[Comparing the effect of acupuncture and oral piroxicam in reduced pain and improved function of patient with chronic mechanical low back pain]

Low Back pain [LBP] is extremely common. Studies have shown life time prevalence as high as 84%. Mechanical chronic LBP [mechanical CLBP] is the leading cause of LBP that have a multifactorial cause, which includes functional instability, abnormal posture and emotional stress. Treatment of these patients is aimed to reduced pain, maintaining mobility, and minimizing disability. This study compares acupuncture vs. oral prioxicam in the reduced pain and Active Daily living [ADL] improvement in mechanical CLBP. In a randomized trial, 52 patients with mechanical CLBP were recruited using strict inclusion and exclusion criteria from Shiraz medical university clinics. All patients classified two groups: A group received acupuncture [2 sessions per week] and B group received Oral piroxicam [30 mg/day] for 2 weeks respectively. Evaluation tools were pain intensity [VAS] and ADLs at baseline, after and 4 weeks after treatment. The analyses of variance showed that means VAS of group A was 7.39 +/- 0.42, 3.88 +/- 0.96 and 3.02 +/- 0.52, and group B was 7.12 +/- 0.61, 4.55 +/- 0.93 and 3.91 +/- 0.28 at baseline, after and 4 weeks after treatment, respectively [p<0.005]. Acupuncture was more effective than oral piroxicam in the reduced pain intensity and ADLs improvement of patients. However, preliminary results suggest that Long- term continuous treatment with acupuncture sustains the effectiveness in pain reduction

[Diabetes diagnostic indexes and self efficacy of diabetic patients referred to Nader Kazemi center, Shiraz 2006]

Diabetes as a chronic disease demands special self care behaviors lifelong. Self efficacy is a basis for promoting self care behaviors in diabetes which play a major role in treatment and control of the complications. The study aimed at assessing the self efficacy of diabetic patients and its related factors. This cross sectional study was conducted with 100 diabetic patients, recruited through simple random allocation. Data were collected using the DMSES Questionnaire as well as checking FBS and HbA1c at the laboratory of the center. All statistics were computed using the SPSS software [P-value<0.05]. Correlation between self efficacy [with a mean score of high: 147 [11%], medium: 89 [36%] and low: 57 [53%]] and diabetes diagnostic index [HbA1c= 10.24] was negatively significant [r=0.76]. It was also significant differences between single and married as well as educated and illiterate persons regarding their self efficacy scores. Self efficacy in diabetic patients is not at a desirable level which needs to be promoted within self care programs

[ effect of a stretching- strengthening exercise program on decreasing pain index on workers with musculoskeletal complaints]

Musculoskeletal disorders are the leading cause of disability among people during working years which impose high expenses on the society in different aspects. this study was conducted to assess the effect of a stretching- strengthening exercise program on decreasing pain index on workers with musculoskeletal complaints. This quasi-experimental study was done on cleaning unit workers in one of the factories producing hygiene instruments in Shiraz in 2006. All the fifty four employees were considered in our study. First, all workers were evaluated by the physiatrist under complete musculoskeletal examination and pain intensity was assessed by VAS and BPI indices. After 3 months, to confirm the chronicity of symptoms, the second examination was done and then exercise program was recommended for 3 months. The collected results were analyzed by SPSS software and non-parametric Wilcoxon test. The primary mean of the VAS index was 5.00 +/- 2.27cm while after 3 months it was raised to 5.32 +/- 2.76 cm and reduced to 1.98 +/- 2.07 after doing exercise program, which is a significant decline [p<0.001]. Mean of different indices of BPI showed significant decrease after completing exercise program [p<0.001]. Doing an exercise program based on type of work, and availability of facilities in work environment is effective in decreasing musculoskeletal complaints as a primary cause of disability among workers

Comparison of validity of decision rules in identifying primary osteoporosis in post menopausal women: a comparison

Clinical decision rules have been designed and developed to assist physicians in identifying the patient with osteoporosis. The aim of this study was to evaluate the performance of three decision rules in an Iranian post menopausal population. Three osteoporosis risk indices, the osteoporosis self assessment tool [OST], osteoporosis risk assessment instrument [ORAI], and the body weight criterion for 5573 out patients without any risk factors for secondary osteoporosis or receiving active bone medication and with negative history of prior fragility fraction were calculated. BMD at spines and femoral neck were measured via dual x-ray absorptiomety and the patients categorized to normal, osteopenic and osteoporotic according to WHO criteria. The sensivity, specifity, positive predictive value negative, predication value and area under receiver operating curve in identifying the osteoporotic women were determined for each decision rule and compared. In this study, the prevalence of osteoporosis was 30.8%, 20% in lumbar spines and neck of femur, respectively. The sensivity of these risk indices in indentifying women with osteoporosis ranged from 70% to 84/1% and the specificity ranged from 44.6-65.6%. The area under curve [ROC] in identifying those patients with osteoporosis was significantly better for OST [0.75] and ORAI [0.74] compared with the body weight criteria [0.66]. The negative predicative value ranged from 80% to 93%, while positive predication values ranged from 33% to 54%. Our data provide evidence showing OST, ORAI to be useful clinical tools, assisting clinicians in making decisions regarding which women need to be to referred for BMD testing but more evidence however needed is to confirm validity of body weight criterion