Reliability of postural control during double-leg standing in subjects with nonspecific chronic low back pain: Dual-task paradigm and manipulated visual and somatosensory inputs.

BACKGROUND: The aim of this study is to evaluate the test-retest reliability of the Center of Pressure (COP) parameters in quiet double-leg standing in subjects with Non-Specific Chronic Low Back Pain (NSCLBP) during dual taking associated with manipulated visual and somatosensory inputs. MATERIALS AND METHODS: In this observational cross-sectional study, the static balance of thirty NSCLBP patients were assessed during a double-leg stance by using the force platform. Subjects were accosted by manipulated somatosensory and visual inputs during dual taking in eight different conditions (with and without vibration, eyes-open and eyes-closed, and with and without auditory Stroop test). The COP parameters were recorded as follows: range sideways and range fore-aft as well as mean velocity and area variables. The cognitive task parameters included the reaction time and error ratio. The intra-class correlation coefficient (ICC) was computed to assess the intersession reliability of COP parameters. RESULTS: in intersession, range sideways, range fore-aft, and mean velocity measures possessed moderate to high ICC, but area owned high ICC only in one condition (double-leg stance, eyes-close, with vibration, and with auditory Stroop test). Notably, other conditions had low ICC, and moderate to high and low to very high ICC were reported for reaction time and error ratio. CONCLUSION: Among the parameters studied in the present study, the mean velocity measure seems to be the most reliable variable of postural control in the subjects with NSLBP especially in more challenging conditions, i.e., quiet double-leg standing with eyes closed and adding vibratory inputs during dual-tasking.

Confirmatory Factor Analysis, Reliability, and Validity of the Persian Version of the Coping Strategies Questionnaire for Iranian People With Nonspecific Chronic Neck Pain.

OBJECTIVE: The purpose of this study was to assess the reliability and construct validity of, and perform confirmatory factor analysis of, the Persian version of the Coping Strategies Questionnaire (CSQ) for Iranian people with nonspecific chronic neck pain. METHODS: We performed psychometric testing of the Persian version of the Coping Strategies Questionnaire. Participants were 123 native Persian speakers with chronic neck pain lasting at least 3 months. They were between 18 and 55 years old. The CSQ was administered by self-report. After 5 to 7 days, 94 participants completed the questionnaire in the retest session. Confirmatory factor analysis was done to assess the model fit (χ2 test, comparative fit index, and root-mean-square error of approximation) of the 7-factor solution of the Persian version of the CSQ. The Cronbach α was used for internal consistency; intraclass correlation coefficient, standard error of measurement, and minimal detectable change for reliability; and nonparametric tests of group differences and correlations for construct validity. To assess the construct validity, we examined the ability of the CSQ to discriminate people based on sex, level of education, and physical activity. Correlations with the Short Form Health Survey (SF-12), Tampa Scale for Kinesiophobia, visual analog scale, Fear-Avoidance Beliefs Questionnaire, Pain Catastrophizing Scale, and Neck Disability Index were also determined to test the validity. RESULTS: Confirmatory factor analysis measures-χ2 test, comparative fit index, and root-mean-square error of approximation-were 1.72, 0.76, and 0.07, respectively. Internal consistency was excellent (0.85). All intraclass correlation coefficients were above the acceptable level of 0.70, with the highest reliability obtained for the Praying subscale in both test and retest sessions. The standard error of measurement for the CSQ total score was 2.26, and the minimal detectable change was 6.25. The Cronbach α for the total score and for the subscales ranged from 0.75 to 0.93. Scores of the subscales of the CSQ and other questionnaires showed low correlation except for the physical component of the SF-12. The Catastrophizing subscale had a positive correlation with the Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, and Neck Disability Index, and a negative correlation with the SF-12. CONCLUSION: The CSQ has acceptable and good measurement properties to assess coping strategies in Iranian people with nonspecific chronic neck pain. It is a reliable measure, though, for validity only The Catastrophizing subscale showed significant correlation with other scales, but the findings should be interpreted with caution because of the limitations of the study.

Translation, reliability, and validity of the avoidance endurance questionnaire in Iranian subjects with chronic non-specific neck pain.

BACKGROUND: To cross-cultural adaptation, test-retest reliability, construct validity of the Persian version of avoidance endurance questionnaire (AEQ) in Iranian subjects with chronic nonspecific neck pain (CNSNP). OBJECTIVE: The AEQ differentiates endurance responses [ER; positive mood scale (PMS), thought suppression scale (TSS), pain persistence behavior scale (PPS), humor/distraction scale (HDS), and behavioral endurance scale (BES) from fear-avoidance responses (FARs; anxiety/depression scale (ADS), catastrophizing scale (CTS), helplessness/hopelessness scale (HHS), avoidance of social activities scale (ASAS), and avoidance of physical activities scale (APAS)]. METHODS: One hundred and thirty persons with CNSNP took part in this psychometric study. The translation process was done by Beaton guideline. Test-retest reliability and internal consistency were presented by intraclass coefficient (ICC) and Cronbach's alpha, respectively. The construct validity was measured by the correlation between AEQ subscales and the Short-form health survey (SF-12), visual analog scale (VAS), fear-avoidance beliefs questionnaire (FABQ), pain catastrophizing scale (PCS), Tampa scale for kinesiophobia (TSK), and neck disability index (NDI). RESULTS: The Cronbach's alpha of all FAR and ER subscales was more than 0.7, and ICCs of all FAR subscales were more than 0.8 and ICCs of ER subscales were reported between 0.59 and 0.86. The correlation between FAR subscales and TKS, FABQ, FABQ.PA, FABQ.W, NDI, PCS, and VAS were the limit between -0.239 and 0.199, and the association between ER subscales and the abovementioned questionnaires was the limit between 0.179 and 0.644. CONCLUSIONS: The Persian version of AEQ showed acceptable reliability (test-retest, internal consistency) for FAR and ER, and also the construct validity was acceptable. The Persian version of AEQ had acceptable psychometric properties, thus it is a good instrument to identify fear avoidance and ERs of the pain.

Determining the frequency of dry eye in computer users and comparing with control group / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the frequency of dry eye in computer users and to compare them with control group.METHODS: This study was a case control research conducted in 2015 in the city of Birjand.Sample size of study was estimated to be 304 subjects (152 subjects in each group,computer user group and control group).Non-randomized method of sampling was used in both groups.Schirmer test was used to evaluate dry eye of subjects.Then,subjects completed questionnaire.This questionnaire was developed based on objectives and reviewing the literature.After collecting the data,they were entered to SPSS Software and they were analyzed using Chi-square test or Fisher`s test at the alpha level of 0.05.RESULTS: In total,304 subjects (152 subjects in each group) were included in the study.Frequency of dry eyes in the control group was 3.3% (5 subjects) and it was 61.8% in computer users group (94 subjects).Significant difference was observed between two groups in this regard (P<0.001).The frequency of eye symptoms in the control group was 7.9% (n=12),and it was 34.2% in computer users group (n=52),which significant difference was observed between two groups in this regard (P<0.001).Frequency of dry eye syndrome in computer users by gender and age groups showed no significant correlation in this regard (P=0.8).The mean working hour with computer per day in patients with dry eye was 6.65±3.52h,while it was 1.62±2.54h in healthy group (T=13.25,P<0.001).CONCLUSION: This study showed a significant relationship between using computer and dry eye and ocular symptoms.Thus,it is necessary that officials need to pay particular attention to working hours with computer by employees.They should also develop appropriate plans to divide the working hours with computer among computer users.However,due to various confounding factors,it is recommended that these factors to be controlled in future studies.

Diagnostic value of ultrasonography in the diagnosis of nasal fractures.

INTRODUCTION: This study examined the diagnostic value of ultrasound and radiography compared with clinical examinations as the gold standard method to determine whether ultrasound can be used for early diagnosis of nasal fracture. METHODS: This prospective study was conducted on 128 patients with clinical signs of nasal fracture. Radiography in all patients was performed by 2 different radiologists on Waters and lateral view with a 10-MHz ultrasound probe, and clinical examinations were done by an ENT specialist. Radiography and ultrasound findings were recorded and compared with the final diagnosis which was based on clinical examinations. Results were analyzed with different statistical methods to determine sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. RESULTS: In the assessment of fracture with ultrasound, sensitivity was 84%, specificity 75%, accuracy 82%, positive predictive value 91%, and negative predictive value 61%. In the assessment of fracture on lateral view radiography, sensitivity was 50%, specificity 72%, accuracy 55%, positive predictive value 84%, and negative predictive value 32%. On Waters view radiography, sensitivity was 53%, specificity 65%, accuracy 56%, positive predictive value 82%, and negative predictive value 31%. On lateral-waters view radiography, sensitivity was 64%, specificity 58%, accuracy 62%, positive predictive value 82%, and negative predictive value 34%. Fracture diagnosis by ultrasound was significantly better as compared with radiography (P = 0.04). CONCLUSION: The nasal bone ultrasound study is a useful method in determining the nasal fracture and radiography can be replaced with ultrasound in early diagnosis of fracture.

Comparison of the effect of endoscopic sinus surgery versus medical therapy on olfaction in nasal polyposis.

Chronic rhinosinusitis is a common inflammatory condition in western countries. Nasal polyposis has different symptoms such as nasal obstruction, anterior or posterior nasal drip, reduced sense of smell, and facial pain. Medical and endoscopic treatments are the two main treatments for nasal polyposis. Our aim was to compare the efficacy of different methods on olfactory function. This is a non-randomized clinical trial study that was done on 60 patients who were divided into two groups (medical and surgical). Patients were matched based on age, history of smoking, and the severity of obstruction. The radiologist score of Lund-Mackay staging system was used to match patients in two arms of the trial based on the severity of nasal obstruction. Patients in surgery groups underwent functional endoscopic sinus surgery under general anesthesia and then received Fluticasone propionate nasal spray for 8 weeks (400 mcg bd). Patients in the medical group were only prescribed with Fluticasone propionate with the same duration and same dose as mentioned. As a result of treatment protocol, both medical and surgical group experienced improvement in olfactory function but statistical analyses revealed that surgery resulted in better resolution of symptoms. Our observation revealed that combined treatment had a better effect than medical treatment in restoring olfaction in patients with nasal polyposis.

Amplitude changes in otoacoustic emissions after exposure to industrial noise.

Noise-induced hearing loss (NIHL) is a frequent problem in industrial settings, especially where a high noise level is present. It is permanent, and irreversible, but preventable. Routine audiometry (an objective and time consuming) test is used for NIHL screening. Otoacoustic emissions (OAEs) are recently proposed as a more sensitive test for early diagnosis of NIHL. In this study, we aimed to compare the results of pure tone audiometry (PTA) with OAE in the diagnosis of NIHL. In a cross-sectional study on 120 workers (in three groups: Not exposed to noise, exposed to noise without NIHL and exposed to noise with NIHL), we compared the results of PTA and OAE. OAE can detect some changes in the function of hearing system in subjects exposed to noise, and these changes are apparently prior to hearing loss, which is diagnosed by PTA. OAE is a more sensitive method for the early diagnosis of cochlear damage than PTA, and can be performed in industrial settings for NIHL screening.

Hearing status in neonatal hyperbilirubinemia by auditory brain stem evoked response and transient evoked otoacoustic emission.

Hyperbilirubinemia at neonatal period is one of the major deteriorating factors of the auditory system. If left untreated, it may cause certain cerebral damage. This study aims to evaluate the impact of hyperbilirubinemia on the hearing of neonate. This study was conducted on 35 newborn babies with jaundice (bilirubin more than 20 mg/dL). Auditory brainstem response (ABR) and transient evoked otoacoustic emission (TEOAE) tests were performed, after treatment and one year after. ABR test results indicated that 26 children (74.3%) had normal hearing but 9 (25.7%) suffered from an impairment. As for TEOAE test, 30 children (85.7%) passed whereas the remaining (14.3%) seemed to be failures. The comparative results of the two tests pointed to autonomic neuropathy /autonomic dysreflexia symptoms in 5 babies. Due to the high incidence of autonomic neuropathy/autonomic dysreflexia among hyperbilirubinemic babies, screening in this regard seems reasonable. Our result emphasizes the necessity of more experiments on the afflicted areas.

A comparative study of brain perfusion single-photon emission computed tomography and magnetic resonance imaging in patients with post-traumatic anosmia.

BACKGROUND: Loss of smell is a problem that can occur in up to 30% of patients with head trauma. The olfactory function investigation methods so far in use have mostly relied on subjective responses given by patients. Recently, some studies have used magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) to evaluate patients with post-traumatic anosmia. The present study seeks to detect post-traumatic anosmia and the areas in the brain that are related to olfactory impairment by using SPECT and MRI as imaging techniques. METHODS: The study was conducted on 21 patients suffering from head injury and consequently anosmia as defined by an olfactory identification test. Two control groups (traumatic normosmic and nontraumatic healthy individuals) were selected. Brain MRI, qualitative and semiquantitative SPECT with 99mtc-ethyl-cysteinate-dimer were taken from all the patients. Then the brain SPECT and MRI were compared with each other. RESULTS: Semi-quantitative assessment of the brain perfusion SPECT revealed frontal, left parietal, and left temporal hypoperfusion as compared with the two control groups. Eighty-five percent of the anosmic patients had abnormal brain MRI. Regarding the MRI, the main abnormality proved to be in the anterior inferior region of the frontal lobes and olfactory bulbs. CONCLUSIONS: The findings of this study suggest that damage to the frontal lobes and olfactory bulbs as shown in the brain MRI and hypoperfusion in the frontal, left parietal, and left temporal lobes in the semiquantitative SPECT corresponds to post-traumatic anosmia. Further neurophysiological and imaging studies are definitely needed to set the idea completely.

Serial nasal bone reduction: a new approach to the management of nasal bone fracture.

Nasal bone fracture is the most common type of facial bone fracture. Although these injuries often do not seem to be severe, undertreatment of nasal trauma could lead to significant long-term problems. The postreduction incidence of nasal deformities requiring subsequent rhinoplasty or septorhinoplasty ranges from 9% to 50% in different studies. A clinical trial study on 330 cases with simple nasal bone fracture was performed. These patients were divided into 2 groups randomly. In the case group, serial nasal bone reduction was performed, and in the control group, classic nasal bone reduction was performed. The failure rate following the initial reduction in the first visit after reduction was 14.3% and 14.1% in the case and control groups, respectively, but their difference was not significant (P > 0.05). After serial reduction in the case group (step 3), the failure rate was diminished to 4.19%. It was statistically superior to the failure rate of the control group after 1 month of follow-up (14.7%) (P = 0.001). Serial nasal bone reduction could be helpful to diminish the failure rate of nasal bone reduction.

Antrochoanal polyp: a comparative study of endoscopic endonasal surgery alone and endoscopic endonasal plus mini-Caldwell technique.

Antrochoanal polyp (ACP) originates in the maxillary sinus. To diminish the regrowth rate of choanal polyp, a complete removal of the antral portion and its attachment is necessary. There are several methods for this purpose, but in this study two techniques were comparatively investigated. This retrospective study was conducted by analyzing the database of 40 operated patients for ACP, 19 of whom underwent an endoscopic endonasal removal of polyps and 21 experienced endoscopic endonasal surgery with mini-Caldwell operation. The two techniques were compared with regard to their complications and regrowth rate. It emerged that post-operative complications (bleeding, synechia, ostia stenosis) in both groups were mild and there was not any significant difference between the two groups. Out of 19 cases in the endoscopic endonasal surgery group, 4 had recurrences, while in the mini-Caldwell group we had no recurrence. (P = 0.042)). This result implies that, in order to prevent incomplete excision and recurrences, combined approaches (endoscopic endonasal surgery and mini-Caldwell) should be considered, particularly when the attachment site of the antral part of ACP is undetected.