Feyz Medical Sciences Journal
Year:2021 | Volume: | Issue: |Papers Count:12

Background: Rheumatoid arthritis is the most common chronic systemic inflammatory and autoimmune disease. Considering that one of the important goals of treatment of this disease is to achieve remission, this study was designed to identify the factors associated with the prognosis of this disease to select a treatment appropriate to its severity. Materials and Methods: In this study, the records of 433 patients with rheumatoid arthritis were examined by several rheumatologists and their assistants in Tabriz and Kashan centers and the factors affecting the prognosis of patients using logistic regression test was determined. Results: Results showed that the variables of disease duration, DAS28 at the first visit, treatment regimen and TNF inhibitors have a significant effect on patients' prognosis (P <0. 05) so that with an increase of one unit (year) duration of the disease, the chance of a poor prognosis in patients increases 1. 117 times,The chance of a poor prognosis among patients in whom the disease activity was severe at the beginning of the referral is 2. 369 times higher than in patients in whom the disease activity was moderate,Also, the chance of a poor prognosis among patients on a mono-therapy regimen is 9. 346 times higher than in patients on a double-therapy regimen. Conclusion: Increasing duration of the disease, severe disease activity at the beginning of the visit, lack of commitment to treatment and use of a mono-therapy regimen at the beginning of treatment increase the chance of poor prognosis in patients.

Background: Introducing an accurate method with minimal invasiveness to evaluate vascular involvement in diabetic patients is essential. This study aimed to evaluate the Ankle-Brachial Index (ABI) in diabetic patients without vascular symptoms of the lower extremities. Materials and Methods: A descriptive-analytical study was performed in 2020 on 339 lower extremities of diabetic patients without peripheral vascular involvement and a history of cardiovascular disease, referred to clinics or emergency rooms of selected hospitals in Ahvaz. After recording demographic information and clinical sign/symptom: Pain, paresthesia, vascular ulcers, pallor, no capillary filling, ABI and lower vascular Doppler were recorded, also. Mann-Whitney and independent t-test, Pearson correlation and Rock curve were used to compare data. Results: Out of 339 Dopplers, 42 cases (12. 4%) were abnormal and out of these 42 cases, 33 cases (9. 7%) were severe and 9 cases (2. 7%) were mild. Other findings of the study showed that the mean ABI in patients with abnormal Doppler was significantly lower than patients with normal Doppler (0. 93 vs. 1. 13). In the study based on the severity of vascular involvement, the lowest ABI was observed in patients with severe involvement (0. 88). However diagnostic power of ABI in the diagnosis of abnormal Doppler at the cut-off point of 1. 085 was low, that the sensitivity and specificity to 59. 5% and 81. 5% were obtained, respectively. Its positive and negative predictive values were 31. 3% and 93. 4%, respectively. The overall accuracy of the test was 78. 7%. Finally, it was found that ABI has a direct and significant relationship with age and an inverse and significant relationship with creatinine. Conclusion: Based on the findings of this study, reduction of ABI in patients with peripheral vascular involvement occurs in asymptomatic diabetic patients but does not have high diagnostic power in diagnosing abnormal Doppler cases and other methods should be used in addition to it.

Background: This study aimed to the relationship between specific cognitive components and balance and functional mobility in women with multiple sclerosis. Materials and Methods: The research methodology was descriptive correlational method, and it was practical in terms of objective. 62 women with relapsing and flexible MS were selected using available sampling procedure of the study. To measure the cognitive components including TMT test was used to measure executive performance,auditory/verbal memory was measured using CVLT-II test and in order to assess motor functions including balance, walking speed, and functional mobility Berg Balance Scale, Timed Foot 25-Walk, and Up and Go tests were used, respectively. Falls Efficacy Scale International, to measure the fear of the risk of falling, was used. Results: Correlation coefficient results showed that there is a meaningful relationship between auditory/verbal memory with balance (r=0. 669), functional mobility (r=0. 771), fear of falling risk (r=0. 602) and walking speed (r=0. 778) and between executive performance balance (r=0. 795), functional mobility (r=0. 820), fear of falling risk (r=0. 791) and walking speed (r=0. 778), and with the results from multiple regression analysis showed that a large percentage of changes in balance, functional mobility, and walking speed are predictable from cognitive components (P=0. 001). Conclusion: According to the results in present study, it seems that there is a significant relationship between cognitive components with balance, functional mobility, walking speed and fear of falling, and cognitive components can largely predict the motor function of patients with MS.

Background: Gastroesophageal reflux is very common in infants and its diagnosis is not through clinical signs but through diagnostic tests, especially ultrasound. This study aimed to determine the prevalence of physiological and pathological gastroesophageal reflux in neonates born in Kashan. Materials and Methods: In this cross-sectional study, 214 infants underwent ultrasound to assess the presence of GERD. First, the infant was fasting for one hour, then breast milk or formula was given as desired, and finally for 15 minutes in the mother's arms was upright position and an ultrasound was performed. The collected data were analyzed by SPSS software version 16 using chi-square and independent t-tests. Results: The results showed that 180 neonates (84. 1%) had reflux, of which 125 neonates had physiological reflux and the rest were pathological. Also, the type of GERD did not have a significant relationship with the variables related to the infant (sex, weight and type of nutrition) and mother (age, gestational age and type of delivery) (P>0. 05). Conclusion: The results showed that the prevalence of gastroesophageal reflux (physiological and pathological) was high in neonates, so it seems that screening for neonatal reflux with ultrasound and following the course of neonatal physiological reflux to recovery and also following the treatment of pathological reflux are useful in reducing longterm reflux complications.

Background: In dental treatment, sometimes the results and complications of treatment along with the failure of the dentist in establishing a professional relationship with the patient, can lead to dissatisfaction and complaints against the dentist. This study aimed to offering a picture of dental malpractices in Kashan. Materials and Methods: In this descriptive cross-sectional study, we assessed complaints against dentists and experimental dentists between 2008-2019 in Kashan. The study checklist includes complainant and therapist variables, type of treatment, and complaint variables. Data analysis was performed by SPSS-22 and Chi-square and Fisher's exact tests for qualitative variables and t-test and analysis of variance for quantitative variables. Results: The results showed that 25(48%) of 52 complaints were proved to be medical malpractice. The mean age of complainants was 42. 9±, 10. 77 and 29 cases (55. 8%) were women. Most practitioners that had complained of were male (82. 7%). The frequency of complaints was related to general dentists (75%), experimental dentists (17%), and specialists (8%), respectively. 86. 5% of complaints were related to private centers and 13. 5% were related to governmental centers. The most common cause of complaints was dissatisfaction with treatment (96. 2%) and the most type of malpractice was due to lack of expertise (32. 7%). Conclusion: According to this study, one of the most important reasons for complaints against dental practitioners is the lack of communication between patients and dentists. Increasing scientific and technical skills and improving communication skills with patients can prevent many complaints.