Researcher Bulletin of Medical Sciences
Year:2010 | Volume:15 | Issue:3 (75)|Papers Count:13

Background and Aim: Cerebral palsy is characterized by non-progressive abnormalities in the developing brain that create motor and postural deficits in the developing child. The most common feature of cerebral palsy is spasticity. In rehabilitation, orthotics has been used to prevent complications of spasticity and improve gait. There are some reports about effectiveness of tone-reducing AFO on decreasing tone in spastic cerebral palsy. The purpose of this study was to compare the effects of tone-reducing AFO on tone and gait between two groups of children with spastic diplegia. Materials and Methods: This randomized clinical trial was conducted on 30 children with spastic diplegia aged 2-8 years. They were assigned to either a control group (18 subjects) or a case group (12 subjects). All children were tested before and after 12 weeks of neurodevelopmental treatment 3 days a week by Modified Ashworth Scale and recording of the foot-print on a piece of paper fastened to the floor for the measurement of stride length, width and foot angle. Children in the case group wore the tone-reducing AFO approximately 6 hours a day. Results: A significant difference was found in muscle tone of the whole body between the two groups (p=0.025). Pretest and post-test difference of the plantar flexors and hamstrings in the case group were also significant (p=0.025, p=0.005). A significant difference was found in the right stride length (p=0.02) and the left stride length (p=0.03) between the two groups, but difference in stride width and foot angle were not significant. Conclusion: Tone-reducing AFO would significantly reduce tone of the whole body, the plantar flexors and hamstrings and increase stride length in spastic diplegic cerebral palsy.

Background and Aim: Doppler sonography is widely applied for evaluating velocity of intracranial artery and different stimuli reactivity of cerebral artery. The aim of this study was to evaluate the effects of hyperventilation on middle cerebral artery of patients with migraine without aura and control group using transcranial Doppler sonography. Materials and Methods: In this study, 30 patients aged averagely 35 years suffering from migraine without aura were compared with 30 normal age- and sex-matched subjects. Reactivity indices of right and left middle cerebral artery were evaluated before and after hyperventilation. Both groups did not use any drug during the past 48 hours before the trial and did not have any other systemic disease. Results: Heart rate, pulsatile index, resistance index, means velocity, end diastolic velocity, systolic velocity was evaluated on 30 patients (19 females and 11 males) and 30 controls. Pulsatile index was more in right middle cerebral artery of migraine subjects without aura when compared with control group. Other reactivity indices were more or less similar in both groups. Conclusion: In patients with aura-free migraine pulsatile index in right middle cerebral artery was more than control group, hence, further studies to evaluate probable effect of hyperventilation in intracranial artery in these patients are strongly recommended.

Background and Aim: Weight faltering is one of the most important health problems of children in developing communities. Factors such as infectious diseases in some regions and nutritional factors in the others have been suggested as risk factors for weight faltering. Since determining the risk factors of malnutrition and preventing them in children is crucial, a study was conducted to determine the major immediate risk factors of weight faltering up to 2 years of age in children attending health care centers in east region of Tehran. Materials and Methods: This study was carried out using existing data. Via cluster sampling 1660 two-year old children attending to 5 health care centers in east region of Tehran were selected and data was gathered from their health files. Term birth, being offspring of a uniparous labor, having no certain post-natal, genetic or congenital diseases and on time attending to health center for growth monitoring were the study inclusion criteria. The chi-square, Mann-Whitney U and logistic regression tests were used to determine relationship between risk factors and weight faltering. The major risk factors were determined by odd's ratio. Results: Girls consisted 55.5% of the children. Mean of the birth weight was 3202±463 grams. Weight faltering was occurred in 1119 (67.4%) children from birth up to 2 years of life. The great number of children had weight faltering in 9 to 11 months of age. Frequency of risk factors of weight loss was the least during the first 6 months of life. Weaning (OR=64.7), introducing complementary foods (OR=16.9), diarrhea (OR=15.3) and respiratory infections (OR=11.8) were the major risk factors. Mother's educational level and job status were not related to weight loss. Conclusion: Prevalence of weight faltering was high in the studied sample, hence, further attention and survey are strongly recommended. Since the major risk factors of weight faltering up to 2 years of age are controllable, it seems that enabling mothers towards proper feeding of children could help to reduce the prevalence of weight faltering.

Background and Aim: Myocardial infarction continues to be a major public health problem in many countries. Given the disparity of outcome in different studies and its importance, we evaluated the outcome of patients with ST segment elevated myocardial infarction (STEMI) and its influencing factors in Loghman hospital. Material and Methods: This longitudinal study conducted between 2007-2008. All patients with STEMI admitted in Loghman hospital were included. The subjects were followed up for 30 days concerning their vitality status. TIMI risk score, demographic and clinical factors were also determined and their association with death was evaluated. Results: Totally, 85 patients with a mean age of 58±14 years were evaluated, of whom 67% were males. Death occurred in 21.2%. Among died subjects, 77.8% had TIMI score of at least 8 when compared to 7.5% of alive patients (p<0.005). Sex, history of diabetes mellitus, smoking, angina and family history of coronary disease had no effect on mortality. Totally, 61% of patients who died didn’t receive streptokinase vs. 22.4% in alive subjects (p<0.005). Conclusion: Our measured survival rate is acceptable and TIMI risk score is a useful tool in predicting outcome of patients with STEMI.

Background and Aim: According to World Health Organization (WHO) reports, 80000-100000 young adults begin to consume the narcotic substances, most of whom living in developing countries. Besides family environment, school has important role in forming the one's behaviors as the pioneer educating social environment. This study was conducted to determine the smoking pattern in Tehran students during 2008.Materials and Methods: This was a cross-sectional study with a cluster multi stage randomized sampling using the GYTS (Global Youth Tobacco Survey) and demographic questionnaires on 4523 students in Tehran. Data were analyzed using chi square test. Results: Overall, 4523 students (50.2% boys and 49.8% girls) were studied with the mean age of 14.69±2.09 years. Totally, 25.5% of students have ever smoked cigarettes, and 54.9% ever smoked water-pipe. Most of the subjects commenced smoking when they were 14-15 years old (27.6%), while 38.8% purchased cigarette from stores or markets. Boys smoked more frequently in public places (36.6%), whereas girls experienced smoking at home (51.6%). Unfortunately, 22% of subjects smoked more than 5 cigarettes per day. Almost one in five current smokers had gave up and attempted to stop smoking and this was more pronounce among boys (p<0.01). Conclusion: Our results were in agreement with most of other studies of its kind worldwide. With respect to the incidence of experience and consumption of tobacco, designing and accomplishment of preventive program with first level of approach for lower ages, and inspection and execution of tobacco sale prohibition for adolescences seem to be reasonable.

Background and Aim: Studentship is a period in which many behavioral patterns are forming. Thus, the aim of this study was to determine the frequency and causes of smoking among students residing in Golestan University of Medical Sciences’ dormitories. Material and Methods: A cross-sectional analytical study conducted among the dormitories male and female students in 2009. The sample size consisted all of the university dormitories’ students. The data gathered using a validated and reliable questionnaire, then, analyzed using SPSS software and statistical tests including chi-square, logistic regression and independent t-test, when appropriate. Results: Of 669 students, 538 filled out the questionnaires completely and 67.3% were female. Totally, 92.4% of the students were single and 83.5% had experience of cigarette smoking, while 6.2% were current smokers (17.3% of males and 0.8% of females). Living with a smoker friend was the most important reason for smoking. There were significant associations between smoking and age, sex, region and year of education (p<0.05), however, we couldn’t find any significant relationship between smoking and filed of study and marital status (p>0.05). Conclusion: The results indicated low prevalence of cigarette smoking among the students. However, preventive measures should be taken to persuade youth toward healthier behaviors. It seems parental control and monitoring children’s friend finding are crucial issues.

Background and Aim: Post-LASIK infection is a life threatening condition. The present study was conducted to measure the rate of corneal interface contamination during laser in situ keratomileusis (LASIK), determine probable sources of the contamination, and evaluate how the cornea reacts to the contamination. Material and Methods: In this case series, 200 eyes were evaluated for the corneal interface contamination at the end of LASIK. Cultures were obtained from the upper and lower eyelid margins and the inferior fornices before surgery and from the corneal interface and the instrument at the end of surgery. Media were cultured at 37°C for 14 days under aerobic and anaerobic conditions. Bacteria from positive cultures were isolated and identified by biochemical procedures to determine the species of the organisms. Results: The rate of contamination was 24.5%. The most common retrieved organism was Staphylococcus epidermidis (43 cases, 87.7%). None of the contaminated or non-contaminated cases developed corneal ulcers; however, 2 eyes developed diffuse lamellar keratitis. Conclusion: The corneal stroma has the ability to clear introduced microorganisms during LASIK.

Background and Aim: Renal stone or urolithiasis is one of the most important and common problems in pediatric field. The prevalence of renal stone is 1.7-4.1% in girls and 4-9% in boys. The incidence of renal stone in pediatric group is 1/1000–1/7600 hospital admission. The aim of this study is to evaluate the prevalence of urolithiasis in patients admitted in Mofid children's hospital. Material and Methods: This is a descriptive study conducted between 2003-2007 on all patients admitted in Mofid Children's Hospital. Children whose ultrasonography reported renal stone were included. The laboratory tests of serum creatinine, venous blood gas, serum calcium, phosphate and uric acid and the urinary levels of creatinine, calcium, phosphate, uric acid, magnesium, sodium, cystine, citrate and oxalate were achieved. The demographic data and the results of ultrasonography and laboratory data were gathered and analyzed by t-test, Fisher's exact test, regression analysis and ANOVA test, when appropriate. Results: The prevalence of renal stone was 17% and the most common etiology for renal stone was hypercalciuria. Hematuria was the most common clinical presentation of renal stone (24%) in study group. There wasn’t any previous history of renal stone in 87.6% of our patients. Our patients showed renal stone in 95.4% and ureteral stone in 4.6%. In 32.2% of the patients ultrasound showed hydronephrosis and in 19.8% renal stone was accompanied with urinary tract infection. The main predisposing factor for renal stone in our study was hypercalciuria (73.5%). We also found a significant correlation between the stone size and urinary levels of calcium, sodium, uric acid, protein, creatinine and specific gravity and serum bicarbonate (p-value <0.000, 0.001, 0.002, 0.002, 0.007, 0.000 and 0.000, respectively). Conclusion: We concluded that renal stone is common in pediatric in patients and the main predisposing factor for renal stone is hypercalciuria.