The effect of conditioning exercise on the health status and pain in patients with rheumatoid arthritis: a randomized controlled clinical trial.

BACKGROUND: Rheumatoid Arthritis (RA) is a systemic and inflammatory disease of unknown etiology which is mostly characterized by inflammation of the synovial joints. Studies have proved that most people with RA avoid doing physical activities due to fear that it may worsen the pain or cause pressure on joints, resulting in decreased muscle strength and ultimately leading to disability of patients. We aimed to investigate the effects of conditioning exercises on the health status and pain in patients suffering from RA. METHODS: In this randomized controlled clinical trial, we enrolled 66 women with confirmed RA referred to the rheumatology clinic of Hafez hospital, Shiraz, southwest Iran during May-July 2013. Balanced block randomization method was used to randomize the participants into case and control groups (two groups of 33 each).Data were collected using visual analog scale (VAS), Arthritis Impact Measurement Scales 2 short form (AIMS2-SF), and demographic questionnaire. After obtaining written informed consent, the participants in the case group were asked to participate in conditioning exercise programs including aerobic, isometric, and isotonic exercises and received a training booklet explaining the exercises that they could do at home after the intervention. RESULTS: There was a statistically significant difference between the health status scores of the patients in the case groups before and after the intervention (P=0.001). The pain score also decreased significantly in the case group compared with the control group after the intervention (P=0.003). CONCLUSION: We concluded that physical training programs, especially conditioning exercises, could improve the health status and reduce pain in patients with RA. TRIAL REGISTRATION NUMBER: IRCT201308187531N3.

The efficacy of acupressure at the Sanyinjiao point in the improvement of women's general health.

OBJECTIVES: This study's objective was to examine the effectiveness of Sanyinjiao point (SP6) acupressure on women's general health. DESIGN: This was a randomized, single-blind clinical trial. SETTING: The setting for this trial was at Medical University, Bojnoord University of Medical Science, Bojnoord, Iran. MATERIALS AND METHODS: Eighty-six (86) university students were recruited for this study. Their demographic characteristics were gathered before the intervention commenced. Participants completed General Health Questionnaires (GHQ) prior to participation. Next, they were randomly assigned to either the acupressure-receiving group or the sham-pressure-receiving group. The study group received acupressure at the Sanyinjiao point, while the control group received sham pressure. OUTCOME MEASURES: Both groups completed GHQ after both the first and second months of intervention. Data analysis was carried out using SPSS version 13.5 for Windows. RESULTS: The mean age of those who completed the study was 20.84±1.64 years. Mean scores of GHQs were similar between groups before intervention (p>0.05). The general health of participants in both groups improved after intervention, and the amelioration in four domains was significant in the groups (p<0.05 within group). It was found that acupressure was more effective than sham pressure. In addition, there was a statistically significant difference between the two groups in the four domains of their general heath after the first month of the intervention (p<0.0001). Furthermore, the general health status of the participants changed much more after the second month in both the acupressure intervention and the sham pressure groups; nevertheless, acupressure was more effective than sham pressure (p<0.05). CONCLUSIONS: Both acupressure and sham pressure were effective in promoting women's general health; nevertheless, the efficacy of acupressure was more than that of sham pressure. SP6 acupressure could be regarded as a self-manageable approach to improve women's general health.

Early excision and skin grafting versus delayed skin grafting in deep hand burns (a randomised clinical controlled trial).

INTRODUCTION: Early excision and grafting (E&G) of burn wounds has been reported to decrease hospital stay, hospital costs and septic complications, and some purport reduced mortality while decreasing hospital costs. In today's practice, all burn wounds unlikely to achieve spontaneous closure within 3 weeks are excised and grafted. Early studies did not demonstrate dramatic differences in cosmetic or functional results. This is particularly true with burns of the face, hands and feet. In this study, early excision and skin grafting was compared with delayed skin grafting in deep hand burns. MATERIALS AND METHODS: From September 2006 to February 2008, 50 patients with hand burns and average burn size less than 30% total body surface area (TBSA) deep second- and third-degree were randomly divided into early E&G group (group I) and delayed grafting group (group II). Gradual and careful limb and digit range of motion was started on about 10th-14th postoperative day. We used a questionnaire based on the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to evaluate final functional outcome. Further, hypertrophic scar formation, contracture and deformities were followed and managed accordingly. RESULTS: The most common site of involvement was the metacarpophalangeal (MCP) joint with frequency of 39% and 40% in groups I and II, respectively. There were no statistically significant differences between both groups regarding deformity severity, scar formation, sensation, major activities and overall satisfaction. DISCUSSION: In treating burns of the hand, the primary goal should always be to restore the functionality of the hand. Although early surgery shortens the healing time and lessens the hospital stay, our results did not show any significant difference between these two methods regarding the function, scar formation, daily activity limitation and overall satisfaction.

Effect of acupressure at the Sanyinjiao point on primary dysmenorrhea: a randomized controlled trial.

OBJECTIVE: We conducted this study to assess the effect of acupressure at the Sanyinjiao point on primary dysmenorrhea. METHODS: Eighty-six students participated in the study. All participants met the inclusion criteria. The study group received acupressure at Sanyinjiao point, while the control received sham acupressure. The severity of dysmenorrhea was assessed at the following time periods: prior to the intervention, 30 min, 1, 2 and 3h following the intervention. Data were analyzed using SPSS. RESULTS: The acupressure caused decline in the severity of dysmenorrhea immediately after intervention in both groups during their first menstrual cycle, although, there difference was not significant (p>0.05). In addition, during the same cycle, the severity of the dysmenorrhea decreased more in study group rather than control group at 30 min, 1, 2 and 3h after intervention (p<0.05). During the second menstrual cycle, acupressure made dysmenorrhea reduced in both study and control groups; however, the decline was more salient among participants of the study group at all stages after the intervention (p<0.05). CONCLUSIONS: Acupressure at Sanyinjiao point can be an effective, feasible, cost-effective intervention for improving primary dysmenorrhea.

A novel DNA sequence variation in the first genetically confirmed allgrove syndrome in iran.

Allgrove syndrome or triple-A syndrome is an autosomal recessive disorder characterized by adrenal insufficiency, achalasia and alacrima. Affected patients may also present with a constellation of central and peripheral nervous system manifestations. The gene for Allgrove syndrome (ALADIN) is located on chromosome 12q13. Here we report a 23-year-old man with alacrimia, achalasia, optic atrophy and progressive amyotrophic lateral sclerosis-like presentations. Sequencing of ALADIN gene showed a novel 6-bp sequence variant that the patient was homozygous and his father was heterozygous for the defect. A probable mechanism of action of this newly diagnosed missense mutation would be to cause abnormal splicing of the ALADIN gene.