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Relationship between anthropometric indices and Mizaj (temperament) in Persian medicine
Full text linkBackground: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj. Methods: Four PM experts determined the Mizaj of 121 participants. Those who had ≥70 agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression. Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. Cold-Mizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj.  Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination
Comparison of Recurrent Urinary Tract Infection in Children with Different Grades of Vesicoureteral Reflux
Full text linkBackground and Objective: Urinary reflux is the most common urological abnormality in children. About half of the children with urinary infection have urinary reflux at the same time. Considering the importance of urinary reflux in children and contradictory results reported regarding the relationship between different grades of vesicoureteral reflux and recurrent urinary tract infection, this study was conducted with the aim of comparing recurrent urinary tract infection in children with different grades of vesicoureteral reflux.
Methods: This cross-sectional study was conducted on 150 children with pyelonephritis and vesicoureteral reflux who refered to Amirkola Children's Hospital in 2011-2019. Reflux grades were determined by voiding cystourethrogram (VCUG) or direct radionuclide cystography (DRNC). Children were followed up for 2 years and in case of clinical symptoms with positive urine culture, they were considered as recurrent urinary tract infection.
Findings: Of the 150 children studied, 126 (84%) were girls and 24 (16%) were boys with a mean age of 27.17±11.53 months. 95 people (63.3%) had once, 37 people (24.7%) twice, 8 people (5.3%) three times, and 10 people (6.7%) four times experience of recurrent urinary tract infection. The odds ratio of recurrent urinary tract infection was more than two times higher in children with grade 3 and 4 reflux involvement than in children with grade 1 and 2 reflux (OR=3.20, 95% CI=1.05-9.75, p=0.041). However, there was no significant difference in recurrent urinary tract infection in children based on age at diagnosis, gender, and whether the reflux was unilateral or bilateral.
Conclusion: The results of the study showed that children with moderate and severe involvement of vesicoureteral reflux experience higher recurrent urinary tract infection compared to mild involvement
Complications of patients with hematologic malignancies in a selected Iranian population
Full text linkBackground: Hematologic malignancies in childhood and their treatments can cause dental anomalies and jaw bone abnormalities; therefore, the aim of this study was to assess the prevalence of these disorders in children. Methods: This cross-sectional study was conducted on all children diagnosed with hematologic malignancies that referred to in Amirkola Children’s Hospital from 2011 to 2018. All of children underwent clinical evaluation in a Dental Radiology Clinic and panoramic imaging was performed. The radiographs were examined for dental anomalies and jaw bone abnormalities. The data were analyzed by descriptive analysis using chi-square, Mann-Whitney and Kruskal-Wallis with a 95 confidence interval. Results: The study population consisted of 32 children and 9.46 of these patients showed intraoral signs in clinical evaluations. Panoramic radiographs indicated dental anomalies in 12 (63.9) and jaw bone abnormalities in 17 (89.4) patients. The most common dental anomaly and bone abnormality were taurodontism and changes in lamina dura, respectively. By measuring the mandibular cortical index (MCI), it was revealed that 13 had osteopenia, in which 4 of them had severe osteopenia (osteoporosis). The statistical analysis demonstrated that there was a significant difference between the incidence of osteoporosis and changes in lamina dura with the gender (p<0.05). Conclusion: Due to early onset of osteopenia and osteoporosis and the presence of dental and bone abnormalities in half of study population, early assessment of their clinical and radiographic condition can be helpful in the prevention and the early treatment of their oral complications
Frequency of fruit and vegetable consumption and oral health-related quality of life among the elderly in Amirkola (Babol, Iran)
Full text linkIntroduction: Considering that nutrition plays a prominent role in the health of the elderly, oral health and the associated quality of life are very important for a healthy diet. The aim of this study was to investigate the association between the frequency of fruit and vegetable consumption and oral health-related quality of life (OHRQoL) among the elderly in Amirkola.
Materials & Methods: This study was part of the second phase of the Amirkola elderly cohort study conducted on 750 older people who underwent a special oral and dental examination in 2016-2020 using the Oral Health Questionnaire. The frequency of fruit and vegetable consumption was assessed with the Semi-Quantitative Food Frequency Questionnaire (SQFFQ), OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI), and information on age, sex, history of systemic diseases, and the number of teeth was extracted from the full data set completed by specialists for each patient. Data were analyzed with SPSS 20 using the chi-square statistical test, ANOVA, and Pearson correlation coefficient. A value of p<0.05 was considered significant.
Results: Non-smokers and people with a higher level of education had a better OHRQoL (P=0.022 and P=0.036, respectively). There was no significant relationship between the frequency of fruit and vegetable consumption and OHRQoL, but a significant relationship was found between the frequency of fresh herb consumption and OHRQoL (p=0.005). In men, there was a significant relationship between the number of teeth and frequency of vegetable consumption as well as between OHRQoL and frequency of fresh herb consumption in men (P=0.048, r=0.096).In women, a significant relationship was observed between the frequency of total vegetable consumption and OHRQoL (p=0.021, r=0.129).
Conclusion: According to the results of the present study, it was found that the amount of fruit and vegetable consumption has no effect on improving the OHRQoL among the elderly of Amirkola city
Comparison of Clinical Findings of Acute Appendicitis and Mesenteric Lymphadenitis in Children with Acute Abdominal Pain
Full text linkBackground and Objective: Mesenteric lymphadenitis is an inflammatory process that has similar clinical symptoms to appendicitis among diseases associated with acute abdominal pain. Therefore, the aim of this study was to compare clinical and paraclinical findings in children with appendicitis and mesenteric lymphadenitis.
Methods: This cross-sectional study was conducted on 214 children who were admitted to Amirkola Children's Hospital in 2011-2021 with the diagnosis of appendicitis (112 people) or mesenteric lymphadenitis (102 people). Appendicitis and mesenteric lymphadenitis were diagnosed based on pathology and ultrasound, clinical symptoms, laboratory parameters and ultrasound of children were compared in two groups.
Findings: Out of 214 children, 112 (52.15%) were girls and the mean age of the children was 7.53±3.19 years. Children with appendicitis compared to children with mesenteric lymphadenitis were more likely to have tenderness (42.2% vs 85.7%, p<0.001), rebound tenderness (40.2% vs 4.9%, p<0.001), vomiting (79.5% vs 61.8%, p=0.004) and pain shift (11.8% vs 25%, p<0.013). Also, WBC (9774.51±3971.35 vs 15358.04±4635.20, p<0.001), neutrophil (63.42±17.05 vs 77.02 ± 10.51, p<0.001), ESR (19.73±18.56 vs 38.57±27.29, p<0.001) and CRP (18.00±27.98 vs 52.77±40.30, p<0.001) were significantly higher in children with appendicitis. Ultrasound sensitivity (0.73-0.88) was 80.4% in diagnosing appendicitis and rejected mesenteric lymphadenitis with 100% probability.
Conclusion: The results of the study showed that some clinical symptoms with leukocytosis, neutrophilia and high CRP can help differentiate appendicitis from mesenteric lymphadenitis. But ultrasound can have a more definitive result in this regard
Clinical, endoscopic, and demographic characteristics of idiopathic duodenal ulcers compared with helicobacter pylori positive ulcers
Full text linkBackground: Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers. Methods: A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn's disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group. Results: The findings showed that 417 patients (64.5) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39±15 and 42±17, respectively. In this case, 33 patients (29.7) with idiopathic ulcers and 56 patients (25.1) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21) with idiopathic ulcers and 31 patients (16.5) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers Conclusion: The present study demonstrated that the idiopathic ulcers included 17.1 of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers
Assessing the Responsiveness of the Persian Version of the Western Ontario Meniscal Evaluation Tool in Patients with Meniscus Injuries
Full text linkBackground and Objective: Responsiveness is one of the important properties of health-related questionnaires in demonstrating the changes in a patient's clinical conditions before and after therapy. The present study was carried out with the aim of assessing the responsiveness of the Western Ontario Meniscal Evaluation Tool (WOMET) and determining its minimal clinically important difference in patients undergoing physical therapy interventions after meniscus injuries.
Methods: This cross-sectional methodological study was performed on 100 patients aged 18-70 years with meniscus injuries who underwent physical therapy interventions. Patients completed WOMET and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaires in the first and tenth sessions. The minimum score obtained from the WOMET questionnaire was zero and the maximum was 1600, and the minimum score obtained from the KOOS questionnaire was zero and the maximum was 168. Internal and external responsiveness were the primary outcomes, and effect size tests, ROC curves, and correlation coefficients were used to examine them. The relationship between the WOMET and KOOS questionnaires were considered as secondary outcomes, which were evaluated by calculating the correlation coefficient.
Findings: The results of internal responsiveness showed that the standardized response mean for the entire WOMET questionnaire was 0.11 (insignificant) and Cohen's d score for the entire WOMET questionnaire was -1.586 (large). The difference in the mean internal responsiveness between recovered (20%) and unrecovered (80%) patients reached a significant level (p<0.001). This questionnaire had an acceptable external responsiveness; the area under the curve of the ROC curve was greater and equal to 0.7 and the optimal cut-off point was 20.031 (p<0.001). The Pearson correlation coefficient between WOMET and KOOS questionnaires (except the emotions subscale) was moderate to large (0.5-0.8) with p<0.001.
Conclusion: The findings of the study showed that the Persian version of the WOMET questionnaire has a high level of responsiveness and is a suitable tool for evaluating the quality of life among patients suffering from meniscus injury
Evaluation of the Effects of Low-Level Laser Therapy on the Rate of Relapse of Mandibular Incisors after Fixed Orthodontic Treatment: A Randomized Controlled Trial
Full text linkBackground and Objective: Stability is one of the major issues in orthodontics. The purpose of this study is to investigate the effect of Low-Level Laser Therapy on the rate of relapse of mandibular incisors.
Methods: This Single-blinded Randomized Controlled Trial consisted of twenty patients (aged 12-18 years) seeking orthodontic treatment. The subjects were divided into two groups with randomly permuted blocks (n=10): experimental and control groups. The Little’s irregularity index was measured on plaster models prior to treatment using American Board of Orthodontic Measuring Gauge. After unraveling of initial crowding, archwires on mandibular anterior segments of both groups were removed. The experimental group received Low-Level Diode Laser at 808 nm wavelength, 250 mW power, 4J energy and continuous wave mode, on coronal third of lower central and lateral incisors and canines’ roots for sixteen seconds three times a week, within a four-week period. The relapse rate was quantified on each plaster model using Little’s irregularity index at the end of first (T1), second (T2), third (T3), and fourth (T4) weeks.
Findings: The study population consisted of twenty patients aged 12-18 years who had 5-9 mm crowding and proper oral hygiene. At T1, the relapse rate was 0 mm and 0.05±0.15 mm in experimental and control group, respectively, which was not statistically significant (p=0.343). Over the following weeks, however, there was statistically significant difference between the relapse rate of the two groups (p=0.003). The mean rate of relapse percentage was 4.48±4.31 mm in experimental and 12.06±5.52 mm in control group, which was significantly lower in Low-Level Laser Therapy group.
Conclusion: The application of Low-Level Laser Therapy at 808 nm wavelength on mandibular incisors during orthodontic retention phase may slow down the relapse rate. Therefore, it could be considered as an effective adjunct to reduce immediate relapse
Determination of plasma transcobalamin-II and zinc levels in newly-diagnosed and long-standing grand mal epileptic patients
Full text linkBackground: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly–diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group. Methods: Thirty patients aged 36.76±12.91 years with newly–diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 ±12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 ±12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits. Results: Plasma level of TCII in the newly–diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls 14.89 ±3.24 and 21.84± 2.73 vs. 9.55±1.24, (n=30), respectively. Plasma level of Zn was decreased in the newly–diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group 69.28± 6.41 and 80.56 ±6.12 and vs.75.80±1.59, (n=30), respectively. Conclusion: This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly–diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes.  
A Rare Case of Association between Pseudohypoparathyroidism and Type 1 Diabetes Mellitus
Full text linkBackground and Objective: Type 1 diabetes mellitus (T1DM) as an autoimmune disease is associated with hyperglycemia and pseudohypoparathyroidism with hypoglycemia. In this study, we report a rare case of association between type 1 diabetes and pseudohypoparathyroidism.
Case Report: A 12.5-year-old female patient with a one-month history of polyuria and polydipsia was admitted with severe lethargy and vomiting, and due to high blood sugar and metabolic acidosis, Diabetic Ketoacidosis (DKA) was diagnosed. She was first treated with DKA protocol and then Basal- Bolus Protocol of insulin. The patient had a history of seizures due to hypocalcemia at the ages of 8 days and 2 months. In re-examination during hospitalization due to hypocalcemia-hyperphosphatemia and high parathyroid hormone, the diagnosis of false hypoparathyroidism was proposed and treatment with oral calcium tablet and calcitriol capsule was done and she was discharged after seven days with a good general condition.
Conclusion: In patients with pseudohypoparathyroidism, in the event of a disturbance in glucose status, the pattern is usually hypoglycemia, but in our patient, this association was in the form of hyperglycemia and DKA in the context of T1DM, which is an indication of the rare association of these two diseases. Therefore, one should think about early diagnosis and proper treatment of this rare association