[Patch therapy in adults with ametropic amblyopia]

To evaluate the effect of patch therapy on visual acuity in adults with ametropic amblyopia. This randomized clinical trial was performed on 66 patients with unilateral ametropic amblyopia aged 9 to 35 years referred to a clinic in Shahroud. The patients were randomly assigned to two groups. In the treatment group, based on the visual acuity of the amblyopic eye, 3-6 hours daily patching of the sound eye with an eye pad was prescribed; no patching was performed in the control group. Visual acuities of both eyes were compared between the two groups before and 3 and 6 months after patch therapy. Mean age of patients was 16 +/- 4.6 years in the treatment group and 17.2 +/- 7.1 years in the control group [P=0.42]. Mean visual acuity was 0.39 +/- 0.17 LogMAR before patch therapy which increased to 0.19 +/- 0.09 LogMAR after 3 months and 0.07 +/- 0.03 LogMAR after 6 months in the treatment group [P<0.001]. There was no significant change in mean visual acuity of the control group during the same period. There was no significant difference between mean visual acuity of the treatment group based on duration of daily patching. This study revealed that patch therapy on the sound eye can improve visual acuity in amblyopic eye in adults and that age is not an obstacle for this promotion. Therefore, use of patch therapy is recommended for rehabilitation of adults with ametropic amblyopia

Effect of manual lymph drainage massage on hand edema and shoulder pain in hemiplegic-paretic patients post stroke

Shoulder pain and hand edema associated with hemiparesia and hemiplegia are common complications after the stroke and restricts the patient's daily activities. Therefore, this study was conducted to evaluate the effect of manual lymph drainage [MLD] massage on hand edema and shoulder pain in hemiplegic-paretic patients post stroke. In this randomized clinical trial study, 62 stroke patients with age ranging of 35-70 years and having shoulder pain and hand edema associated with hemiparesia or hemiplegia were selected and randomly divided into two groups of case and control. Then, manual lymph drainage massage [MLD] was performed in the case group for five sessions and each session last 20 minutes. The MLD was not performed for the control group. Sensory, affective, intensity and general condition of shoulder pain and also circle size of wrist and middle part of the arm were assessed using of McGill Pain Questionnaire-Short Form: [MPQ-SF] and tape gauge, before and 24 hours after last session of MLD in both the case and control group. The acquired data were analyzed using independent t and paired t-tests. The means of sensory components of shoulder pain before and after massage was 2.3 +/- 0.9 and 1.3 +/- 0.4, respectively [p<0.05]. Based on the Visual Analogue Scale [VAS], the mean of shoulder pain intensity, after massage, in the case and control group was 3.3 +/- 1.2 and 4.8 +/- 1.5, respectively. The mean of arm circle size before and after massage in the case group was 29 +/- 4.6 and 28.1 +/- 3.9 centimeter, and in the control group was 29.4 +/- 4.1 and 29.7 +/- 3.9 centimeter, respectively [p<0.05]. Also, the mean of wrist circle size, before and after massage in case group was 17.2 +/- 1.1 and 16.4 +/- 0.9 centimeter, while in the control group, it was 16.9 +/- 0.8 and 17.1 +/- 1.1 centimeter, respectively [p<0.05]. Based on the results of this study application of MLD by the health care personnel would be effective in prevention or decrease of shoulder pain and hand edema

[Evaluation of quality of life in patients with diabetes mellitus, based on its complications, referred to Emam Hossein Hospital, Shahroud]

Diabetes mellitus is an important and global health problem and is the seventh leading cause of death in the United States. It causes a high mortality and produces many personal, familial, social and financial problems. This study was performed to evaluate quality of life in diabetic patients based on the complications. ????This study was performed on 150 patients with diabetes mellitus selected by unrandomized sampling from patients referred to Shahroud Imam Hossein hospital. Based on the disease complications the sample was divided into 4 groups: without complication, microvascular complication, macrovascular complication and miro-macrovascular complication. Quality of life was assessed in physical, emotional and social aspects with audit of diabetes dependent qoL [ADDQoL] questionnaire. Average age of the sample was 59 years. 79.3% of patients were married, 62.8% were uneducated, 78.7% of patients did not have any educational course about diabetes mellitus. The mean of the total score of the quality of life in without complication group was 60.4 +/- 11.6, in microvascular complication group was 56.4 +/- 10.4, in macrovascular complication group was 61 +/- 7.8 and in micro-macrovascular complication group was 50.1 +/- 11.7. The quality of life of 4 groups was significantly different [ANOVA, P<0.05]. There was not a significant correlation between demographic variables and the quality of life score. The results showed that diabetes mellitus complications have significant and advert effects on the quality of this patient's life. Therefore, rapid diagnosis of the disease and its complication and use of appropriate therapeutic strategies in prevention or decreasing the complication is essential

[ comparison of acute and delayed psychological effects of motor vehicle accidents in individuals referred to Imam Hossein Hospital of Shahroud in 2004]

Psychological complaints are common after motor vehicle accidents [MVA] and might be strong predictors for long term complications and problems of the accidents. This study was performed to compare the acute and delayed psychological complications of MVA in Shahroud. The sample consisted of 42 MVA victims selected by unrandomized sampling from those referred to Imam Hossein hospital. The general health questionnaire [GHQ] and symptom checklist-90-revised [SCL-90-R] were used for evaluating psychological symptoms and screening psychological patients. The mean scores of each psychological dimension in 4 phases: reception time, one, three and six months after the accident were obtained and were compared with statistical tests [t-test, repeated measures ANOVA and one-way ANOVA]. The average age of the sample was 24.4 +/- 8.5 years. The mean score of all psychological dimensions, except summarization and obsessive compulsive dimensions, increased from reception time to one month and 3 months later [p<0.05]. Then the scores decreased to 6 months after the accident time [p<0.05]. Three months after the accident time, unmarried patients had a higher score of depression compared to the married ones [p<0.05]. The mean scores of depression, phobic, paranoid and psychoticism were higher [p<0.05] in unemployed versus employed persons. Based on our results, the psychological problems started from accident time until 3 month later. Therefore, the fast and early diagnoses of the complications, use of appropriate pharmacological and psychological interventions, also effective planning for their rehabilitation are both essential and important