مجله دانش و تندرستی در علوم پایه پزشکی
سال چهارم شماره 4 (زمستان 1388)

Abstract Enough information about lumbar vertebrae translation and rotation in Iranian population is not available. So, A preliminary study aimed to study of quantitative motion profiles of lumbar spine in Iranian population was done. A total of 22 healthy volunteer males aged between 21-43 years participated in this deh1ive study. Radiographic variables contain vertebral translation and rotation in sagital plane which were calculated with Panjabiُs method. The method proposed from putto was used for lumbar flexion – extension radiography. Three radiographies were taken in neutral, full flexion and full extension positions. The variables were calculated using CARA software after scanning. The deh1ive statistics were utilized to deh1ion of variables. The results demonstrated 1. 15 mm translation in L1-2 level, 1. 58 mm in L2-3 level, 2. 4 mm in L3-4 level, 2. 80 mm in L4-5 level and 1. 18 mm in L5-S1 level. For rotational motion, results showed 10. 25 º rotations in L1-2 level, 11. 83º in L2-3 level, 13. 61º in L3-4 level, 17. 11º in L4-5 level and 16. 26º in L5-S1 level. The results of present study demonstrated average translation less than 3 mm and average rotation less than 20º in lumbar motion segments. These results support idea of some researchers and are disagree with some others.

Intertrochantric fracture treatment is one of the orthopedic problems in the elderly. Especially in unstable fractures and patients with osteoporosis the outcome of treatment is not satisfactory. This study introduces criterion which might be effective in the prognosis of the treatment. Between 2002-2007, 128 patients with unstable intertrochantric fracture who had a severe osteoporosis in terms of sigh’s criterion (grade 1-3) and were treated with DHS and had a Tip Apex Distance (TAD) below 25mm were followed up. In this patient Y/B (diameter of femoral neck/diameter of body of nail) and X/A (great diameter of femoral head/ diameter of pitch of nail) were calculated and failure of treatment was evaluated in different groups. The total amount of treatment failure was 33 (26%). the average age of patients was 74.4 years old. 86 patients were female and 42 of them were male. The greatest failure rate was seen in B1 group (21 cases) with Y/B≥3.6mm and in B2 group (23 cases) with X/A≥3mm. The mean of Y/B and X/A were 3.64 and 3.08 millimeters, respectively. Noting the high incidence of treatment failure especially in B1 and B2 groups which shows great incidence of the treatment failure in patients with large femoral neck and head diameter, new treatment measures should be taken to improve the treatment prognosis of unstable intertrochantric fractures especially in patients with large femoral neck and head diameter.

Activation of the cyclic adenosine monophosphate (cAMP) pathway produces mechanical hyperalgesia, sensitizes nociceptive spinal neurons, and phosphorylates the transcription factor cAMP-responsive element binding protein (CREB), which initiates gene transcription. This study examined the role of the cAMP pathway in a model of chronic pain, by assessing associated behavioral changes after inhibition of Adenylyl syclase in rostral ventromedial medulla (RVM). In this study, thirty-six Sprague- Dawley rats (weighing 250-300 g) were divided into six groups including control, vehicle, sham and SQ-22536 (50, 100 and 200 nmol) groups. Formalin was injected into the right paws of all groups. Intra-RVM injection of SQ-22536 (100 nmol) decreased formalin induced nociceptive pain in the 5th, 10th, 15th, 25th, 35th, 50th and 55th minutes. Also, SQ-22536 (200 nmol) decreased formalin induced nociceptive pain in the 15th minute. Therefore, inhibition of the adenylyl cyclase inhibitoion in the rostral ventromedial medulla decreases formalin induced nociceptive behaviors in rats.

Cutaneous Leishmaniasis (CL) is an endemic parasitic disease in Iran. The residual unpleasant scar of this disease could be a potentially serious psychological threat to the patients. Based on the results of our previous study on the efficacy of trichloroacetic acid (TCA) in the treatment of CL, this study was designed to evaluate the effect of topical 5% TCA cream in the treatment of papulonodular leishmaniasis lesions. In this case series study, among the patients who were referred to skin disease and leishmaniasis research center(SDLRC), 16 patients with positive direct smear for leishmaniasis were randomly selected for treatment with 5% TCA cream or, twice a day for 8 weeks or up to complete healing(epithelization)of the lesions. At the end of the treatment period, the response rate was assessed as complete cure, partial cure or treatment failure. The size of the scar was measured 6 months after complete epithelization of the lesions. The data were analyzed using SPSS version 12. The mean area of the lesions was 38.81± 81.9 mm2 before the treatment, and 3.6± 9.1 mm2 at 6 month follow up period. Complete cure was achieved in 1 patient (6.3%) at week 2, in 13 patients (86.7%) at week 7, and in all patients at week 8. There was no serious reaction in none of the patients. Only one patient had mild erythema at week 2 and edema at the application site at week 5 which completely was resolved within 2 weeks. Our results showed complete cure in all cases at week 8 without any serious side effects. Considering the efficacy of TCA in decreasing the size of the residual scar and its low cost compared to other treatments, 5% TCA cream could be considered as an alternative modality for intralesional glucantime in the treatment of CL. Further assessment as a double blind randomized clinical trial is warranted.

In order to help establish appropriate treatment goals, increase awareness of fall risk, and assign appropriate assistive device, balance assessment is necessary for most of the elderly in health setting. Falls have significant relationship with the health of elderly people; and its early identification will lead to reducing future fall risk. Therefore, the present study was done with the aim of comparing three functional tests in identifying elderly non-fallers and fallers. Materials: In this causal-comparative study, 52 elderly men and women were selected from Subjects three parks in Tehran. Having Completed a consciousness evaluation questionnaire through convenience sampling and based on participants’ self-reports, the subjects were divided into an elderly group (27 people) with a history of one or more falls in the previous one year and an elderly group (25 people) with no history of falls. The data were collected through Timed up & Go test, Functional Reach test and Berg Balance Scale and they were analyzed via MANOVA and Pearson correlation coefficient tests(P

The nurses are known as a high risk group for occupational low back pain. This study was carried out to determine the relationship between back pain with psychosocial factors and psychological stress in nurses in Amol hospitals. In this analytical study 400 nurses working in Amol hospitals completed a questionnaire including 3 parts; demographic data, psychosocial stress related to work and work related psychological stress. Results of the crude and adjusted odds ratio were expressed at 95% confidence interval. 324 (81%) of the participating nurses have experienced low back pain at least once over the last year. Their average age of the participants was 32.4+6.2 years, the average height was 166.7+ 8.7cm and the average weight was 67.7+9kg. Among the demographic factors, factors such as gender (female) (OR=2.8), regular exercise (OR=0.4), increased height per centimeter (OR=1.06) and increased weight per/kg (OR=1.04) had statistically significant relationships with back pain. Among the work-related psychosocial factors, it was observed that for one degree of increase in the intensity of a dissatisfaction with colleagues, the likelihood of back pain would increase up to 80%. As for the work-related stressful factors for each degree of increase in the scale (always, often, sometimes and never) of hasting to work, the likelihood of back pain would decrease up to 40%. Back pain is one of the most serious problems of the nursing job which is associated with psychological stress at work. Therefore, in order to reduce and prevent the complications resulting from back pain, it seems necessary to adjust and improve the psychosocial environment of the hospital and to train stress coping techniques to the workers.

Mongolian spots (Congenital Dermal Melanocytosis) are the most frequently encountered pigmented lesions in newborns. The spots typically appear as congenital blue-grey macules. These lesions vary in size and color. The most common location is the sacro-gluteal area. Its prevalence varies from 10% in Caucasians to more than 90% in Mongolians. Only a limited number of studies were carried out to investigate the frequency of these spots in Iran. This study was conducted to study Mongolian spots prevalence and their common sites in newborns at Lolagar hospital

This descriptive-Analytic study was carried out for two years (2004-2006) at Lolagar hospital in Tehran. During this period, 1706 newborns were examined by pediatricians for Mongolian spots prevalence and their common sites in newborns.

Mongolian spots were observed in 37.3% (637 Neonates) neonates. The most frequent site of involvement was the sacral, followed by the gluteal area. Mongolian spots prevalence did not show any significant statistical relationship to sex, gestational age, mother’s age, birth weight and delivery type (P>0.05).

The prevalence of Mongolian spots at Lolagar hospital was similar to the prevalence reported in previous studies in Tehran and Yazd. However it was different from the prevalence reported in studies done in Ahvaz and Bosher. A complementary genealogical study on a representative Iranian sample is necessary.

This study was carried out to evaluate the family physicians program (strengths and weaknesses) in Maragheh. In this descriptive cross-sectional study, the study population included 375 under care people, family physicians, health system managers and staffs from Rural Health Centers in Maragheh. Data collection instruments were questionnaire and checklist which have already been confirmed for reliability& validity. SPSS software was used for date analysis. About %97 of participants had awareness about family physician implementation; 97/6% used family physician services and 96/8 had health insurance. The major strengths of family physician program were: developing the health files for all people, improving prenatal and child care, increasing easy access to physician and medicine, and decreasing health expenditure for people. However, the major weaknesses were: increasing health houses customers, lack of job security and delay in salary payment for family physician team members, and limited availability of physician in health houses. The study results imply some suggestions that can solve family physician weaknesses, improve quality of delivered care, and increase customer’s satisfaction: 1. developing electronic health files for family physician clients. 2. Motivating and briefing specialists on the manners of dealing with referred patients and giving appropriate feedback. 3. Revising and redefining the target population. 4. Solving financial problems of family physician team members.

Regarding the high prevalence of sleep disorders in the general population and noting the effect of sleep disorders on people mental and physical function, this study was performed to assess the pattern of sleep, daytime sleepiness and risk factors in an urban Iranian population in Shahroud. 400 residents from Shahroud (Northern city in Iran) who were at least 15 years old were randomly selected via a two stage sampling procedure. A 48-item questionnaire was administered to the subjects. 377 questionnaires were returned. Epworth sleepiness scale and a 4-point scale were used for snoring and sleep apnea. The mean age of subjects was 30 years old and females formed the majority of the subjects (62.3%). Based on Epworth sleepiness scale, 41.6% of the subjects had scores higher than 6, and 13.9% of the subjects had severe daytime sleepiness (ESS>10). The average score of sleepiness was 6.2 with a standard deviation of 3.8. According to clinical signs, 1.6% of the subjects had sleep apnea. 12 % subjects had less than 6 hours round the clock. The mean and median waking time was 7 a.m. and more than 40% of the subjects slept after the midnight. Results show a high prevalence of sleep disorder among this population and more attention to them is required.