Acta Medica Iranica
Volume:54 Issue: 12, Dec 2016

Evaluation of communication abilities in the elderly is crucial for activities which will be performed to improve their quality of life. A valid and reliable questionnaire is needed for assessing communication abilities. We aimed to translate and validate the speech, spatial, and qualities of hearing scale (SSQ) in Iran. The forward-backward procedure was applied to translate the questionnaire from English into Persian. After linguistic validation and pilot study, a cross-sectional study was carried out, and psychometric properties of the Iranian version of the SSQ were tested. Number of 333 elderly individuals with impaired hearing completed the questionnaire. Number 48.3% were hearing aid users and 51.7% was not. Reliability was assessed by internal consistency (Cronbach's alpha) and test-retest analysis. Exploratory factor analysis was performed for extracting factor structure of the Persian version of SSQ. Confirmatory factor analysis was performed to compare different models of factor loadings. The Mean age of participants was 62.00 years (SD=9.58 years), and the mean SSQ score was 5.1 (SD=1.2, ranged: 3.17-6.27). Reliability evaluation revealed high internal consistency and good test- retest reliability. Cronbach's alpha coefficient was 0.96 and the Pierson Correlation at test-retest analysis was 0.73 for Quality of hearing factor, 0.88 for Spatial and o.73 for Speech understanding factor. The results of exploratory factor analysis (EFA) indicated a four-factor solution for P-SSQ that jointly accounted for 52.40% of the variance observed. Confirmatory factor analysis approved the three factor solution but proposed a possible fourth factor. The Iranian version of the SSQ has acceptable psychometric properties, and it will be helpful for assessing different kinds of communication abilities in the Iranian elderly population.

Streptococcus agalactiae is acommensalorganism, but it may cause infection in susceptible hosts. The aim of this study was to evaluate PCR assay compared with conventional culture method for direct detection of Streptococcus agalactiae. Total of 203 paired low vaginal swabs were collected from women at 35-37 weeks of pregnancy from June 2013 through February 2014 for detection of Streptococcus agalactiae using PCR assay targeting 16S rRNA, cfb, scpB, and atr genes and culture method following broth enrichment. The results were recorded and evaluated for determining of sensitivity, specificity, positive and negative predictive values of PCR assaycompared with culture method. Prevalence of Streptococcus agalactiae was determined as 7.39% (n=15) using culture method; 19.70% (n=40) by PCR targeting 16S rRNA gene; 18.23% (n=37) by targeting atr gene; 17.24% (n=35) by cfb gene; and 8.87% (n=18) by scpB gene. Generally, a total of 49 specimens were considered true positive (27 samples by PCR assay using the four genes in sum, 4 samples only by atr gene PCR, 3 samples only by cfb gene PCR, 2 samples only by culture method, and 13 samples by PCR assay and culture method in common) and prevalence of Streptococcus agalactiae determined 24.14% in Hamadan. The current data demonstrated that performing only culture method for detecting GBS from pregnant women leads to missed false negative carrier individuals. Thus, it is recommended that both the PCR assay and conventional culture method to be performed in order to detect Streptococcus agalactiae.

Some adipocytokines are cardioprotective or pro-inflammatory for cardiovascular system. Chronic infection with Chlamydia pneumoniae and Helicobacter pylori has been also considered as novel risk factors for atherosclerosis. The main aim of the current population-based study is to investigate the potential link between circulating adipocytokines and Chlamydia pneumoniae or Helicobacter pylori IgG seropositivities. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C.pneumoniae and H. pylori. Omentin-1, visfatin, adiponectin, and high sensitivity C-reactive protein were measured by highly specific enzyme-linked immunosorbent assay methods. The prevalence of IgG antibodies against C. pneumoniae and H. pylori among the studied population was 20.4% (51 women) and 57.2% (143 women), respectively. There were no significant differences in adipocytokine levels between H. pylori IgG seropositive and H. pylori seronegative subjects. Similar results for visfatin and omentin-1 were found when C. pneumoniae IgG seropositive were compared with C. pneumoniae IgG seronegative subjects. However, in general linear model adjusted for age, body mass index and hs-CRP levels revealed significant difference between C. pneumoniae seropositive and C. pneumoniae seronegative subjects for circulating adiponectin. In conclusion, Chlamydia pneumoniae IgG seropositivity was associated with higher adiponectin levels in postmenopausal women. The elucidation of interaction mechanism of Chlamydia pneumoniae and a cardioprotective adipocytokine (adiponectin) will be useful in future therapeutic strategies.

Autosomal dominant congenital cataract (ADCC) is the most common form of inherited cataracts and accounts for one-third of congenital cataracts. Heterozygous null mutations in the crystallin genes are the major cause of the ADCC. This study aims to detect the mutational spectrum of four crystallin genes, CRYBA1/A3, CRYBB1, CRYBB2 and CRYGD in an Iranian family. Genomic DNA was isolated from whole blood cells from theproband and other family members. The coding regions and flanking intronicsequences of crystalline genes were analyzed by Sanger sequencing in aproband with ADCC. The identified mutation was further evaluated in available family members. To predict the potential protein partners of CRYBA1/A3, we also used an in-silico analysis. A de novo heterozygous deletion (c.272-274delGAG, p.G91del) in exon 4 of CRYBA1/A3 gene, leading to a deletion of Glycine at codon 91 was found. This genetic variation did not change the reading frame of CRYBA1 protein. In conclusion, we identified a de novo in-frame 3-bp deletion in the proband with an autosomal dominant congenital cataract, but not in her parents, in an Iranian family. This mutation has occurred de novo on a paternal gamete during spermatogenesis. The in-silico results predicted the interaction of CRYBA1 protein with the other CRY as well as proteins responsible for eye cell signaling.

Occult HBV infection of hemodialysis (HD) patients is informative in terms of virus transmission. It may be of clinical importance in HD patients. The aim of this study was to investigate the prevalence of anti-HBc in the HD Patients. Number of 126 patients undergoing hemodialysis were included in this study from main hemodialysis units in Yazd. Hepatitis B surface antigens (HBsAg), hepatitis B core antibody (anti-HBc) were examined in all subjects. Finally, stored serum samples from anti-HBcAb positive, HBsAg negative patients were anonymised and tested for HBV DNA by real time quantitative PCR assay. The age range of the patients was 17-88 years. Of the 126 patients, 123 patients (97.6%) were HBC-Ab negative and 3 (2.4%) were positive. Of 3 patients with Anti-HBC positive, HBV DNA was detected in 1 patient. This study showed a low rate of isolated anti-HBc (2.4%). HBV DNA was also detected in 1 patient.

Intraventricularhemorrhage (IVH) is one of thecommon morbidities among preterm neonates. In thepresentstudy, we set out to evaluate the efficacy of two prophylactic modalities (ibuprofen and indomethacin prophylaxis) for prevention of IVH in our local setting. A prospective study was carried out in Akbar-Abadi Hospital, Tehran-Iran (2013-2014). Ninety-six preterm neonates who cared in closed incubator entered the study. Neonates randomly assigned into 3 groups; control, oral indomethacin (0.2 mg/kg indomethacin daily for 3 days) and oral ibuprofen (10,5,5 mg/kg ibuprofen every 24 hours during 3) administration. For all subjects brain sonography examination was performed in 3rd day, first, 2nd week of life and when infants reached to 36 and 42 weeks of postmenstrual age. The IVH prevalence and the effectiveness of the drugs among groups were statistically assessed. Of all 93 subjects; 14 cases had IVH (15.1%). IVH was significantly more frequent in the controls than in other groups (P=0.049). Prophylactic treatment could significantly decrease the incidence of grade 3 or 4 IVH in experimental groups (P=0.008). There were no significant differences between the three experimental groups with respect to theincidence of GI bleeding, Oliguria, renal dysfunction or NEC (P>0.05). This study demonstrates that low-dose prophylactic indomethacin and ibuprofen are equally associated with a reduction of IVH without any significant side effects like renal dysfunction, GI bleeding or NEC.

The marked shift in the patterns of drug use in Iran, from opium smoking to injecting drug use, has led to serious health-related outcomes. This study was designed to explore characteristics of people who inject drugs (PWID) in Tehran, Iran. Nine hundred and four PWID were recruited from treatment and harm reduction facilities, as well as drug user hangouts in public areas in Tehran. Participants were interviewed using the Persian version of the World Health Organization Drug Injecting Study Phase II questionnaire. The median age at the time of the first illegal drug use, at the time of the first injection and current age was 20, 24 and 32, respectively. In more than 80% of the cases, the first drug used was opium. The transition from the first drug use to the first drug injection occurred after an average of 6.6 and 2.7 years for those who had started drug use with opium and heroin, respectively. Two-thirds of the participants shared injecting equipment within the last 6 months. Difficulty in obtaining sterile needles and thehigh cost of syringes were reported as the major reasons for needle/syringe sharing. Approximately 80% of community-recruited PWID reported difficulties in using treatment or harm reduction services. Self-detoxification and forced detoxification were the most common types of drug abuse treatment in alifetime. Despite a dramatic shift in drug policy in Iran during the past few years, wider coverage of harm reduction services, improvement of the quality of services, and education about such services are still necessary.

The aim of this study was to evaluate the psychometric properties of tools "Team-Based Learning Student Assessment Tool", Classroom Engagement Survey (CES) and to assess the reaction of learners toward TBL sessions at Tehran University of Medical Sciences. This descriptive study was done in 2013. The first step was to assess the reliability and validity of the tools. TBL-SAI questionnaire include 39 items, and CES consists 8 items. The validity was assessed through Delphi rounds by experts and reliability, through internal consistency and Test-Retest approach. Then, the reaction of medical students (N=78) was assessed concerning the aspects of team-based learning sessions through TBL-SAI and CES. The data were analyzed through descriptive tests. Our results have study confirmed the TBL-SAI and CEA validity. The tools ’reliability was approved through: TBL-SAI Cronbach's alpha=0.79, CES Cronbach's alpha=0.71 and TBL-SAI ICC=0.82, CES ICC=0.75. The result of the second phase showed the TBL_SAI scores of participation were appropriate concerning TBL session (12.89±159.60). According to confirmed validity of tools, these can be used in researches related to team-based learning in Iran. It could facilitate assessing the learners’ reaction of team-based learning studies at Iranian medical science universities. In the present study, the reaction of students who participate in TBL sessions had been positive and their participation, satisfaction, and accountability had been improved.

Parapharyngeal abscess is a life-threatening disease. Upper respiratory tract infection is the main cause in children. We present a 15-month-old boy admitted to the emergency ward with the chief complaint of difficulty in breathing caused by parapharyngealabscess. His condition deteriorated gradually, and he transferred to the operation theater quickly for abscess drainage and because of the difficulty in orotracheal intubation; a tracheostomy was performed. His respiratory condition deteriorated 2 days after PICU admission, and the medical team noticed an unexplainable respiratory distress. A chest x ray obtained and showed a right side pneumothorax and subcutaneous emphysema around theneck area. The case presented here, had not been diagnosed at the first examination; however, there were enough clinical clues (such as respiratory distress, drooling, torticollis, bulging of theneck, previous viral respiratory infection, possible pharyngeal trauma). The story of this case reminds us the importance of the precise physical exam and history taking which could be life-saving.

Plasma cellmyeloma constitutes about 10% of all hematologic malignancies. Metastatic cutaneous lesions without underlying bony involvement are rare and associated with advanced disease, poor prognosis and high tumor burden. IgG is the most common subtype and IgD is believed to have a more aggressive course.

Primary adenoid cystic carcinoma (ACC) of Bartholin’s gland is a rare gynecologic malignancy. We report a case of locally advanced ACC of Bartholin’s gland. A 62-year-old presented with left Bartholin’s gland carcinoma and underwent left radical vulvectomy, left-sided inguinal-femoral lymph node dissection, posterior pelvic exenteration, and pedicle abdominal muscle flap. On her 3 months follow-up exam she was disease free.Pelvic exenteration for thetreatment of this rare disease in the vulva is a potential curative option.