Journal of Paramedical Science and Rehabilitation
Year:2016 | Volume:5 | Issue:2|Papers Count:10

Purpose: This study was conducted to assess the effect of corneal cross-linking on tear film osmolarity in patients with progressive keratoconus using the TearLab device.Methods: 66 eyes of 66 patients including 40 men and 26 women with age range of 15 to 35 years old with progressive keratoconus who were candidates for corneal cross-linking surgery, were evaluated in this prospective study. These indicated patients for corneal cross-linking surgery had no history of eye or systemic disease associated with ocular manifestations. They hadn’ t worn contact lenses since 3 weeks before study and also they hadn’ t used drugs (effective on tear layer) or contact lenses for 6 months after surgery except their treatment period. Tear osmolarity was measured preoperatively and 6 months after surgery using the TearLab device. After all, data analysis was performed by descriptive and analytical statistical methods.Results: The mean Osmolarity before the corneal cross-linking surgery is 303.82±15.50 mOsm/L and after the surgery is 306.64±14.49 mOsm/L. There is no significant difference in tear film Osmolarity before and after the corneal cross-linking (P=0.192).Conclusion: Corneal cross-linking had no significant impact on tear film osmolarity in progressive keratoconus patients and we can’t consider dry eye as a side effect of corneal cross-linking.

Purpose: With increasing the elderly population, physical disability increases as well. In this regard, hygiene, control and social systems devote a lot of attention to such issues. Some prevalent diseases in elderly population include a decrease in balance, postural control disorders, neuromuscular function, muscular mass, power, resistance, movement and joint instability. The purpose of this study is to evaluate the effects of resistance training on static balance and pain in elderly women with osteoarthritis and varus knee by using Elastic band for 8 weeks.Methods: Twenty-four women who have been diagnosed by osteoarthritis and varus knee with average age of (50, 60), took part in this study voluntarily and were divided into 2 groups randomly. In order to evaluate balance, BIODEX balance system was applied and levels of pain were measured by Visual Analogue Scale (VAS). Experimental group performed resistance training for 8 weeks, 3 days in a week by elastic band. For statistical analysis and synthesis, dependent and independent T student tests were applied.Results: Results indicated that no remarkable changes occurred in static balance test between experimental and control groups (p=0.147), however, meaningful changes were observed in pain test between experimental and control groups (p=0.001).Conclusion: Resistance training course with elastic band can influence knee pain, however, it has no effect on static balance. Moreover, resistance training with elastic band can be a useful method for reducing pain in knee joint of elderly women who suffer from osteoarthritis and varus knee.

Purpose: International approach to health care quality lead to effective management of resource and services with consideration of increasing of cost, competition benefits in marketing and patient safety. Accreditation is one of the health care quality tools. This study is an attempt to address the issue of evaluation of accreditation implementation according to opinion of in Health information management staffs.Methods: This cross- sectional study implemented in all Health Information Management departments using a self-administer questionnaire. One-way analysis of variance was used to compare means of accreditation in multiple groups. Besides, Friedman Test used to detect differences in questionnaire items.Results: The data yielded by this study provides strong evidence about effective leadership and management, knowing accreditation targets, dynamic and efficiency of function, motivation staff by award and staff involvements. In contrast, the data showed challenges like increasing work load, insufficient education for quality improvement, notify progress of work, funding allocations, less motivated staff and lack of team work.Conclusion: There is ample support for the education; team work and effective management that help to best implementation of accreditation. These play positive effect on staff functions and help to solve the challenges in health information department.

Purpose: Children with specific language impairment have shown specific defects in story coherence. The present study investigated story coherence in Persian speaking children with specific language impairment and normal development.Methods: This study is cross-sectional. Samples are 50 children with normal development and 10 children with specific language impairment. Children with language impairment had normal hearing, nonverbal IQ, and emotional status. Their language impairment detected by test of language development. Single-episode story (A1) and three-episode story (A3) were elicited and transcripted by using of Persian Narrative Norms Instrument. The story scored based on coherence elements. In both transcription and scoring stages, the percent agreement between inter-rater were calculated. To compare scores of the stories and episodes between two groups of children, Independent t-test and Mann-whitney test were applied.Results: In children with normal development, percent agreement in transcription obtained 100%.Percent agreement of scoring in "A1" and "A3" respectively were 96% and 94.51%. The mean of scores of both "A1" and "A3" story were significantly different (p=0.00) between two groups. Two groups were also significantly different (p=0.00) in different episodes of "A3" story.Conclusion: Children with specific language impairment has score lower than children with normal development in Coherence.

Purpose: Osteoarthritis is one of the biggest problems of the elderly population which may lead to disability and health problems and has socioeconomical consequences. Therefore, a therapeutic method that can help these people and reduce the complications of this disease has great importance. The aim of this study was to investigate the effect of aquatic exercise therapy on the quadriceps muscle electromyography and pain management in women with knee osteoarthritis.Methods: Thirty elderly women with knee osteoarthritis were selected and then divided into two groups by simple random sampling, experimental (age: 58.73±4.78) and control (age: 56.93±5.43). It should be noted that the average age of the experimental and control groups was not significant (P=0.344, t=0.963). The experimental group did aquatic exercise therapy for a period of 20 sessions with a frequency of five sessions per week, and each session lasted for 60-45 minutes. Before and after the intervention, the electrical activity of the quadriceps muscles using surface electromyography bio-vision made in Switzerland and pain using a visual pain scale (Visual analog scale) were measured. Data were analyzed by paired and independent sample t-test at a significance level of p£0.05.Results: Although aquatic exercise therapy did not have a statistical significance on electrical activity of the vastus medial is oblique (p=0.711), vastus lateral is (p=0.494) and rectus femur is muscles (p=0.831), however, it increases the mean of the electrical activity of the muscles. Results also showed this training reduce pain in patients (p=0.001).Conclusion: Aquatic exercise therapy had no desired effect on quadriceps muscle electromyography. However, this trial has a desirable effect on reducing pain in women with knee osteoarthritis.

Purpose: The present research aimed to study the corneal hysteresis (CH) and corneal resistance factor (CRF) in Pellucid Marginal Corneal Degeneration (PMCD) by means of Ocular Response Analyzer (ORA) Methods: This retrospective observational study performed based on patients’ medical records from January 2013 to October 2015. A total of 102 eyes from 63 patients with age range of 20 to 50 years were included. Inclusion criteria for this study was diagnosis of PMCD based on clinical and paraclinical evaluations. Exclusion criteria for this study consisted of any other corneal disease, severe dry eye, glaucoma, using any ocular medication, pregnancy or nursing, systemic disease, history of previous eye surgery, older than 50 years and eyes suspect to another corneal ectasia. The data of CH, CRF and other outcomes of ORA were obtained and data analysis was performed using SPSS software for descriptive and analytical statistical methods.Results: According to the outcomes of ORA in our study, CH, CRF, Goldmann-correlated intraocular pressure (IOPG) and corneal-compensated intraocular pressure (IOPcc) were (mean ± SD) 9.18±1.47, 8.48±1.72, 12.38±3.42 and 14.58±3.08 respectively. There is no statistically significant difference between male and female for CH (P=0.12), IOPG (P=0.07) and IOPcc (P=0.37) except for CRF (P=0.01).Conclusion: These data provide normative values for PMCD measured using the ORA. Corneal biomechanical outcomes of ORA include CH and CRF in PMCD may be employed for diagnosis and treatment of PMCD.

Purpose: Outpatient services are a significant part of the health care delivery system. Dominance of the non-governmental sector in delivery of these services along with the government stewardship role in health system indicates the importance of monitoring the non-clinical aspects of quality in the outpatient services. The aim of this study was to evaluate the Responsiveness of the health system in the sector of outpatient services for households living in selected areas in Mashhad.Methods: This descriptive-applied study was performed as a cross sectional in 2014. The sample size included 1000 households that selected by multistage sampling from low and high income areas of Mashhad. Data was collected by WHO questionnaire which had three parts and its validity and reliability were assessed and approved. Data were analyzed by Descriptive and inferential statistics in SPSS.Results: The findings generally showed that more than 60 percent of the responders, expressed outpatient services responsiveness as good. The aspects of confidentiality and the quality of the amenities, acquired the highest and lowest level from the respondents view, respectively. The level of responsiveness from the view of residents in the high income area has been reported higher than the low income area.Conclusions: Quality of health services should be a goal that can be achieved with a good stewardship in the health system. Since most institutions that providing outpatient services are outside of the Ministry of Health as a stewardship of health system of Iran, establishing the appropriate mechanisms to monitor of this goal seems necessary.

Purpose: Muscle weakness is one of the main factors which results in physical complaints and depression in elderly women. Therefore, the aim of the present study was to investigate the effect of a period of selected Pilate’s exercises on thigh muscle strength and depression among elderly women.Methods: In the present quasi-experimental study, 23 healthy elderly women between 55 and 60 years old volunteered from elderly women in Isfahan. The participants were selected through non-probability inconvenient sampling and divided randomly into two groups; one experimental group (N=12, age 56.75 ± 4.61 years old, weight 61.75 ± 5.41 Kg and height 161.83 ± 7.01 Cm) and one control group (N=11, age 59.09 ± 10.20 years old, weight 62.78 ± 2.81Kg and height 158.81 ± 5.03 Cm). The experimental group was treated using Pilate’s exercises for 60 minutes, three times a week for 8 weeks, however, the control group received no treatment and was engaged in daily routine activities. Muscle strength was measured using a manual Dynamometer (Power Track II Commander TMJ Tec medical) and rate of depression was obtained with Beck Questionnaire. All of the above variables were measured before and after treatment (Pilate’s exercises). Data were analyzed by paired- samples t-test and one-way analysis of variance at a significant level of P<0.05.Results: The results showed that there was a significant improvement on scores obtained from the muscle strength measurement (quadriceps, hamstring) in the experimental group after 8 weeks of exercise, whereas no significant improvement was observed in the control group. The results also suggest a significant difference in the depression scores of the experimental group after treatment, but there was no significant difference in the control group.Conclusion: Considering the results of the current study, it seems that the selected Pilate’s exercises improve muscle strength and depression among elderly women. Therefore, it could be considered as an effective intervention.

Purpose: Several instruments designed to assess the impact of voice disorders on various aspects of physical, mental and social subjects, including the Voice Handicap Index. In patients with vocal cord paralysis, speech sounds are affected more than the other sub-systems. The aim of this study is to assess the quality of life in vocal cord paralysis patient with Voice Handicap Index.Methods: A total of 10 subjects, including 9 men and 1 woman with age range of 23 to 55 years, were recruited for the present study. Sampling was performed between Julys to 15 August 2013 in speech therapy clinics in city of Mashhad. After completing the Persian version of questioner by patient, the data were analyzed using SPSS software with Pearson correlation test.Results: The Pearson correlation between subtests of the functional and emotional dimensions was 0.474, the functional and physical domains subtests 0.821 and the subtests of physical and emotional dimensions of 0.669 In present study, the relationship between functional and emotional domains of subtests was average, between emotional and physical domains subtests was strong and between physical and functional domains was very strong.Conclusion: The impact of disabilities of voice disorders mainly differs from person to person and influenced by some factors such as occupation, work environment, family reactions to the quality of voice disorder and generally personality. Voice disorders in patients with vocal fold paralysis had a considerable impact on the quality of their lives. Patient-oriented assessments such as the voice handicap index to evaluate patients with vocal cord paralysis are recommended along with other speech evaluations.

Purpose: The purpose of this study was to compare the effect of night time sleep on the consolidation of fine motor skills in 19 to 25 year old students following a training session with and without neuromuscular facilitation through proprioceptive sensors.Methods: In this study22 right-handed students (19-25 years old) with good sleep quality and no neuromuscular disease were randomly divided into the control and experimental (neuromuscular facilitation) groups. Participants of the experimental and control groups practiced one training session of dart throwing on the first day (54 attempts) and immediately participated in acquisition test (9 attempts). Afterwards, in the morning of second day, the retest (9 attempts) was performed. To evaluate the development of performance accuracy, the tests of acquisition and the retest were compared. To analyze the data, the analysis of variance for between-within subjects with a significant level of α=0.05 were used.Results: The results did not show a significant difference in accuracy performance before and after the night sleep (F=3.9, P=0.62) as well as between the two groups (F=0.13, P=0.71).Conclusion: The results of this study show that night sleep with and without proprioceptive neuromuscular facilitation before fine motor skills training have no effect on the components of accuracy.