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Background and Objective: Lower back pain is one of the common discomforts of the occupational-musculoskeletal system, and the scope of motion measurement is important for assessing the effectiveness of therapeutic interventions. This study was carried out to evaluate the reproducibility of the modified-modified Shober's technique [MMST] in measuring the range of motion of lumbar in patients with non-specific chronic low back pain
Methods: In this descriptive-analytic study, the range of motion of lumbar [flexion and extension] of 15 patients with non-specific chronic low back pain was measured in three times with modified -modified Shober's technique by two physiotherapists. To achieve this, the correlation coefficient [ICC] was used. Two measurements with an interval of one hour and one week were run to evaluate the reproducibility within-days and between-day, respectively
Results: Flexion and extension were measured by the first assessor in within-day that showed a high reproducibility for flexion [ICC=0.88] and extension [ICC=0.71], findings also revealed an acceptable ICC for flexion [ICC=0.85] and extension [ICC=0.68] in between-days
The second assessor measurements of flexion and extension in whiten-day also presented high reproducibility for flexion [ICC=0.85] and extension [ICC=0.76]; moreover, in between-days evaluation, correlation was found for flexion [ICC=0.81] and for extension [ICC=0.71]
Conclusion: This study showed that the modified-modified Shober's technique is applicable for measuring the reproducibility of range of lumbar motion in patients with non-specific chronic lumbar pain
Subject(s)
Humans , Chronic Pain , Lumbar Vertebrae , Physical Therapists , Reproducibility of Results , Range of Motion, ArticularABSTRACT
Introduction: decentralization is known an improve process and Promotion of health system and Inevitable part of wide reforms to promote equity, efficiency, quality, Economic justification. Administrative assignment is a method for Decentralization of government. The aim of this study was Comparison of Efficiency and Effectiveness of Karaj Shahid Rajaie Hospital before and after decentralization
Methods: this study was analytical and Comparison. Undertaken work cross - sectional. The data were collected via the questionnaire and Data collection form. After of data collection of before and after decentralization analysis was carried out with the SPSS 19 software and Statistical methods used are descriptive and analytical statistics [Mann-Whitney U]
Results: after of decentralization inpatient beds 4.8%, occupation beds 3.6%, percent of occupation Bed 0.3%, numbers of discharge of those 3.4% rate of rotation of the hospital bed 1.3% was increase . Numbers of inpatient in the after decentralization 3.3% and numbers of outpatient
16.5% increased hospital costs with inflation 2012, 19% decreased and hospital total revenues was increase overall of 6.5% .hospital infection rates in the after decentralization, 0.06% increased employee satisfaction average before of decentralization was mean and after decentralization was high. There are significant differences [P <0.0001], inpatient satisfaction average before of decentralization was low and after decentralization was mean. There are significant differences [P<0.0001]
Conclusion: efficiency and Effectiveness of karaj Shahid Rajaie Hospital after decentralization was Improvement, therefore Politicians and managers of health system should good infrastructure for the use of this mechanism in order to health system reform, especially public Hospitals
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Introduction: While hospital care has always been one of the basic requirements, Payment Method of treatment is an important factor to create equity in utilization of care. On the other hand, length of stay is one of the key indicators in hospital performance showing the efficiency of hospital care in resource consumption. The purpose of this study was to survey the effect of Payment Method of Treatment cost on the patient length of stay in educational and health centers in Qazvin in 2014
Methods: In this cross-sectional descriptive-analytic study, 640 samples were randomly selected from among inpatients' documents at Qazvin's selected educational and health centers. Data entry form was used for data gathering and Kolmogorov-Smirnov, Mann Whitney and Kruskal- Wallis tests were used for data analysis
Results: The mean and standard deviation for inpatient length of stay were 5.454 and 6.143, respectively. Demographic factors such as age, occupation, marital status affected the length of stay [P <0.001]. The maximum length of stay was related to the patients with insurance from the Committee of Help [8.8days] and the minimum length of stay belonged to the patients without any type of health insurance [3days]. It was also found that basic and supplemental health insurance affected the patients length of stay
Conclusion: Concerning the limited resources of health system in hospital sector and the influence of Payment Method of treatment on patient length of stay, proper use of insurance for appropriate and adequate utilization of hospital care and reducing unnecessary accommodation are undoubtedly necessary
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Evaluation of gastric emptying rate using nuclear scintigraphy as the gold standard method has been studied in various animals, but there is no report in suckling lambs. The aim of this study was to develop a nuclear scintigraphic method to visualize and measure abomasal emptying rate by estimation of scintigraphic half emptying time [T[1/2]] in the live neonatal lamb. Five healthy, female Iranian fat tailed Ghezel lambs, 7-10 days of age, were fasted at least 12 h and then fed with 1 mCi of [99m] Tc-DTPA added to 150 cc fresh ewe milk. Scintigraphic images were obtained in the standing position using a parallel hole, low-energy, triple head gamma camera. Images were stored digitally for 90 min and were analyzed using a nuclear medicine software program. The number of radionuclide counts from all three views during scintigraphic evaluations showed a time-dependent decrease in the number of radionuclide counts from the laterals [P<0.01] and the ventral view [P<0.001] of the abomasum. There was no significant difference in the number of radionuclide counts from all three views during scintigraphic evaluations. 51.70 +/- 3.54 percent of the abomasums content was emptied after 90 min. Evaluating the ROI showed that half emptying time [T[1/2]] was 67.13 +/- 8.64 min. This study was showed that nuclear scintigraphy can be used to evaluate the abomasal emptying rate in suckling lambs
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Intellectual disability [ID] has a worldwide prevalence of 1-3% and results from extraordinary heterogeneous. To shed more light on the causes of ID in Kerman Province, in Southeast Iran, we set out in 2008 to perform systematic clinical studies and homozygosity mapping in large Iranian families with ID. Fifty seven families with a minimum of two mentally retarded children from Kerman Province were initially tested for metabolic disorders, by Tandem mass spectrometry. Fragile X testing and standard karyotyping were performed for all probands of families. Cases with autosomal recessive [AR] pattern of inheritance and microcephaly were subjected to homozygosity mapping by using several microsatellite markers for known MCPH loci. Three out of seven families with X-linked pattern of inheritance were positive for fragile X syndrome. Chromosome abnormality was not observed in any of dysmorphic patients and all families were negative for metabolic tests. Among the remaining 50 families of AR ID, six were found to be microcephalic, of which 2 linked to two MCPH loci [33.3%]. The rest 4 families were not linked to any of the known loci. The results of this study showed that ID with microcephaly comprised 12% of ID cases in Kerman Province. In two families with apparent linkage to the MCPH5 and MCPH6 locus, mutation screening was not successful, which might indicate that either the mutation is located in the regulatory sequences of the gene or that there might be another genes present in these regions, which is mutated in such cases
Subject(s)
Humans , Female , Male , Intellectual Disability/etiology , Microcephaly , Intellectual Disability/epidemiologyABSTRACT
Hyperthyroidism can occur with pregnancy. Thyroid storm is a life-threatening exacerbation of hyperthyroidism. The mortality rate for thyroid storm remains surprisingly high at approximately 20%. A 21-year-old primigravida woman presented at 25 weeks, with severe pre-eclampsia and uncontrolled hyperthyroidism was scheduled for emergency cesarean section. Treatment includes rapid alleviation of thyrotoxicosis and general supportive care. Thyroid function tests may not help in differentiating thyroid storm from symptomatic hyperthyroidism. The major risk of anesthesia in the poorly controlled thyrotoxic patient is thyroid storm, which must be aggressively treated with beta-blockers, iodide, and antithyroid drugs
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Panoramic radiography is the preoperative imaging technique of choice for impacted mandibular third molar surgery. However, controversy exists regarding the ability of panoramic radiography in determining the relationship of the mandibular third molar roots with the inferior alveolar canal. This study aimed to assess the ability of panoramic radiography in determining the relationship of mandibular third molar roots with the inferior alveolar nerve [IAN] canal. This diagnostic accuracy study was conducted on 100 panoramic radiographs that were evaluated by 5 oral and maxillofacial surgery residents. They offered their expert opinion on the relationship of third molars with the IAN canal based on panoramic radiographs. These perspectives were compared with the actual post-surgical findings. Kappa and weighted Kappa reproducibility tests were used for data analysis. Among 100 understudy cases, physical contactbetween the mandibular third molar roots and the canal was not observed in 88 cases intra-operatively; while this relationship existed in 12 cases. The panoramic radiography had a diagnostic sensitivity of 83.3%, specificity of 83%, positive predictive value of 40% and negative predictive value of 97.3%. The overall accuracy was 85%. Kappa and weighted Kappa coefficients of reproducibility were 61% and 79%, respectively. Panoramic radiography can be confidently used as the most reliable and commonly accessible imaging technique. Considering the obtained negative predictive value, panoramic radiography is capable of revealing the involvement of third molar roots with the IAN canal with 97.3% accuracy. Panoramic radiography had a low diagnostic value in determining the morphology of roots
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Sexual cells in male fishes are microscopic and smaller than eggs in females. Due to the late maturation age in sturgeons, the biopsy of gonads and histological studies are one of the most important and reliable ways to detect and separate males and females from each other at early ages. The aim of the present study was to determine and divide the sexes in farmed Acipenser persicus reared under artificial conditions. In order to detect and determine sexual maturation stages, gonads of 81 farmed A. persicus were sampled by biopsy. Samples were fixed and studied by light microscope. Results showed that males and females were 30 [37%] and 51 [63%] individuals, respectively. The determination of sexual maturation stages in A. persicus showed that 16% were at stage I, 23.5% at stage I - II, 59.3% at stage II and 1.2% at stage III. The number of females was higher than that of males, but sexually mature females were at lower maturation stages than males in the same age and rearing conditions
Subject(s)
Animals , Biopsy , Sexual Maturation , FishesABSTRACT
Moyamoya disease is a rare, chronic cerebrovascular occlusive disease of unknown etiology. It is characterized by progressive stenosis of the arteries of the circle of Willis leading to ischemic strokes in young people and cerebral hemorrhage, which is more frequent in adults. Secondarily, an abnormal network of fine collateral vessels arises at the base of the brain. The term moyamoya refers to the angiographic appearance of the cerebral vasculature. We present such a disease in an 18-month-old Iranian girl with global developmental delay, which is a very rare presentation of moyamoya disease. She was diagnosed by magnetic resonance imaging [MRI] and magnetic resonance angiography [MRA]
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We evaluated the serum levels of IgG antibodies to Helicobacter pylori, Chlamydia pneumonia and cytomegalovirus and the level of the inflammatory markers C-reactive protein and fibrinogen in 57 patients with acute coronary syndrome, 65 with unstable angina, 60 with stable angina and 44 healthy controls, and whether these markers were associated with cardiac instability 6 months after admission. There was a significant increased risk of late coronary events [cardiac death or readmission with acute coronary events] associated with seropositivity to C. pneumoniae [adjusted odds ratio 2.12; 95% confidence interval: 1.16-4.08]. Other parameters were not significantly associated with late cardiac events after adjustment for age, sex, diabetes mellitus, hypertension, hyperlipidaemia and smoking behaviour
Subject(s)
Female , Humans , Male , Heart Diseases/blood , Heart Diseases/chemistry , Prognosis , C-Reactive Protein , Fibrinogen , Chlamydophila pneumoniae/pathogenicity , Chlamydia Infections/complications , Immunoglobulin G , Cytomegalovirus Infections/complications , Risk FactorsABSTRACT
Mutations in the SLC26A4 gene in the DFNB4 locus is responsible for syndromic [Pendred syndrome] and non-syndromic hereditary hearing loss [HHL]. In many populations, mutations in this gene have been reported as a second cause of HHL. The objective of this study was to investigate the prevalence of SLC26A4 mutations in our HHL consanguineous families. After completing clinical evaluation and obtaining signed consent forms from each family, we included 80 families with two or more affected individuals, referred to the Genetics Research Center [GRC]. All families that previously tested negative for the DFNB1 locus were candidates for homozygosity mapping using STRs for DFNB4 locus. Families localized to this region were subjected to complete DMA sequencing. Twelve out of 80 families were mapped to DFNB4. Sequence analysis of 12 linked families revealed 10 mutations in 8 families. [T420I, 1197delT, G334V, R409H, T721M, R79X, S448L, L597S, 965insA, and L445W]. The T420I, G334V, L597S and R79X were novel mutations; we did not find any mutation in the four linked families, nor did we detect any nonsyndromic families with mutation in the SLC26A4 gene. We have been able to identify mutation in the SLC26A4 gene in only 8 of 80 families. In 12 families, we detected some degree of diffuse or nodular goiter; three out of 12 families showed thyroid function impairment and in five of 12 families there were positive prechlorate discharge tests. Eight families that showed mutation had normal temporal bone scan. This investigation, demonstrated that the SLC26A4 gene mutation is the most prevalent syndromic hereditary hearing loss in Iran, a finding in accordance with reports from other countries
Subject(s)
Humans , Deafness/congenital , Membrane Transport Proteins/genetics , Mutation/genetics , Hearing Loss/epidemiology , Vestibular Aqueduct , Hearing Loss, SensorineuralABSTRACT
To evaluate and compare tear secretion and tear film instability following laser in situ keratomileusis [LASIK] and laser assisted subepithelial keratectomy [LASEK]. In a randomized clinical trial, 30 eyes of 15 patients underwent LASIK and 30 eyes of 15 patients underwent LASEK to correct myopia. Tear secretion and tear film instability were tested preoperatively, 2 and 6 weeks, and 6 month postoperatively, using TBUT [tear break-up time] and Schirmer I and II tests. Six month after surgery, TBUT, Schirmer I, II tests decreased significantly in LASIK group compared with LASEK group. There was no significant difference between LASIK and LASEK groups preoperatively. The decrease in tear secretion was greater after LASIK than LASEK at 6 months' follow up. Proper treatment of dry eye is required after LASIK and LASE, particularly after LASIK surgery
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Background and Purpose: There are various therapies for stress urinary incontinence [SUI] which include conservative, medical and surgical therapies, each with advantages and disadvantages. In this article, the results of simultaneous needle suspension and anterior colporrhaphy in patients with SUI who had grade III and II cystocele in physical examination
Methods and Materials: From 1380 to 1382 [2000-2003], 135 women with complaints of UI referred to Urology and Gynecology clinics. Of these, 72 patients suffered from SUI and 21 patients from mixed urinary incontinence with a predominance of SUI. Due to SUI severity, physical examination [cystocele grade II and III] and failure of conservative therapies, 58 patients underwent simultaneous anterior colporrhaphy and needle suspension
Results: Peri- and postoperative mortality did not occur. In 13 cases [22.4%], foley catheter was removed two days after surgery but they were unable to void. In 11 cases, the problem was solved after catheterization for one week. In 2 cases, UI occurred and CIC was recommended; after two weeks CIC, they were able to urinate. In one case, sonography and cystoscopy were done due to dysuria resistant to medical treatment; cystoscope was used to extract the suture which had migrated to the bladder. 55 patients [94.9%] indicated improved symptoms one year after surgery. Perfect success [dryness] was observed in 47 patients [81%]. Urinary residue, measured one month after surgery, was less than the normal upper limit in all cases
Conclusion: Success rate of this study is higher than previous studies. Simultaneous needle suspension and anterior colporrhaphy is therefore recommend for patients with SUI and grade III and II cystocele due to the high success rate and low morbidity and mortality rate of the procedure
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Congenital hearing loss with many genetic and environmental causes affects 1 in 1000 newborns. Mutations in the GJB2 [Gap Junction Beta-2] gene encoding the gap junction protein connexin 26 have been established as the main cause of autosomal recessive non-syndromic hearing loss. The aim of this stand was to study the frequency of one mutation [35delG] of GJB2 gene in Kerman non-syndromic deaf population. For this purpose, 130 chromosomes from 65 patients were studied and 35delG mutation was diagnosed in 3 [2.3%] chromosomes [one patient was homozygote and the other one was heterozygote]. This rate of frequency is significantly higher comparing to that in the whole population of Iran
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Of the 205 cases of spinal tuberculosis diagnosed during a 15 year period [1979 -1994], 125 cases were treated by anterior spinal surgery. Surgical treatment consisted of anterior decompression, debridement and fusion, using autogenous iliac or rib bone graft following Hodgson's technique. In cases with involvement of both anterior and posterior elements and in those with unstable spine after anterior surgery, posterior fusion was also performed. Antituberculous chemotherapy was administered pre - and postoperatively in all cases. The average follow-up was 15.5 months [15 days to 8 years]. There were six complications and three mortalities. No pseudarthrosis or increased kyphotic deformity occurred. Results were rated as excellent in 64%, good in 31.2% and poor in 4.8%. It is concluded that anterior spinal fusion is a safe and effective method of treatment for vertebral body involvement in spinal tuberculosis