The reliability and validity study of the Kinesthetic and Visual Imagery Questionnaire in individuals with Multiple Sclerosis

OBJECTIVE: Motor imagery (MI) has been recently considered as an adjunct to physical rehabilitation in patients with multiple sclerosis (MS). It is necessary to assess MI abilities and benefits in patients with MS by using a reliable tool. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) was recently developed to assess MI ability in patients with stroke and other disabilities. Considering the different underlying pathologies, the present study aimed to examine the validity and reliability of the KVIQ in MS patients. METHOD: Fifteen MS patients were assessed using the KVIQ in 2 sessions (5-14days apart) by the same examiner. In the second session, the participants also completed a revised MI questionnaire (MIQ-R) as the gold standard. Intra-class correlation coefficients (ICCs) were measured to determine test-retest reliability. Spearman's correlation analysis was performed to assess concurrent validity with the MIQ-R. Furthermore, the internal consistency (Cronbach's alpha) and factorial structure of the KVIQ were studied. RESULTS: The test-retest reliability for the KVIQ was good (ICCs: total KVIQ=0.89, visual KVIQ=0.85, and kinesthetic KVIQ=0.93), and the concurrent validity between the KVIQ and MIQ-R was good (r=0.79). The KVIQ had good internal consistency, with high Cronbach's alpha (alpha=0.84). Factorial analysis showed the bi-factorial structure of the KVIQ, which was explained by visual=57.6% and kinesthetic=32.4%. CONCLUSIONS: The results of the present study revealed that the KVIQ is a valid and reliable tool for assessing MI in MS patients. .

Estimating the relapse risk of Plasmodium vivax in Iran under national chemotherapy scheme using a novel method.

OBJECTIVES: This study aimed to estimate the relapse risk of Plasmodium vivax under national chemotherapy scheme using a novel method, and assessed its pattern in Kahnooj, a malaria endemic area in Iran. METHODS: The authors traced repeated episodes of malaria attack between 1994 and 2001 and then, estimated the risks of secondary attack of P. vivax, classified by the species in their primary attack. It is suggested that the difference between the secondary attack rate in those who were infected by P falciparum and P. vivax in their primary attack may estimate the P. vivax relapse rate indirectly. RESULTS: This method showed that the relapse risk of P. vivax with in one and two years after the primary attack were 16.8 and 24.5% respectively. The risks of relapse before three or after 18 months were very low. INTERPRETATION & CONCLUSION: The relapse pattern of P. vivax was compatible with the dominant pattern in most of the temperate areas. In addition, the relapse risk was very close to the estimated relapse risks in clinical trials on anti-relapse drugs. Therefore, we concluded that the anti-relapse therapy in the study area was effective; also, this method may estimate the relapse risk of P. vivax accurately.

Comparing the results of light microscopy with the results of PCR method in the diagnosis of Plasmodium vivax.

BACKGROUND AND OBJECTIVES: Although polymerase chain reaction (PCR) is a new technique in the diagnosis of malaria with very high accuracy; light microscopy is still conventional diagnostic method in Iran. In this study we checked the accuracy of light microscopy using the results of PCR as gold standard in Iran. METHODS: The blood samples were collected from 124 febrile cases in Kahnooj district. The blood slides were read by microscopists, and double checked by experts in provincial referral laboratory. DNA samples were processed by PCR to amplify species-specific sequences of 18s subunit ribosomal ribonucleic acid (18ssrRNA) genes of Plasmodium vivax and P. falciparum. RESULTS: The sensitivity and specificity of microscopy in the detection of Plasmodium spp infection were 77% (95% CI: 46-94%) and 100% (95% CI: 95-100%), correspondingly. Also, the estimated positive and negative predictive values were 100% (95% CI: 66-100%) and 97% (95% CI: 91-99%), respectively. INTERPRETATION AND CONCLUSION: According to these results, we believe that the accuracy of light microscopy in the diagnosis of malaria in Kahnooj was acceptable. Expert micorscopists in endemic areas of Iran such as Kahnooj and available equipments in one hand and expensive PCR test on the other hand may convince that in current situation we do not have to change the diagnostic method.