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The Predictive Role of Preoperative Leukocytosis, Anemia and Thrombocytosis with the Severity of Epithelial Ovarian Tumors
Get PDFBACKGROUND AND OBJECTIVE: Ovarian cancer is the sixth common cancer among women in the world. Preoperative blood cell count can be a biomarker that predicts the severity of different types of cancer and determine the type of surgery. Therefore, the present study was conducted to determine the predictive role of the three blood markers of anemia, leukocytosis and thrombocytosis in the stage and grade of epithelial ovarian cancer before the operation.
METHODS: In this cross-sectional study, the data of 60 patients with epithelial ovarian cancer were evaluated. Demographic data, hemoglobin, white blood cell count and platelets were statistically compared based on the stage of disease and the grade of mass differentiation as good, moderate and undifferentiated.
FINDINGS: 61.1% of patients with thrombocytosis were in stage 3 and 33.3% of patients with leukocytosis were in stage 2 (p≤0.05), while 20.5% of the patients with anemia were in stage 3 (p>0.05). Moreover, 52.4% of patients with leukocytosis and 61.1% of patients with thrombocytosis had grade 3 tumor (p≤0.05), but only 34.1% of patients with anemia were in this group (p>0.05). Based on the evaluation of the ROC curve, cut-off point of the white blood cell was calculated to be 9050/ml with a sensitivity of 64% and specificity of 65% and platelet count was calculated to be 266000/ml with a sensitivity of 88% and specificity of 53%.
CONCLUSION: Based on the results of this study, preoperative leukocytosis and thrombocytosis were correlated with stage and grade of epithelial ovarian cancer and had a predictive role
A Case Report of Mucopolysaccharidosis Type VI
Get PDFBACKGROUND AND OBJECTIVE: Mucopolysaccharidosis type VI (MPS VI) is a lysosomal storage disorder and autosomal recessive caused by arylsulfatase B deficiency in the body and progressive accumulation of glycosaminoglycan in different organs. Considering that this disease has low prevalence in Iran and worldwide, we report a case of MPS VI diagnosis in this study.
CASE REPORT: A five-year-old boy was referred to Imam Khomeini Clinic in Esfarayen due to impaired growth and dyspnea. In the biography of this boy, there is the history of previous hospitalization due to dyspnea when he was three months, two years and three years old and was treated with antibiotics and salbutamol spray for three days each time. The pediatrician got suspicious of MPS because of the child's peculiar face. Blood tests were performed in terms of the levels of lysosomal enzymes and the urine sample was sent to the Metabolic Laboratory of Hamburg University Medical Center to study the glycosaminoglycan levels. After six months, the results of the tests indicated low levels of serum arylsulfatase B and the increase in chondroitin and urinary levels of dermatan sulfate. To investigate the presence of complications, echocardiography, electromyography, eye and ear examinations as well as radiography for chest, back, hip and hand were performed. Clinical and paraclinical findings confirmed the MPS VI disease and therefore, treatment with naglazyme enzyme was started for the patient.
CONCLUSION: Based on the results of this case report, growth impairment, history of hospitalization due to respiratory problems and the patient’s peculiar face are key points for further investigation regarding MPS VI disease
Effect of Motor Imagery Training with Sensory Feedback on Sensory-Motor Function of the Upper Extremity in Patients with Chronic Stroke
Get PDFBACKGROUND AND OBJECTIVE: Conventional rehabilitation in stroke patients is more likely to use repetitive movements to improve motor function, which may be difficult for people with motor limitations. Mental imagery training can be done without moving the affected limbs, and this method is safe, cheap and accessible. The aim of this study is to investigate the effect of motor imagery training with sensory feedback on sensory-motor function of the upper extremity in patients with chronic stroke.
METHODS: In this non-randomized clinical trial, 30 stroke patients with level of upper extremity function according to Brunnsrom’s recovery ≥ 2, and cognitive function level according to MMSE ≥ 21 were selected through non-probability sampling from rehabilitation centers and randomly divided into intervention and control groups. Patients in the control group received conventional rehabilitation programs, and patients in the intervention group received motor imagery training with sensory feedback in 12 sessions (45 – 60 minutes), in addition to conventional rehabilitation programs. Before and after the interventions, sensory and motor functions were assessed using Box-Block test, Purde-Pegbord test, range of motion, FMA-UE total and FMA-UE coordination/speed, 2-point-discrimination, Nottingham-Sensory Assessment, Modified-Ashworth Scale and Stroke Impact Scale.
FINDINGS: Mean percentage of changes in motor function and speed/coordination of upper extremity, shoulder and elbow range of motion and gross dexterity was higher in the interventional group (50%, 50%, 80%, 50% and 80%, respectively) compared with the conventional rehabilitation group (20%, 18%, 50%, 30% and 30%, respectively) (p≤0.05). However, both interventions had similar effect on sensory function, fine dexterity, muscle tone and activities of daily living.
CONCLUSION: The results of the study showed that motor imagery training with sensory feedback along with conventional rehabilitation could enhance the motor function, gross dexterity and range of motion of the upper extremity in chronic stroke patients
When does obesity begin in northern Iranian children?
Get PDFBackground: Identifying the onset of obesity in children can be helpful to design the prevention programs for obesity and its complications. The aim of this study was to evaluate the onset of obesity in children. Methods: This cross-sectional study was conducted on the first grade of primary school children in Sari (urban areas) (Mazandaran Province, Iran) in 2014. The names and contact information of the first grade of primary school children (6–7 years old) were obtained through referring to Sari Health Center (Schools Health Unit). The onset of obesity was identified and recorded based on a body mass index (BMI) higher than 95 (for age and gender) and the weight/age and height/age Centers for Disease Control and Prevention (CDC) growth charts which were available in the child health records. Results: There were 127 obese children (71 boys, 56 girls) in the current study. The mean weight, height and BMI of children were 32.63±4.918 (kg), 123.02±5.166 (cm) and 21.52±2.369 (kg/m2), respectively. Furthermore the chance of obesity increased as the child grew up and there was an upward trend from 3 to 6 years old. Conclusions: According to the results the obesity frequency remains high; thus, it is important to pay special attention toward children's weight gain during this period even if it is not within the overweight/obesity range
Seasonal incidence of type I diabetes mellitus in the north of Iran
Get PDFBackground: Type I diabetes mellitus (T1DM) with growing frequency which is considered as a world health threatening problem is an autoimmune disease with insulinupenia. Considering the relationship between the incidence of T1DM and environmental factors, the aim of this study was to assess seasonal incidence of T1DM and its association with birth season. Methods: This cross-sectional study was conducted on 112 diabetic patients (66 males, 46 females) less than 18 years, referred to Pediatric Endocrine Clinic (Amirkola Children's Hospital) during 2011-2017. All the needed information was extracted from the patient's files and asking questions of their parents. Data were collected in a checklist. Comparison between different seasons and age groups was done by Pearson's chi-square test. Data were analyzed using SPSS 19 and p£0.05 was considered significant level. Results: The mean age of the patients during diagnosis of T1DM was 7.34±3.70 years. The incidence of T1DM was significantly increased in the cold seasons (especially winter) (P<0.008). A more increased incidence was seen in cold seasons in the aged group of 5-9 years old compared to other groups. However, no significant difference was found in all groups in terms of birth season. Conclusions: The results of this study suggest the effects of season as an environmental factor on diabetes incidence. This seasonal diversity is more prominent in the age less than 10 years. So, attention to maintaining the public health and to preventing from viral infections in cold seasons is recommended
Manual therapy in the treatment of carpal tunnel syndrome in diabetic patients: A randomized clinical trial
Get PDFBackground: Generally, conservative interventions including physiotherapy modalities and manual therapy have been recommended in the management of carpal tunnel syndrome (CTS), but this subject has not been studied in diabetic patients with CTS. Therefore the aim of this study was to investigate the effects of manual therapy on diabetic patients with CTS.
Methods: Thirty diabetic patients with CTS were randomly divided into two equal groups: modality group and manual therapy group. Participants in the modality group received transcutaneous electrical nerve stimulation (TENS) and therapeutic ultrasound (US) and patients in the manual therapy group received manual techniques for the median nerve and its surrounding structures. Interventions were applied 3 times weekly for 4 weeks in both groups. Visual analogue scale (VAS), symptom severity scale (SSS), functional status scale (FSS) and median neurodynamic test (MNT) were evaluated before and after the interventions in both groups. Paired t-test and independent t-test were used for statistical analysis.
Results: Paired t-test revealed that all of the outcome measures had a significant change in the manual therapy group, whereas only the VAS and SSS changed significantly in the modality group at the end of 4 weeks. Independent t-test showed that the variables of SSS, FSS and MNT in the manual therapy group improved significantly greater than the modality group.
Conclusions: Manual therapy techniques applied to mechanical interface of the median nerve and nerve mobilization possess more appropriate and valuable effects on hand difficulties than modalities in diabetic patients with CTS
Isolated hepatitis B core antibody in HIV infected patients--can response to hepatitis B vaccine help to elucidate the cause?
Get PDFBackground: Concomitant hepatitis B and HIV infections are common. In some of these patients, HBcAb is the only serologic marker of hepatitis B. This study was conducted to elucidate the cause of isolated HBcAb in HIV-infected patients via hepatitis B vaccination.
Methods: In this interventional study during 2014-15 in the HIV Clinic in Hamadan, thirty four patients with HIV infection and isolated HBcAb positive isolate, received hepatitis B vaccine and their responses to vaccination were investigated. Demographic data, stage of disease, and status of CD4 and HCV Ab were extracted from the patients' medical records and were entered in a checklist.
Results: Of the 103 HIV positive patients, the prevalence of HBs Ag, and HBc Ab isolates were 6.79% (n=7) and 46.6% (n=48), respectively. All of the patients with isolated HBcAb were positive for HCV Ab. Among the 48 patients with isolated HBc Ab, 34 (70.8%) were available and examined for HBV DNA in serum samples. The result of PCR was negative in all. After the first round of hepatitis B vaccination, HBs Ab titer exceeded 10 International Units Per Liter (IU/L) in 58.8% of patients with isolated HBc Ab. With the completion of the three-dose of vaccine, this titer was observed in 97% of patients. Significant correlation was observed between titer of antibodies and values of CD4 cells.
Conclusions: Due to favorable response to hepatitis B vaccination in HIV positive patients with isolated HBc Ab, false positive HBc Ab and recovery from previous infection were more probable than hidden hepatitis B
Analysis and visualization of Iranian scientific activities on thalassemia according to scientometric indicators
Get PDFBackground and aim: Today, scientometrics is the main method of assessing and comparing the scientific publications of countries, universities, scientific institutions, specific subjects and authors. The aim of this study was to evaluate the Iranian scientific outputs on thalassemia based on scientometric indicators. Material and methods: In this scientometric study, the social network analysis was used to investigate the co-authorship, word co-occurrence and collaborative coefficient. The study population included 476 articles on thalassemia, indexed in the Web of Science (WoS) from 2006 to 2016. Excel ،Raver-matrix ،SPSS19، UCINET 6/28، Netdraw 2/141 and VOSviewer were utilized for data analysis based on scientometric indicators. Findings: The growth rate (27.94) suggested that scientific outputs on thalassemia had an increasing trend in the WoS. Mean collaborative coefficient was 0.78, and the findings showed that there was a significant relationship between the number of authors and citations to each paper (p=0.05). The Pearson correlation coefficient was 0.650, indicating a direct and positive relationship among the studied variables. However, the co-authorship network of authors and institutes with density of 0.006 and 0.015 indicated low coherence of researchers' network in the field of thalassemia. Conclusion: In the field of thalassemia, both scientific outputs and scientific cooperation level have increasing trend, but compared to other fields, the collaborative network has no good coherence, and it is a great way to achieve the desired status
The effect of plasma rich in growth factors (PRGF) in the treatment of periodontal three-walled intrabony defects
Get PDFIntroduction: The aim of periodontal treatment is to regenerate periodontium. Regenerative treatments include the use of plasma that is rich in growth factors (PRGF).
Materials & Methods: In a randomized clinical trial, 20 three-walled intrabony defects from five patients with moderate periodontitis were randomly assigned to three groups. Patients in the control group underwent debridement of lesions. In the first treatment group, the defects were debrided and cenomembrane was applied. The third group was treated with debridement, PRGF and cenomembrane. Measures of vertical probing depth (VPD), vertical clinical attachment level (VCAL), gingival index (GI; Sinless and Loe) and radiographic index (by digital subtraction) were made preoperatively and 6 months post-surgery. Wilcoxon signed-ranks and Chi-square tests were used for analyzing quantitative and qualitative variables, respectively.
Results: All three groups showed improvements in all measures except GI. Intra-group comparison for clinical attachment level (CAL) indicated significant difference in all groups before and after surgery (P<0.05); there was no correlation in CAL among groups before surgery Intra-group comparison demonstrated significant differences in all three groups before and after surgery (P<0.001). A statistically significant difference was found in radiographic indices among the groups post-surgery (P=0.009).
Conclusion: The use of PRGF was associated with improvements in all parameters but not for GI
A cone-beam computed tomography study of apical and mental foramen’s location in mandibular premolars
Get PDFIntroduction: Knowledge of the internal anatomy of the tooth, apical foramen (AF) and mental foramen (MF) is considered a basic prerequisite before root canal surgical and non-surgical treatments. The aim this study is evaluation the distance and situation of AF & MF to anatomic apex of mandibular premolar.
Materials & Methods: In this cross-sectional study, CBCT images of mandibular premolars from 240 patients with a minimum age of 20 years were evaluated. The location and distance of the MF and AF from the anatomical apex in mandibular premolars were investigated. The information was compared in both genders and both sides of mandible, and analyzed using ANOVA, Chi-Square and T-Test.
Results: In the right quadrant, the mean distance from AF to the anatomic apex in the first premolars was higher than the second ones (p = 0.02). There was a significant difference among the mean distances from AF to the anatomic apex in various positions of the AF in both quadrants. The MF was closer to the second premolars in both sides (p <0.00). No significant difference was observed between two genders and two sides of the jaw.
Conclusion: possibility of lateral extrusion of canals in the mandibular premolars , the use of the auxiliary devices such as apex locator is useful. According to different place of MF, it’s necessary to pay attention to this position during the periapical surgeries in the mandibular premolars, specially in second premolar