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OBJECTIVE: Assess the impact of inpatient rehabilitation on the quality of life and life satisfaction of individuals with spinal cord injury by considering the level of injury. DESIGN: QuasiExperimental study. SETTING: Rehabilitation Hospital. PARTICIPANTS: A total of 71 Patients with Spinal cord injury were admitted for rehabilitation. INTERVENTION: The quality of life and life satisfaction of patients were assessed both before and after 63 days of inpatient rehabilitation. MAIN OUTCOME MEASUREMENTS: Functional independence measure score (FIM), the Short Form-36 (SF-36), and the Life Satisfaction Scale (LSS). RESULT: The average age of the study population was 34 ± 14 years. At the end of 63 days, significant improvements were observed in FIM, mood, health, physical performance, role physical, role emotional, pain, and total score of LSS (Π - Value <0.05). The variation in FIM changes significantly improved the total LSS score in the thoracic and thoracolumbar subgroups, but not in the cervical group. In addition, the total score of SF36 was improved significantly just in the cervical subgroup (Π = 0.006). No significant correlations were found between SF-36 and LSS scores (before and after the intervention) in relation to marriage, education, and time. CONCLUSION: In the context of spinal cord injury, inpatient rehabilitation can play a role in improving functional independence which, in turn, impacts certain aspects affecting life satisfaction and the quality of life. It is important to note that the extent of this correlation varies among patients with different injury levels. In some cases, even minor changes, such as those seen in quadriplegic patients, could have a significant impact on their quality of life.
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OBJECTIVE: This study aimed to investigate the improvements of functional independence following inpatient rehabilitation and compare those improvements between different levels and severities of Spinal Cord Injury (SCI). Prognostic factors affecting the patient's outcomes were also studied. SETTINGS: Rofeideh Rehabilitation Hospital. OUTCOME MEASURES: Spinal Cord Independence Measure version III (SCIM III), and Functional Independence Measure (FIM). METHOD: In this retrospective cohort study, 180 patients with SCI were enrolled to record their functional independence upon admission and discharge, and the changes were compared between different levels and severities of injury using non-parametric tests. The prognostic factors of outcomes were studied by generalized estimating equation (GEE) analysis. RESULTS: The independence changes were significant for all the severities (American Spinal Injury Association Impairment Scale (AIS)) and levels of injury except for the patients with AIS A and B at upper cervical levels (P < 0.05). The level of injury, AIS, Length of Stay (LOS), and pressure ulcer had a significant prognostic value on patient's outcomes. Furthermore, there was a significant difference between different levels of injury with the same AIS grade in functional improvement (P < 0.05), while there was a significant difference between AIS groups with the same level of injury only at upper and middle cervical lesions (P < 0.05). CONCLUSION: Recording the values of functional independence before and after rehabilitation in individuals with SCI can help clinicians approximately expect the outcomes of future patients. Moreover, a deeper study of the prognostic factors can provide a more logical expectation of rehabilitation outcomes.
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PURPOSE: Ulnar neuropathy at elbow is the second-most common compression neuropathy. The main aim of this study was to assess the diagnostic value of ultrasonography (US) as an alternative method to electrodiagnosis (EDX), which had traditionally been used as the method of choice. METHODS: This diagnostic study was conducted on 66 participants (32 patients` elbows and 34 normal elbows) referred for EDX. Both groups were reassessed by US to evaluate the consistency of the two tests. The quantitative parameters of US, such as cross-sectional area (CSA) of the ulnar nerve at three different levels around the medial epicondyle (ME) were compared between groups. RESULTS: Our findings demonstrated that CSA at the ME and 2 cm distal to the ME were significantly larger in the patient group than normal participants. This higher nerve size was more prominent among those who had predominant axonal loss rather than demyelinating lesions (P<0.01). Finally, we evaluated US diagnostic value with the best singular feature (2 cm distal to ME) at a cutoff of 9 mm2, which revealed specificity of 80% and sensitivity 84%. CONCLUSION: Based on these results we can conclude that US is a sensitive and specific method in diagnosing ulnar neuropathy at the elbow and can be used as an acceptable complementary method, in particular when EDX is not available.
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BACKGROUND: This descriptive study aimed to determine the serum level of alpha-1 antitrypsin (AAT) in patients with severe asthma. MATERIALS AND METHODS: The serum level of AAT was determined in 43 patients with severe asthma. Pulmonary function tests were performed and data were analyzed by SPPS version 19 software. RESULT: The mean age of patients was 41±13.8 years (range 14 to 78 years). The AAT level was within the normal range (90-200 mg/dl) in 38 patients (88.4%) and less than normal in 2 patients (4.7%). CONCLUSION: No association was observed between the serum level of AAT and lung function in severe persistent asthmatic patients. The prevalence of AAT deficiency was low in patients with severe persistent asthma. These results must be confirmed by further longitudinal investigations using larger cohort studies.
