Does Baseline Mental Health Influence Outcomes among Workers’ Compensation Claimants Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion?

Methods@#WC recipients undergoing single-level MIS TLIF were identified. PROMs of Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), 12-item Short Form Physical and Mental Composite Scale (SF-12 PCS/MCS), and Patient-Reported Outcomes Measurement Information System Physical Function evaluated subjects preoperatively/postoperatively. Subjects were grouped according to preoperative SF-12 MCS: <41 vs. ≥41. Demographic/perioperative variables, PROMs, and MCID were compared using inferential statistics. Multiple regression was used to account for differences in spinal pathology. @*Results@#The SF-12 MCS <41 and SF-12 MCS ≥41 groups included 48 and 45 patients, respectively. Significant differences in ΔPROMs were observed at SF-12 MCS at all timepoints, except at 6 months (p≤0.041, all). The SF-12 MCS <41 group had worse preoperative to 6-months SF-12 MCS, 12-weeks/6-months VAS back, 12-week VAS leg, and preoperative to 6-months ODI (p≤0.029, all). The SF-12 MCS <41 group had greater MCID achievement for overall ODI and 6-weeks/1-year/overall SF-12 MCS (p≤0.043, all); the SF-12 MCS ≥41 group had greater attainment for 6-month VAS back (p=0.004). @*Conclusions@#Poorer mental functioning adversely affected the baseline and intermediate postoperative quality-of-life outcomes pertaining to mental health, back pain, and disability among WC recipients undergoing lumbar fusion. However, outcomes did not differ 1–2 years after surgery. While MCID achievement for pain and physical function was largely unaffected by preoperative mental health score, WC recipients with poorer baseline mental health demonstrated higher rates of overall clinically meaningful improvements for disability and mental health

Prevalence of sexual dysfunction in Saudi women with type 2 diabetes: is it affected by age, glycemic control or obesity?

Objective: Sexual dysfunction [SD], as a diabetes mellitus [DM]-related complication, is common among patients having diabetes. This study aimed to ascertain the prevalence of SD in Saudi women with type 2 DM and to determine whether age, glycemic control, and obesity are associated with SD or not

Methods: A total of 275 Saudi women with type 2 diabetes took part in this cross-sectional study and filled out the Female Sexual Function Index through a fill-coded questionnaire in primary care clinics in King Khalid University Hospital, Riyadh, in the period between January 2013 and May 2013. The level of glycosylated hemoglobin and the body mass index were assessed to evaluate the DM control status and obesity among the patients

Results: SD was reported by 88.7% of the Saudi women with type 2 diabetes. The results showed a significant association between the presence of SD and the increase in age of patients at 92% in the age group above 50 years. Glycemic control did not show a significant association with SD. The obesity factor showed a slight increase in SD by weight, but it was not statistically significant

Conclusion: The prevalence of SD among the Saudi women having type 2 diabetes is high and increases with age. No association was found between SD and glycemic control

Physicians' awareness of guidelines concerning diabetes mellitus in primary health care setting in Riyadh KSA

Objective: this study probed the physicians' awareness of guidelines concerning diabetes mellitus in primary care setting in Riyadh

Methods: this cross-sectional study was conducted in 15 health-care centres and in two university hospitals from May to November 2015. A self-administered questionnaire based on the American Diabetes Association's standard of care was administered to 146 family physicians, and the data were collected for further analysis

Results: as many as 71.3% of respondents were aware of the guidelines. There was a significant difference between physicians' opinion regarding blood glucose levels to confirm diagnosis in patients without symptoms [odds ratio = 2.500; 95% confidence interval 1.191-5.248]. In addition, there was significant variation between physicians holding different qualifications regarding the routine investigations [odds ratio = 6.754; 95% confidence interval 1.425-32.025]. Regarding diagnosis of microalbuminuria, there was significant difference between physicians who had /=10 years [odds ratio = 2.213; 95% confidence interval 1.046 -4.680] and also between different positions [residents and those with post qualification; registrars, senior registrars and consultants] [odds ratio = 2.514; 95% confidence interval 1.185-5.333]

Conclusions: this study demonstrated that family physicians were not fully aware of the latest guidelines about diabetes mellitus. This lack of knowledge may result in fewer adherences to the guidelines and might have a negative impact on quality of care

Camparison of oral candida flora in patients with coronary atherosclerosis and healthy people

Coronary atherosclerosis is a common disorder of the arteries and may block the arteries and cause heart disease. Recently several studies have indicated a role of infectious agents in atherosclerosis and obstructive coronary artery disease. Candida species are normal flora of the human oral cavity and can enter in the blood stream and damage inner walls of coronary arteries by several mechanisms. Thus this study was done to compare the oral candida flora in healthy people and patient with coronary atherosclerosis. In this study, we compared oral candida flora in 90 patients with coronary atherosclerosis and 90 healthy people. All specimens were obtained from oral cavity by swab and cultured on CHOROMagar Candida medium. Identification of isolated colonies was done by RapID yeast plus system. The data were analyzed using the chi-square test. In this study 55.4% [N=61] of patient and 44.6% [N=49] of control group had candida colonization in their oral cavity. Candida albicans was the most common species isolated in both groups. Candida glabrata, Candida krusei, Candida tropicalis and Candida parapsilosis were the most common non albicans species. Although no significant difference was observed between candida colonization in patients and controls, the differences between isolated colony numbers in patient and healthy group were significant [p=0.001]. Hypercolonization of candida species in oral cavity may lead to invasion and enter the organism in the blood stream and damage the coronary arteries

Fate of atrazine in the agricultural soil of corn fields in Fars Province of Iran

Atrazine, a herbicide widely used in corn production, is frequently detected as pesticide in water resources. In this research, four agricultural fields with a long history of atrazine application in Shiraz and its vicinity in Fars province of Iran, have been studied to determine the fate of atrazine through the passage of time. These four farms were cultivated under a crop rotation [corn-wheat] during the past 10 years. Samples were collected from four soil profiles of 0-10, 10-20, 20-40, and 40-60 cm soil depth at different times. The time intervals for soil sampling started before atrazine application and continued until no atrazine was detected. According to the general linear model, there was no significant difference between atrazine residual concentrations and the soil moisture and depth [p?0.05]. But, significant difference between atrazine residual concentrations and the sampling regions was observed [p<0.001]. Based on the data, atrazine leaching and dissipation rate in different soil profiles in the four sampling regions were high and significant. Therefore, there is a high risk of atrazine pollution in groundwater resources of the region

frequency of psychiatric symptoms in patients admitted for surgical treatment of lumber discal hernia

Chronic low back pain is a complex condition produced by multiple factors. There are small researches about the frequency of Psychiatric disorders in discal hernia in Iran. This study investigated the psychological aspects of low back pain in a group of patients. The aim of this study is to evaluate the frequency level of psychiatric symptoms in patients with discal hernia. This research is a descriptive and cross sectional study. The psychological aspects were evaluated by using the Persian version of symptoms checklist-90-Revised [SCL-90-R]. The evaluation was carried out on 40-patients in the neurosurgery wards of the hospitals related to Islamic Azad University of Mashhad. The patients were diagnosed as suffering from lumbar discal herniation. Most of the patients were complaining about severe and chronic pains. The global index of the illness in our research was 1.09 and the most common disorders were found to be paranoid ideation and depression. The relation between pain severity and most common scores of the subscales of SCL-90-R is assessed. it showed higher association of paranoid ideation with 3, 4-5, 7-9, 10 level of pain and obsession and compulsion with score of 6. Patients had higher scores in all scales of the SCL-90-R. This research showed that the frequency of psychiatric symptoms in patients with lumbar discal herniation and low back pain is more than the general population of Iran

Seroprevalence of hepatitis B and C infections among young adult males in Pakistan

This descriptive, cross-sectional study was conducted at 2 military hospitals in Pakistan from January 2004 to December 2005. Young adult males with age range 17-22 years from different districts of Pakistan were screened for hepatitis B surface antigens [HBsAg] and anti-hepatitis C antibodies [anti-HCV]. Out of 5707 young men tested, 95 [1.70%] were positive for anti-HCV and 167 [2.93%] for HBsAg. Although both viruses were distributed evenly throughout Pakistan, seroprevalence was higher in the provinces of Punjab and Sindh than in North-West Frontier province and Baluchistan and Azad Kashmir provinces. Health education to the general public, including barbers, would be an important tool for control/preventive measures

Prediction of preeclampsia and low birthwejght for gestation by uterine and umbilical arteries blood flow velocity waveforms analyses in low risk nullipafious women

To assess the predictive performance of Doppler abnormalities of uterine and umbilical arteries blood flow velocity waveforms [uterine artery protodiastolic notch, Systolic/Diastolic ratio; S/D and Resistive Index; RI] to predict Preeclampsia; [PE] and Intrauterine Growth Restriction;[IUGR]. A prospective study included 70 low risk nulliparous women at 19-26 weeks of gestation, in the Obstetrics unit at Al-Yarmouk Teaching Hospital in Baghdad in the period from January 2004 to January 2005. Their arterial blood pressure; was measured, as they underwent transabdominal ultrasound and pulsed Doppler examinations for evaluating the uterine and umbilical arteries blood flow velocity waveforms, for predicting the development of Preeclanipsia and/or Intrauterine Growth Restriction later in pregnancy when the same women were reexamined at 30-35 weeks of gestation and then followed at delivery time. The incidence of the outcome was 37.1%. All the abnormalities of the studied Doppler indices were not significantly associated with preeclampsia and intrauterine growth restriction as reflected by the variable sensitivities [9.5% to 100%], specificities [29.5% to 97.4%] and low positive predictive values at pretest probability of 10% [12.3 to 28.9]. Uterine and umbilical arteries Doppler blood flow velocity waveforms analysis does not fulfill the requirements for a screening test in unselected low risk population, but may be useful in selected high risk population

Genetic diversity in Egyptian buffalo using microsatellite markers

Three bovine microsatellite markers named: ETH02; CSSM060 and BM1706 were used to study the genetic diversity in six Egyptian buffalo populations. The total number of animals sampled were 92, and collected from Alexandria, Kafr El-Sheikh, Great Cairo, Menofya, Al-Minya and Qina. All markers showed polymorphism with a total number of alleles 12 for each of ETH02, and BM1706 and 13 for CSSM060. Heterozygosity and Wright's F-statistics [F[IS], and F[ST]] were calculated to determine the genetic variation in these populations. High values of observed heterozygosities were noticed in all populations. The lowest heterozygosity was 0.846 observed in Qina for the microsatellite BM1706, in contrast to heterozygosity 1.00 observed in many populations, especially for the microsatellite ETH02. All the F[Is] values were below zero, indicating the absence of inbreeding within the populations under study. Depending on the genetic distances, a dendrogram showing the genetic relationship among the different populations was prepared. High values of the average gene diversity were noticed, for all markers and all populations, ranging from 0.795 to 0.904 with an overall mean of 0.867. Values of gene flow or migration between populations were high, meaning that migration and admixture could have taken place between these populations. It is concluded that the Egyptian buffaloes belong to one breed

Upper Airway Volume Segmentation Analysis Using Cine MRI Findings in Children with Tracheostomy Tubes

OBJECTIVE: The purpose of this study is to evaluate the airway dynamics of the upper airway as depicted on cine MRI in children with tracheotomy tubes during two states of airflow through the upper airway. MATERIALS AND METHODS: Sagittal fast gradient echo cine MR images of the supra-glottic airway were obtained with a 1.5T MRI scanner on seven children with tracheotomy tubes. Two sets of images were obtained with either the tubes capped or uncapped. The findings of the cine MRI were retrospectively reviewed. Volume segmentation of the cine images to compare the airway volume change over time (mean volume, standard deviation, normalized range, and coefficient of variance) was performed for the capped and uncapped tubes in both the nasopharynx and hypopharynx (Signed Rank Test). RESULTS: Graphical representation of the airway volume over time demonstrates a qualitative increased fluctuation in patients with the tracheotomy tube capped as compared to uncapped in both the nasopharyngeal and hypopharyngeal regions of interest. In the nasopharynx, the mean airway volume (capped 2.72 mL, uncapped 2.09 mL, p = 0.0313), the airway volume standard deviation (capped 0.42 mL, uncapped 0.20 mL, p = 0.0156), and the airway volume range (capped 2.10 mL, uncapped 1.09 mL, p = 0.0156) were significantly larger in the capped group of patients. In the hypopharynx, the airway volume standard deviation (capped 1.54 mL, uncapped 0.67 mL, p = 0.0156), and the airway volume range (capped 6.44 mL, uncapped 2.93 mL, p = 0.0156) were significantly larger in the capped tubes. The coefficient of variance (capped 0.37, uncapped 0.26, p = 0.0469) and the normalized range (capped 1.52, uncapped 1.09, p = 0.0313) were significantly larger in the capped tubes. CONCLUSION: There is a statistically significant change in airway dynamics in children with tracheotomy tubes when breathing via the airway as compared to breathing via the tracheotomy tube.

Outpatient management of type 2 diabetic patients: a review of evidence-based literature

Diabetes mellitus is a common, serious, and treatable disease. Good control is associated with fewer complications. The impact of the disease on the patient, family and the community psychologically and physically is staggering. This paper aims to update the reader on certain issues related to the management of diabetes. Recent criteria for the diagnosis are presented followed by non-pharmacological and pharmacological management, glycemic monitoring, prevention, continuity of diabetes care and the control of co-morbidities. Throughout, as far as possible, the best available evidence was used

[Anti-inflamnatey effect of 15 percent benzydamin mouth wash onmoderate periodontits patients]

The periodontal inflammation is one of the most common oral and dental diseases. Periodontitis is advanced periodontal bacterial infection. At present treatment of this disease is oral hygiene instructions, scaling and root planning, plaque control with different mouth washes and in some cases, periodontal surgery. In this investigation, Benzydamin was used as mouth wash which has anti pain and anesthetic properties. The purpose of this research was to study anti-inflammatory effects of using Benzydamin mouth wash 0.15 percent on moderate periodontitis. This was a clinical test study, which has been done in Isfahan University [School of Dentistry]. Sample included 80 patients, [52 female and 28 male] with an average age of 27years. Patients who had moderate periodontitis were tested and divided into 40 person group [case and control]. In both groups before performing the firt phase of treatment, index of gingival inflammation and bleeding index was determined. In case group, patients were given both oral hygience instructions and oral Bensydamin month wash. In control group only oral hygiene instructions were given to them. After one week, both case and control groups were recalled and once more indexes determined and then average was made. Acording to statistical formulas descriptive statistic and t-tests, curves and tables were made. The mean for bleeding index before clinical test were 2.01 and 1.7 and after clinical test were 1.22 and 1.27 for both case and control groups. These differences between two groups were significant. But the mean for gingival inflamation index before and after clinical test were 2.18, 2.01 and 1.87, 2.03 which in both stages. Their differences were not significant. Rsults indicate Benayamin month wash will decrease gingival bleeding and to lesser extend gingival inflamation. In control group, bleeding index was decreased slightly which can be due to oral hygiene instructions

Chronic liver disease among Egyptian military persons: contribution of hepatitis virus infections

In Egypt, viral hepatitis is the major cause of chronic liver disease and liver cirrhosis. The aim of this work is to estimate the frequency of hepatitis virus infections among military persons with chronic liver disease. One hundred and ten male military personnel having chronic liver disease [CLD] were subjected to laboratory investigations including hepatitis viral markers, abdominal ultrasonography and liver biopsy. They were divided into three groups according to results of hepatitis B virus [HBV] and hepatitis C virus [HCV] seromarkers. Group I comprised 31 patients [28.2%] who had evidence of HBV infection, group II comprised 53 patients [48,2%] who had evidence of HCV infection, and group III comprised 26 patients [23.6%] who had evidence of both HBV and HCV infection. Age group

Atrazine adsorption desorption behavior in Darehasaluie Kavar corn field soil in Fars province of Iran

Adsorption desorption behaviors of widely applied atrazine soil were studied, employing a batch technique as a case study in Darehasaluie Kavar corn field in Fars Province in 2005. Samples were collected into 0 to 20 cm soil depth, where was cultivated under a crop rotation [corn-wheat] during the past 10 years. Sorption kinetics exhibited two phenomena: an immediate rapid sorption [1.31 microg/g soil after 12 hours] followed by a slow sorption process [1.37 microg/g soil after 24 hours]. Desorption behavior of atrazine was similar to its adsorption, but at a very slower rate. Atrazine desorption efficiencies were much less effective and incomplete even after a long equilibration time [only 9.16% after 96 hours]. The adsorption-desorption rate for most of the time was positively related to the amount of applied atrazine and the time required for equilibration [P<0.01]. Desorption data exhibited hysteresis phenomena. Atrazine adsorption data described well according to Freundlich [r2=0.95], Langmuir [r2=0.82] and Temkin [r2=0.84] isotherms. However, the fit to Freundlich adsorption model in a non linear form [1/n <1] was closer than the others. Desorption isotherm could be well described by the Temkin [r2=0.96] and Freundlich [r2=0.92] isotherms, but the fit to Temkin model was closer than that of Freundlich

Student screening for inherited blood disorders in Bahrain

In Bahrain and neighbouring countries inherited disorders of haemoglobin, i.e. sickle-cell disease, thalassaemias and glucose-6-phosphate dehydrogenase [G6PD] deficiency, are common. As part of the National Student Screening Project to determine the prevalence of genetic blood disorders and raise awareness among young Bahrainis, we screened 11th-grade students from 38 schools [5685 students], organized lectures and distributed information about these disorders. Haemoglobin electrophoresis, high performance liquid chromatography, blood grouping and G6PD deficiency testing were performed. Prevalences were: 1.2% sickle-cell disease; 13.8% sickle-cell trait; 0.09% beta-thalassaemia; 2.9% beta-thalassaemia trait; 23.2% G6PD deficiency; 1.9% G6PD deficiency carrier. Health education, carrier screening and premarital counselling remain the best ways to reduce disease incidence with potentially significant financial savings and social and health benefits

Extractive spectrophotometric determination of some skeletal muscle relaxant drugs through ion-pair formation with molybdenum [V] and thiocyanate

A spectrophotometric procedure was developed for the determination of orphenadrine citrate [I], tizanidine hydrochloride [II] and pancuronium bromide [III]. The method was based on ion-pair complex formation with molybdenum [V] thiocyanate complex in an acidic medium. Dichloromethane was used for the extraction of the orange red ion-pair and its absorbance was measured at 470 nm. The molar absorptivities were 1.34 x 104, 1.19 x 104 and 4.35 x 104 1 mol-1 cm-1 for I, II and III, respectively. The ion-pair was stable for more than one day at room temperature. The proposed method was applied successfully for the analysis of samples in bulk powder and in dosage forms with recoveries in the range of 99-101%, 99.8-101.4% and 98.9-101.2%, respectively

Spectrophotometric microdetermination of ampicillin and cloxacillin in pure form, mixtures and in pharmaceutical preparations using bromothymol blue

A simple, accurate and highly-sensitive spectrophotometric method for the rapid determination of ampicillin trihydrate and cloxacillin sodium in the pure state, their mixtures and pharmaceutical preparations was described. The method is based on the formation of deep color complexes by the reaction of ampicillin trihydrate [amp.] or cloxacillin sodium [clox.] with bromothymol blue [BTB] at 25 and 50C +/- 2C, respectively, in basic solution containing 30% [v/v] acetone. The effect of pH, time, temperatures, solvent and amount of BTB have also been studied. Beer's law is obeyed within the concentration range 0.4-18 and 0.4-20 mug/ml of amp. and clox., respectively, whereas the optimum concentration ranges as evaluated by Ringbom's method are 1-16 and 1-17 mug/ml, respectively. The specific absorptivity, molar absorptivity, Sandell sensitivity, standard deviation and recovery% are evaluated. The method has been used to determine each of amp. and clox. in pure form, synthetic binary mixtures and pharmaceutical preparations [capsules, vials, syrup and drops] containing both of them

Granulosa cell tumor: Clinical review of four cases.

Patients with a diagnosis of granulosa cell tumor should be followed carefully for the Rest of their lives. Patients treated with surgery only, develop recurrent cancer. Management of recurrent cancer should be aggressive debulking surgery followed by combination chemotherapy. The first choice of chemotherapy is the [cis-platinum, adriamycin, cyclophosphamide]. Hormonal therapy may play a role in managing recurrent disease but the experience is extremely limited. Recently patients with stage I [A] were treated with aggressive surgery plus chemotherapy and hormonal treatment. Review of the experience at Yarmouk Teaching Hospital provided two additional patients with a confirmed diagnosis of granulosa cell tumor of the ovary whom their treatment has been substituted with hormonal treatment of whom all are alive and disease free except one who died because of failure to follow up the treatment. A review of clinical and morrhage which was found to be a frequent preterminal event in advanced recurrent granulosa cell tumors. We are trying here to use the hormonal treatment as an important drug after surgery and to be continued after chemotherapy is stopped

Isokinetic peak torque of hamstrings and quadriceps with chest stabilization

The purpose of this study was to determine whether chest stabilization had an effect on the isokinetic peak torques of the quadriceps and hamstrings. Fifteen [15] female subjects [aged 18 to 30] quadriceps and hamstrings peak torque were tested on the Cybex II dynamometer at sixty [60] deg/sec at two [2] sessions with and without chest stabilization. The subjects were given three [3] warm-up repetitions followed by five [5] maximum repetitions of knee flexion and extension. The computerized data reduction on the Cybex II calculated and recorded the results of the peak torque of the quadriceps and hamstrings. Chest stabilization did not significantly influence the quadriceps peak torque [t= .1345] or influence the hamstring peak torque [t= 2.095] at sixty [60] deg/sec