فهرست مطالب

Middle East Journal of Rehabilitation and Health Studies
Volume:3 Issue: 4, Oct 2016

  • تاریخ انتشار: 1395/08/25
  • تعداد عناوین: 8
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  • Nooshin Abdollahpour, Alireza Ataei Nakhaei, Farnaz Kalani-Moghaddam *, Elham Masoumzadeh, Majid Sezavar Page 1
    Background

    Despite recent pharmaceutical advancements in the production of new antibiotics, antibiotic resistance is increasing at an alarming rate in mammals; given the high prevalence of infectious diseases.

    Objectives

    The current study aimed to determine the epidemiology of different infections in patients admitted to the infectious disease ward of Imam Reza hospital in Mashhad, North-East of Iran.

    Methods

    This cross-sectional study was conducted on 1681 patients referred to Imam Reza hospital of Mashhad during 2006 - 2008. Prepared checklists were used to collect the required data, including age, gender, employment status, place of residence, length of hospitalization and season of admission in patients diagnosed with infectious diseases.

    Results

    In the current study, prevalence of tuberculosis, septicemia, skin and soft tissue infections, urinary tract infections (UTIs), febrile neutropenia, myocarditis, and gastrointestinal infections were estimated at 8.4%, 8.3%, 7.1%, 5.4%, 4.9%, 3.9%, and 3.8%, respectively. Also, major respiratory infections were reported in 5.8% of the studied patients. Among the female patients in the study, 20.9% and 10.56% were diagnosed with pneumonia and tuberculosis, respectively. As for the male patients, 16.1%, 10.7%, and 7.1% were diagnosed with pneumonia, nervous system infections and tuberculosis, respectively.

    Conclusions

    According to the results of the study, the most common causes of hospital admission were respiratory infections (e.g. pneumonia), nervous system infections, tuberculosis, septicemia, skin and soft tissue infections and UTIs. Considering the diversity of infections, epidemiological evaluation of these diseases is essential, especially in regions with high prevalence of infectious diseases. Furthermore, etiological diagnosis is considered imperative for clinicians before initiating therapy in patients with infectious diseases

    Keywords: Iran, Pneumonia, Epidemiology, Infectious Diseases
  • Sanam Moradan *, Majid Mirmohammadkhani, Samaneh Lavvaf Page 2
    Background

    Since the best method of cervical smear is a controversial subject, this study was designed to compare two methods of cervical sampling, consisting of conventional versus liquid base.

    Objectives

    Pap smear is a screening test used to detect pre malignant and malignant processes in the endocervical canal of the female reproductive system. There are two methods, consisting of conventional Pap, in which samples are smeared directly on a microscope slide after collection, and liquid based cytology, in which the smear sample is placed in a bottle of preservative for transport to the laboratory, where it is then smeared on the slide. In this study it was decided to compare these two methods of sampling.

    Methods

    This randomized trial was carried out at the Amir Hospital of Semnan, Iran on 240 females undergoing Pap smear screening from April to September 2012. Patients were divided to two groups including conventional (n = 120) and liquid base cytology smear (n = 120). The results of cytological reports of both groups were compared in regards to sufficiency of sample, presence of blood in the sample, presence of infection and premalignant or malignant condition.

    Results

    Specimen adequacy and smear quality were significantly better in liquid base sampling (P = 0.03); presence of benign cellular changes was not different between the two groups (P = 0.389). Diagnosis of bacterial vaginosis was significantly better with the conventional method (P = 0.007). Also, severe inflammation was more commonly reported in the conventional method than liquid base sampling test (P = 0.029).

    Conclusions

    Specimen adequacy and diagnosis of inflammatory reaction were better in liquid base smear and convention smear, respectively.

    Keywords: Pap Smear, Conventional, Liquid Base
  • Sanam Moradan *, Majid Mirmohammadkhani Page 3
    Background

    Cesarean section is one of the most common surgeries around the world. There are several different techniques for cesarean section. The most common techniques are Pfannenstiel-Kerr (PK) and the newer technique Misgav-Ladach (ML). The objective of this trial was to compare intraoperative and short-term postoperative outcomes between the Pfannenstiel-Kerr and the modified Misgav-Ladach techniques in primary cesarean deliveries.

    Methods

    In a prospective controlled trial, 100 females were randomly assigned to the PK (n = 50) and ML (n = 50) groups. The two groups were compared in terms of duration of surgery and fetus delivery, blood transfusion, febrile morbidity, analgesic use, changes of hematocrit level, bowel transition time, wound infection /dehiscence and neonate five-minute Apgar score.

    Results

    The duration of surgery and fetus delivery was significantly lower in ML than PK technique (P = 0.000). Analgesic use during the post-operative period was significantly lower in ML than PK (P < 0.001). There were no significant statistical differences between the groups in regards to drop of the hematocrit (P = 0.32), fever (P = 0.056) and bowel transit time (P = 1.000). The mean Apgar score of fifth minute was 8.80 ± 0.57 and 9.89 ± 0.42 in PK and ML groups, respectively (P < 0.001).

    Conclusions

    Misgav-Ladach appears to be faster, requires shorter incision and less analgesic drugs than PK, which might lead to better postoperative outcomes.

    Keywords: Cesarean, Misgav-Ladach, Pfannenstiel-Kerr
  • Fereshte Ahmadabadi *, Seyed Mohsen Avandi, Atefeh Aminian-Far Page 4
    Objectives

    The aim of this study was to investigate the effects of short and long-term static warm up protocol on static and dynamic balance and motor performance in gymnast athletes.

    Methods

    In this study, 16 skilled female gymnasts (mean age of 9.62 ± 1.45 years) were randomly categorized to two general warm-up with no stretching (NS, n=8) and general warm-up plus static stretching (SS, n=8) groups. The warm-up protocol included a 10-minute jogging, and the Static Stretch (SS) protocol included stretching programs on the different parts of body during four weeks, three times a week. The stretched body parts were the hamstrings, the gluteus, the quadriceps and hip flexors, and the lower back and shoulder. Each body part was stretched two times to the point of slightly painful yet tolerable muscle discomfort, for the duration of 15 seconds. Before and after acute protocol and also after four weeks, the indicators of the equilibrium of anterior-posterior and internal-external pressure fluctuations range, and track length of the anterior-posterior and internal-external pressure center were evaluated by a force plate in four static and dynamic unilateral and bilateral standing positions.

    Results

    Results of this study showed that static stretching has a significant effect on decreasing in the performance of balance during vault activity in the chronic compared to acute phase (P = 0.001). The results also revealed that there was no significant difference in static and dynamic balance with bilateral standing in the NS group in the acute phase compared to the chronic phase (P ≥ 0.05). However, dynamic balance during unilateral standing in the SW group was significantly decreased after four weeks (P = 0.001).

    Conclusions

    The results may indicate that long duration static stretch exercises can improve static balance during bilateral and unilateral standing in gymnast athletes, yet on the other hand, long duration static stretch exercises may disturb the function of the dynamic balance and so may cause sport injuries in athletics

    Keywords: Postural Balance, Static Stretching, Warm-Up Exercise
  • Sayed Mohammad Razavi, Amir Hossein Shakibamehr, Saeedeh Khalesi * Page 5

    Nevoid basal cell carcinoma syndrome (BCNS) is an autosomal dominant inherited disorder. Multiple organ systems may be affected in this syndrome including abnormalities of the skin, skeletal system, genitourinary system and central nevus system. In this report, we present a case of Nevoid basal cell carcinoma syndrome in a 26-year-old male patient. The patient had multiple odontogenic keratocyst in the posterior of mandible, syndactyly in both hand and bifid rib. After enucleation and curettage, he was followed for two years. A number of both clinical and radiological criteria are used to diagnose this syndrome. Basal cell carcinoma syndrome is diagnosed with two major criteria or one major and two minor criteria. We must suspect this disorder in young patients with multiple odontogenic keratocyst and dental abnormalities whether related or not with other clinical manifestations or familial history.

    Keywords: Odontogenic Keratocyst, Nevoid Basal Cell Carcinoma Syndrome, Gorlin-Goltz Syndrome
  • Maryam Nourelahi *, Behnaz Roshannia, Somayeh Kameli, Mohsen Hormozi Page 6
    Context

    Oral cavity is one of the most common sites for neoplasms with a multifactorial etiology. Tobacco and alcohol are the main risk factors. Periodontal disease is an inflammatory disease affecting periodontal tissues such as gingiva, periodontal ligament and alveolar bone. Periodontal disease is linked to many systemic diseases. Recently a link between periodontal disease and cancer is suggested. The current review article aimed to evaluate the association between periodontal disease and risk of cancer in the oral cavity and some related factors.

    Evidence Acquisition

     Evidence suggests that oral cavity cancer is significantly more prevalent in patients with periodontal disease, poor oral hygiene or more missing teeth. Clinically, gingival squamous cell carcinoma (GSCC) usually appears as an exophytic mass with a granular, papillary or verrucous surface or presents as an ulcerative lesion. Some reported cases of GSCC mimicking periodontal disease include gingival enlargement with no bone invasion, dentoalveolar abscess, erosive erythematosus lesion with keratotic papules, root exposure and tooth mobility, verrucous leukoplakia, verruciform xanthoma and development of hyperplastic granulation tissue after tooth extraction. Greater burden of oral flora that produce carcinogenic metabolites, human papilloma virus (HPV) and other viruses that are residents of periodontal pocket, increased amount of inflammatory mediators and markers and some periodontal pathogens affecting cell cycle leading to mutation and dysplasia are considered as the rational for the relationship between malignant lesions of oral cavity and periodontal disease.

    Results

    Cancer of the oral cavity and periodontal disease are related from different aspects. Periodontal disease and tooth loss are considered as independent risk factors for cancer. Gingival squamous cell carcinoma can also mimic periodontal disease leading to misdiagnosis and delayed commencement of appropriate treatment.

    Conclusions

    Based on evidence, dentists and dental health care professionals should consider periodontal disease as a risk factor for the development of neoplasms in the oral cavity. It also seems a good idea to provide periodontal therapy for patients with cancer to achieve ideal therapeutic results.

    Keywords: Periodontitis, Squamous Cell Carcinoma, Neoplasm
  • Marcos Edgar Fernandez-Cuadros *, Olga Susana Perez-Moro, Jose Antonio Miron-Canelo Page 7
    Background

    Osteoarthritis (OA) is a multifactorial, disabling and degenerative disease that worsens with age and affects patient’s health-related quality of life (HRQOL).

    Objectives

    The current study aimed to assess if age and comorbidities have an influence on knee OA and knee replacement outcome before and after the surgery.

    Methods

    A quasi-experimental intervention study was conducted on a sample of 125 patients with knee osteoarthritis and designed to assess total knee arthroplasty (TKA) outcomes before and after the surgery. One orthopedic surgeon performed all surgeries with the same type of joint prosthesis from 2008 to 2012. The HRQOL was assessed by the short form (36) health survey (SF-36) questionnaire.

    Results

    It was observed that knee osteoarthritis significantly affects all the dimensions of HRQOL before the surgery included in the SF-36 questionnaire and a clinical improvement observed after the intervention with total knee arthroplasty. Age influenced bodily pain (P = 0.012) and vitality (P = 0.002) in knee osteoarthritis (before the intervention), and on physical (P = 0.040) and mental health components (P = 0.002), after total knee arthroplasty. Previous arthroplasties and comorbidities had no effect on knee OA. However, previous total knee/hip arthroplasty were associated with the improvement in physical functioning (P = 0.021) after the TKA; comorbidities influenced the dimension of mental health (MH) (P = 0.036) after the surgery.

    Conclusions

    Total knee arthroplasty is justified according to the perception of clinical improvement and the improvement in the dimensions of HRQOL reported by the patients. Age affects knee osteoarthritis and TKA outcomes. Comorbidities have no influence on knee OA, but affect mental health after the intervention.

    Keywords: Knee, Osteoarthritis, Risk Factors, Quality of Life, Arthroplasty, Comorbidity, Aging
  • Marcos Edgar Fernández Cuadros *_Olga S Pérez Moro_Sandra Álava Rabasa_Juan Manuel García González_José Antonio Mirón Canelo Page 8
    Objectives

    To clinically characterize calcifying tendonitis of the shoulder (CT) through a prospective quasi-experimental before-and-after study, which provides a level of demonstrable evidence to support the decision-making and demonstrate the effectiveness of acetic acid iontophoresis and ultrasound in the treatment of CT.

    Methods

    Prospective, quasi-experimental before-after intervention study was conducted on 44 patients who referred to the rehabilitation department, Santísima Trinidad’s General Foundation hospital, Salamanca, from June 2014 to April 2016. Outcome measures: 1) Pain: measured by visual analogical scale (VAS); 2) calcification size: in millimetres, both measured radiologically at the beginning/end of treatment; 3) Intervention: Iontophoresis with 5% acetic acid at 4.7 mA × 10 minutes and continuous ultrasound 1 W/cm2 /1 MHz × 5 minutes over calcification.

    Results

    Mean age of the subjects was 54.2 years (n = 44), 65.9% female (n = 29), (95% with supraspinatus tendon (n = 38) and 5% with subscapularis (n = 2); 55% had complication in left shoulder (n = 22), 45% in right shoulder (n = 18) and 4.5% bilateral (n = 2). Regarding the occupation, 59.1% had (n = 26) administrative positions and 40.9% manual jobs (n = 18). On personal history: 34.09% were smoker (n = 15), 4.5% had diabetes (n = 2) and calcium intake secondary to osteoporosis was recorded for 2.27% (n = 1) of the subjects. Regarding radiological type: 68.18% formative (n = 30), 38.72% resorptive (n = 14) were observed. Average number of sessions was 19 and 9.01% (n = 4) of the subjects had treatment complications as intolerance/erythema/burn. Average initial pain was 7.7 points (VAS scale), significantly decreased (P = 0.0000) post treatment to 2.2. Initial average size of calcification was 10 mm and significantly decreased (P = 0.0000) post treatment to 3 mm. With respect to the change of calcification: success/cure rate was 56.8% (n = 25), improvement rate was 25% (n = 11); failure rate was 18.2% (n = 8).

    Conclusions

    CT is common in middle-aged working females. It affects supraspinatus tendon. It is associated with smoking. Occupational risk factors are awkward positions and lifting weights. Iontophoresis with 5% acetic acid and ultrasound is a safe, simple and inexpensive technique, capable to reduce pain and calcification, with a recommended degree of scientific evidence (2B).

    Keywords: Physical Therapy, Ultrasound, Shoulder Pain, Iontophoresis, Calcifying Tendonitis