05] after exercise. The results also showed that the experimental group, had reduced pain and showed a significant improvement in the physical performance [p<0/05], compared to the control group

Conclusion: considering the effectiveness of training in the improvement of performance and reduction of pain, this training protocol can be useful in the physical rehabilitation of PFPs

[Relation between pattern of nutrient intake and obesity in Isfahanian Adults: SEPAHAN study]

Background and Objective: The growing evidence suggest on the association between dietary patterns and obesity. This study was done to determine the relation between pattern of nutrient intake and obesity in Isfahanian adults

Methods: In this descriptive - analytical study, dietary data were collected using a semi-quantitative food frequency questionnaire in 8,691 subjects aged 18-55 years. Complete data of 6,724 and 5,203 adults were available for general and abdominal obesity, respectively. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis was applied to derive major nutrient patterns

Results: Three major nutrient patterns were identified: 1] pattern high in fatty acids, cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus, and pantothenic acid; 2] high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and 3] high in glucose, fructose, sucrose, vitamin C, potassium, dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model [95% CI: 0.20-0.76, OR: 0.39, P<0.05]. After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men [95% CI: 1.04-3.04, OR: 1.77, P<0.05], but it was not in women [95% CI: 0.74-1.88, OR: 1.18, P>0.05]

Conclusion: Nutrient patterns were significantly associated with general, but not abdominal obesity in the male Iranians participating in SEPAHAN study

Thorax organ dose estimation in computed tomography based on patient CT data using Monte Carlo simulation

Background: this study presents patient specific and organ dose estimation in computed tomography [CT] imaging of thorax directly from patient CT image using Monte Carlo simulation. Patient's CT image is considered as the patient specific phantom and the best representative of patient physical index in order to calculate specific organ dose

Materials and Methods: EGSnrc /BEAMnrc Monte Carlo [MC] System was used for CT scanner simulation and DOSXYZnrc was used in order to produce patient specific phantom and irradiation of photons to phantom in step and shoot mode [axial mode]. In order to calculate patient thorax organ dose, patient CT image of thorax as voxelized phantom was divided to a 64x64x20 matrix and 6.25 x 6.25 x 6.25 mm[3] voxel size and this phantom was imported to DOSXYZnrc code. MC results in unit of Gy/particle were converted to absorbed dose in unit of mGy by a conversion factor [CF]. We calculated patient thorax organ dose in MC simulation from all irradiated slices, in 120 kV and 80 kV photon energies

Results: effective dose was obtained from organ dose and organ weighting factor. Esophagus and spinal cord received the lowest, and bone received the highest dose. In our study, effective dose in CT of thorax was 7.4 mSV and 1.8 mSv in 120 and 80 kV, respectively

Conclusion: the results of this study might be used to provide the actual patient organ dose in CT imaging and calculation of real effective dose based on organ dose

Efficacy and safety of intravenous sodium valproate in convulsive status epilepticus in children in Shahid Sadoughi Hospital

Status epilepticus [SE] is the most common pediatric neurologic emergency with high mortality and morbidity. There is no consensus on the drug of choice in the treatment of children. The purpose of this study was to evaluate the clinical efficacy and safety of intravenous sodium valproate as a third-line drug in the treatment of generalized convulsive SE of children. In a retrospective study, medical records of those children who were admitted to Shahid Sadoughi Hospital of Yazd due to refractory generalized convulsive SE and were treated by intravenous sodium valproate as a third-line drug from 2009 to 2011 were evaluated. Six girls and five boys with a mean age of 5.12 +/- 1.2 years [range: 3 - 9.6 years] were evaluated. Intravenous valproate was effective for cessation of seizures in seven patients [63.6%]. The mean dose of valproate for stopping seizures was 27.1 +/- 1.4 mg/kg/day. Children whose seizures were controlled by sodium valproate were older than non - responsive children [mean +/- SD: 4.8 +/- 1.2 years vs. 3.1 +/- 0.43 years, p = 0.03] and they also had shorter ICU stay days [mean +/- SD: 2.6 +/- 1.4 days vs. 5.6 +/- 2.8 days, p= 0.01]. Two children had mild and transient nausea and vomiting. None of them had cardiopulmonary or severe paraclinical side effects. Intravenous sodium valproate may be used as an effective and safe third-line antiepileptic drug in the treatment of pediatric generalized convulsive status epilepticus

[Prevalence of depression in personnel of Zanjan university of medical sciences]

Depression has been assumed as a prevalent disorder of the era. Depression cannot be attributed to a particular social class. Factors such as incompatible situations may lead to mental disorders and affect physical immunity. This study was carried out to investigate the prevalence of depression among the staff of Zanjan University of Medical Sciences. This study was of cross-sectional type study whereby 693 subjects were selected through classified randomized sampling. The rate of depression incidence was obtained using Standard Beck Questionnaires. The data was analyzed by Chi-2 tests and cohesion indexes of Kramer and Gama were also used. According to the results of this study 40% of the personnel were suffering from depression. They were identified as 23% with low depression, 13% with moderate depression, and 4% with severe depression. A significant correlation was found between depression and education level, type of settlement, and city where they worked. Regarding the widespread prevalence of depression among the staff, planning and organization of consultation sessions by the authorities is suggested

[Nurses' perceptions of barriers to nursing research utilization in clinical environment in Zanjan hospitals, 2010]

Nursing research plays an outstanding role in the quality of care. One strategy to put the research into practice and change current practice is to identify barriers and then implement tailored interventions to reduce them. Therefore, the purpose of this study was to describe Registered Nurses perceptions of barriers to utilization of research results at University affiliated and educational hospitals of Zanjan, Iran. In this cross-sectional study data were collected using the Funk.s Evidence Based Practice Barriers Scale. Sample of the study consisted of 170 graduate nurses employed in Zanjan Educational Hospitals. Descriptive and inferential statistics were applied to analyze the data According to the research results, the first three important barriers were insufficient facilities [65.3%], lack of time to read research results [64.7%], and insufficient time on the job to implement new ideas [62.4%]. However, perceptions of barriers to research utilization did not show a significant difference based on demographic variables of the nursing staff. It is highly recommended that the Zanjan hospitals education styles should be modified in order to provide the nurses with sufficient facilities and time to read and implement recent research findings

Prevalence of depression in personnel of Zanjan University of Medical Sciences

Depression has been assumed as a prevalent disorder of the era. Depression cannot be attributed to a particular social class. Factors such as incompatible situations may lead to mental disorders and affect physical immunity. This study was carried out to investigate the prevalence of depression among the staff of Zanjan University of Medical Sciences. This study was of cross-sectional type study whereby 693 subjects were selected through classified randomized sampling. The rate of depression incidence was obtained using Standard Beck Questionnaires. The data was analyzed by Chi-2 tests and cohesion indexes of Kramer and Gama were also used. According to the results of this study 40% of the personnel were suffering from depression. They were identified as 23% with low depression, 13% with moderate depression, and 4% with severe depression. A significant correlation was found between depression and education level, type of settlement, and city where they worked. Regarding the widespread prevalence of depression among the staff, planning and organization of consultation sessions by the authorities is suggested

Integrating spirituality into a group psychotherapy program for women surviving from breast cancer

In spite of a significant relation between spirituality and hope, happiness and life satisfaction, the effectiveness of spiritual interventions in the mentioned mental strengths has been less dealt with. The present study is conducted in order to determine the effectiveness of spiritual group intervention on the increase of hope, life satisfaction and happiness in women surviving from breast cancer. Sixty women surviving from Breast Cancer were voluntarily assigned in to case and control groups, and were assessed before and after Islamic perspective spiritual intervention by spiritual experience, hope, happiness and life satisfaction questionnaires. Statistical analysis of data was performed using descriptive and inferential statistics through covariance. The spiritual intervention resulted in significant increase of hope, happiness and life satisfaction [P < 0.05]. Spiritual intervention appears to be a potentially beneficial intervention for increasing mental strengths among those suffering from breast cancer. Therefore, it seems necessary to consider it as an important element incomprehensive treatment, plans, and in palliative and supportive care

Ocular dirofilariasis, a case report

Accidental infection with animal filarial worms in humans is a dilemma for clinicians and parasitologists throughout the world. To date a variety of such rare parasitoses have been reported mostly in tropics and subtropics. Human dirofilariasis is among those unusual zoonotic infections that occasionally have been observed in the eye and in subcutaneous areas exhibiting with nodule for mation. Filarial worms are transmitted to humans through invertebrate biological vectors such as certain species of mosquitoes. The present report describes a peculiar case of ocular dirofilariasis in a 49-year-old man resident in Iran

Efficacy and safety of lamotrigine in lennox - gastaut syndrome

The Lennox-Gastaut syndrome [LGS], one of the most difficult epilepsy syndromes to treat, is characterized by a triad of intractable seizures of various types, a slow [< 2.5-hertz] spike-wave pattern in EEG and mental retardation. The aim of this study was to evaluate the efficacy and safety of lamotrigine as add-on therapy in intractable epilepsy of children with LGS. In a quasi- experimental study, 40 children with LGS referred to the pediatric neurology clinic of Shaheed Sadoughi Hospital in Yazd, between August 2007 and to November 2008, were evaluated. Twenty-two boys and 18 girls with a mean age of 4.12 +/- 1.8 years were evaluated. At the end of three months of treatment with lamotrigine, 12% were seizure free, 52% had> 50% reduction in seizure frequency and 12% had increase in seizures. Means of seizure frequency/per week, before and after treatment were 70 [range 1-180] and 18.6 [range 0-60] respectively, indicating effectiveness of the drug in seizure reduction [P value = 0.003]. The drug was effective in 72% of mixed type seizures, 40% of generalized tonic-clonic and 33% of drop attack and tonic seizures. Transient side effects were seen in 12.5% [drowsiness in 3 and ataxia in 2 children]. No serious side effects were seen. Lamotrigine should be considered as an add-on therapy in management of intractable epilepsy in LGS

Utility of laboratory studies in seizures of children older than one month of age

<p><b>INTRODUCTION</b>Seizure is the most common paediatric neurological disease which occurs in ten percent of children. In approaching a convulsive patient, finding the causes of seizure is essential, and the patient's history as well as the physical examination are important. The role of routine laboratory tests for children's seizures (except neonates) is undetermined, but checking for serum sodium, glucose, calcium and urea routinely has been advised. The purpose of this study was to determine the diagnostic efficacy of these serum chemistry tests in the seizures of children older than one month of age.</p><p><b>METHODS</b>In this descriptive, retrospective study, medical records of 302 hospitalised children with seizure were reviewed. Results of laboratory tests, like sodium, calcium, blood glucose and urea levels, pertinent history and physical examination, and the change in patient management based on serum chemistry test results, were analysed. All the children in the study were classified as having seizure with or without fever.</p><p><b>RESULTS</b>In 302 hospitalised children with seizure, about ten percent of 938 tests were abnormal. 27.7 percent of these abnormal results were seen in 1-12-month-old infants. Only 11 percent of abnormal tests (1.3 percent of total tests) might have caused a seizure. Also, 0.2 percent of the results could not be predicted from the history or physical examination, which was conducted in patients younger than one year of age.</p><p><b>CONCLUSION</b>Routine determination of serum chemistry values in seizures of children does not contribute to therapy, and are costly and time-consuming. It may not be helpful and informative unless the patient is less than one year of age.</p>

Senior nursing students skills in patients health assessment in Zanjan university of medical sciences

Assessing patients' health is the base of nursing process. Also finding patients' problems is necessary for designing care plan by nurses and nursing students. This study was performed to determine the proficiency level of senior nursing students in assessing patients' health in Zanjan University of Medical Sciences in the year 2005. In this descriptive cross-sectional study, all senior nursing students of Zanjan University of Medical Sciences [44 students] were studied. The data gathering tools included a questionnaire consisted of demographic data, which was filled by the samples and an observational checklist which was completed by researchers while observing students' performance in assessing patients' health status. Data was analyzed using descriptive statistics methods, independent t-test, and one-way AN OVA by SPSS software. Twenty point four percent of students had a poor performance in assessing patients' health, 68.2% of them achieved moderate score, and only 11.4% were proficient in assessing patients' health. Most senior nursing students were not skillful enough in assessing health status. The collaboration of administrators of nursing in ministry of health and medical education, hospitals, nursing schools and instructors in order to make appropriate planning for this problem seems necessary

Prevalence of attention deficit hyperactivity disorder in 6 year olds of Yazd city

Attention Deficit hyperactivity Disorder [ADHD] is the most common psychiatric disorder in school age children and has a negative effect on the individual's general functions. The purpose of this study was to estimate the prevalence of ADHD in preschool 6 year old children in Yazd in 2005 and the influence of gender, birth weight, birth order and parental education on ADHD. 400 preschool children including 200 boys and 200 girls were selected randomly through sampling method and the data of the cross sectional research was collected via compiled questionnaires based on the DSM-IV criteria and interview of parents. Data of this investigation was analyzed and evaluated using SPSS: 11.5 software. The results showed that general prevalence of ADHD was 16/3% and more in boys [19/5%] than girls [13%]. Most of the parents of the affected children were illiterate or uneducated. There was no statistically significant relationship between gender, birth weight, order and ADHD frequency. In view of the high prevalence of ADHD among children in Yazd and its undesirable outcome, it is recommended to have a preventive mental health program for screening and treatment

Mlasa syndrome: a case report

Mitochondrial myopathy, lactic acidosis, and siderobiastic anemia [MLASA] syndrome is a rare autosomal recessive disorder of oxidative phosphorylation and iron metabolism. The association between myopathy and siderobiastic anemia was initially reported in 1974. Here we report an 8.5 year old boy with normal cognitive function, suffering from chronic progressive weakness in his lower extremities, inability to walk and palor, Microcytic siderobiastic anemia, mild lactic acidosis and inflammatory myopathy [myositis] in muscle biopsy was detected and treated; the response to corticosteroid therapy and rehabilitation was excellent and the patient was ambulatory after four months

Relationship between para clinical findings of first seizure and one year recurrence ra te in children admitted at shaheed Sadoughi hospital-Yazd

Seizure is the most common pediatric neurology problem that occurs in 10% of children. The purpose of this study was to determine the recurrence rate of seizures after one year and its relationship with paraclinical findings of the first attack. In a historical cohort analytic study, 131 children with first seizure admitted to Shaheed Sadoughi Hospital between March 2004 to August 2005 were evaluated for recurrence rate during one year and its relationship with serum levels of sodium, potassium, glucose, calcium, Hb, MCV and PMN during the first attack. 79.4% of cases were in febrile seizure group and 20.6% in first unprovoked seizure group [FUS].Of the total, 27.84% of patients had seizure recurrence [27.9% in febrile and 25.9% in afebrile group]. Mean survival recurrence rate was 10.11 +/- 0.32 SD months [10.25 +/- 0.33 SD months in febrile group and 9.57 +/- 0.83 SD months in FUS]. Survival analysis showed that seizures recurred later in older patients. Younger age and lower Hb levels in the febrile seizure group and lower MCV in the FUS group were associated with an increased risk of recurrence. In this study, anemia and microcytic RBC were risk factors for seizure recurrence. Therefore, more studies should be done so as to decrease seizure recurrence by treating and preventing anemia

IV lidocaine: a second line drug therapy for pediatric convulsive status epilepticus?

Refractory convulsive Status Epilepticus [SE] which does not respond to first line drugs [benzodiazepines, phenytoin and phenobarbital] heralds an emergency condition, in pediatric neurology which can cause irreparable brain damage. There is no consensus on the choice of drug treatment for refractory generalized convulsive status epilepticus in children. Lidocaine is a valuable forgotten antiepileptic agent with favorable properties which include prompt responses, less alteration of consciousness, and fewer adverse effects such as less respiratory depression. In a retrospective study conducted to investigate clinical efficacy and safety of intravenous lidocaine in treating refractory generalized convulsive SE of children, the medical records of 13 patients admitted to the Shaheed Sadoughi Hospital of Yazd between 2003 and 2005 and treated with intravenous lidocaine, were reviewed. 13 patients, 7 girls and 6 boys [average age 3 years, SD=2.7years] were treated with lidocaine. Neurodevelopmental delay was seen in 38.5%, and in 46.2% of them EEG and neuroimaging abnormalities were observed. Seizures ceased in eight patients [61/5%], without any undesirable side effects. Two patients had to be intubated because of non-responsiveness to lidocaine, and other treatments were begun. Mean duration of ICU stay was 4.77 days, SD=3days. It is recommended that lidocaine be used as a second-line, anticonvulsive drug in the treatment of status epilepticus, especially when faced with unavailability of appropriate respiratory care and intubation equipment

[ case report of inflammatory myopathy and sideroblastic anemia]

Mitochondrial myopathy, lactic acidosis, and siderobastic anemia [MLA SA] syndrome is one of the newly reported mitochondrial diseases, seven cases of which have been reported. We report a child with inflammatory myopathy, sideroblastic anemia and lactic acidosis .The patient is a 8.5 year old boy with normal cognitive function suffering from chronic progressive weakness in lower extremities, inability to walk since four months and pallor. In paraclinical evaluation, sideroblastic anemia, mild lactic acidosis and elevated muscle enzymes were seen. Inflammatory myopathy [myositis] in muscle biopsy was detected as well .The patient was administered oral prednisolone, folic acid, B[6] and underwent regular physiotherapy. He ambulated after four months and resumed education and schooling

[Investigation of oral and dental-care procedures in high school students of Zanjan province - 2005]

Regarding the high prevalence of dental caries and its individual complications and the reports concerning the effects of healthy behavior on oral and dental hygiene, this study was carried out with the aim of investigation of different oral and dental-care procedures among adolescent population of Zanjan province during the academic year 2004-2005. This descriptive study was performed on 1500 high school students through multi-stage cluster random sampling. The study tool was researcher-made questionnaire whose validity and reliability had been confirmed through content validity and repeated test respectively. Descriptive statistics and chi [2] test were used to determine the difference among groups [based on a number of demographic features]. The most common dental-care procedure among the students was brushing [89.7%] and statistical tests showed a significant difference in terms of gender [P=0.001], different educational levels [P=0.04], different schools [P=0.02] and different school areas [P=0.001]. The only common dental-care procedure used by the province adolescents was brushing. Hence, planning for various oral and dental-care procedures in adolescent population is highly recommended

Add-on therapy with topiramate in drug-resistant epilepsy

Intractable epilepsy is defined as epilepsies that are not controled with routine pharmacologic therapy. The present study was conducted to evaluate the efficacy and side effects of topiramate as an add-on therapy in drug-resistant [intractable] epilepsies.For this quasi experimental study 42 children who have referred to Mofid hospital with refractory epilepsy were enrolled. The study population included 14 girls and 28 boys, aged 1-15 years. Seizure attacks were not controlled despite receiving 4-13 drugs [mean 9]. Topiramate was added to the patient's drug in a 4-week titration regimen [1st week 3, 2nd week 5, 3rd week 7, and 4th week 9mg/kg]. Then, after 3 months he/she was reevaluated. Of 42 patients, Lennox-Gastaut syndrome, idiopathic epilepsy, symptomatic epilepsy, and progressive myoclonic epilepsy were revealed in 14 [34%], 8[19%], 16[38%], and 4[9%], respectively. After the 3-month add-on therapy with topiramate, 17% became seizure-free and the frequency of seizure attacks decreased by 50% in 26% of the patients, however, attacks were exacerbated in 5%. Fortunately, hematologic, renal or hepatic side effects were not reported, however, mild transient neurologic complications were observed in 12% of the patients. We have noticed a satisfactory response to topiramate, thus, it can be safely prescribed for intractable seizures

Biotinidase deficiency presenting with dermal manifestations of acrodermatitis enteropathica

Biotin is a water-soluble vitamin and co-factor for activation of carboxylases apoenzymes. Biotinidase enzyme is essential for release of biotin from apoenzymes. Absence of biotinidase is an autosomal recessive trait with a prevalence of 1 in 60000. Clinical manifestations of biotinidase deficiency include dermatitis, alopecia, seizures, hypotonia, developmental delay, hearing loss, visual impairment and immunodeficiency. With early diagnosis and treatment with biotin supplements, it is possible to prevent clinical manifestations and neurological deficits. We report a case of biotinidase deficiency with seizures, developmental delay, acrodermatitis enthropathica manifestations and mild compensated acidosis