Journal of Paramedical Science and Rehabilitation
Year:2015 | Volume:3 | Issue:2|Papers Count:9

Purpose: A hematological finding in cobalamin and folic acid deficiency is increased neutrophil lobulation (hypersegmentation). There are contradictory reports about correlation of neutrophil hypersegmentation (NH) to iron deficiency in recent studies. This study re-examines the relationship between both iron deficiency (ID) and iron deficiency anemia (IDA) to hypersegmentation. The effect of folate deficiency was also investigated.Methods: Due to the high prevalence of iron deficiency in young Iranian women, the study groups were selected among young women.90 subjects, 30-16 years of age, admitted to the Clinical Laboratory of Imam Reza Hospital, Mashhad (29 subjects with ID, 30 with IDA and 31 controls) were studied. Ferritin, folate and cobalamin levels in serum were measured by RIA (Kavos-hyar reagent). Iron and Total Iron Binding Capacity (TIBC) were measured using Colorimetric methods. CBC and RBC Indexes were measured by Sysmex k-21. To investigate each patient's peripheral blood hypersegmentation, 100 neutrophils were counted separately by two experts.Results: Chi-square test revealed significant differences among NH and three groups of ID, IDA and control group (P=0.001). NH showed significant relationships with decreased serum Ferritin and Iron (P=0.001). Logistic regression analysis showed that the relationship between NH and ID /IDA is mostly due to the simultaneous presence of low normal levels of folate deficiency (P=0.044).Conclusions: This study showed a correlation between NH and iron pools and Low normal levels of Folate. Therefore, when observing NH in peripheral blood of patients, especially in women of childbearing ages, it should be suspicious of coexistence of iron and mild folate deficiency and that further investigation must be done. Because NH is a simple and low-cost testing, it could be a useful diagnostic test for screening of IDA/ID and folate deficiency especially for women of childbearing ages.

Purpose: Albinism is a genetic disorder that affects melanin synthesis of the human being. Although not very common, it has serious effects on the visual system, particularly reduced visual acuity. The pattern visual evoked potential is a reliable objective technique for diagnosing the latent and misrouting of this condition. The aim of this study was to use and evaluate the importance and accuracy of a single channel PVEP instead of common multichannel PVEP for detecting asymmetric responses between the latent and misrouting albinism and control group.Methods: In this cross sectional study, the pattern visual evoked potentials were measured using 60 min/arc check sizes with temporal frequency of 3 Hz in twenty four suspected albino people ages of 5 to 43 years (mean age of 19 years). Amplitude and latencies time were measured for both the right and left eye, and then the results were compared with a age- and gender matched, normal group.Results: The latency waves of N75, P100, N135 and P1N1 (N75-P100) amplitude between two eyes of the albino people showed a statistically significant difference. The asymmetric responses of PVEP between two eبله of the albino people were significantly larger than than control group.Conclusion: There is a strong relation between asymmetric responses of single channel PVEP and other clinical signs of albinism, which make this method as a useful objective technique for diagnosing the latent albinism.

Purpose: Cardiovascular diseases are among the most common diseases in all societies. Using data mining techniques to generate predictive models to identify those at risk for reducing the effects of the disease is very helpful. The main purpose of this study was to predict the risk of myocardial infarction by Decision Tree based on the observed risk factors.Methods: The present work was an analytical study conducted on a database containing 350 records. Data were obtained from patients admitted to Shahid Rajaei specialized cardiovascular hospital, Iran, in 2011. Data were collected using a four-sectioned data collection form. Data analysis was performed using SPSS statistical software version 12 by CRISP methodology. In the modeling section decision tree and Neural Network were used.Results: The results of the data mining showed that the variables of high blood pressure, hyperlipidemia and tobacco smoking were the most critical risk factors of myocardial infarction. The accuracy of the decision tree model on the data was shown to be as 93.4%Conclusion: The best created model was decision tree C5.0. According to the created rules, it can be predicted which patient with new specified features may affected by myocardial infarction.

Purpose: In the pathology and treatment of voice, it is essential to understand the problem. In addition, it requires the knowledge of acoustic characteristics of the voice and their relationship with the lesions of the larynx. Functional disphony refers to an impairment of the voice production in the absence of mucosal or neural disease of the larynx, which If left untreated, it leads to laryngeal organic lesion. In this study, to find acoustic differences, the voice of men and women, with functional voice disorders with or without organic lesion of polyp kind have been examined.Methods: This study was done in the way cohort, non-interventional and retrospective. Subjects included 74 patients age ranged from 20 to 69 years with functional voice disorder, with and without vocal fold polyp whose voice was analyzed in the vowel /ae/. The data was analyzed using the praat software (version 5.1.05).Results: In men, all the acoustic parameters showed significant differences: fundamental frequency range (p=0.03), Jitter (p=0.01), Shimmer (p=0.006) and harmonics to noise ratio (p=0.002). However, these parameters did not show significant differences in women with functional voice disorders, with and without organic lesion of larynx (p>0.05).Conclusion: The fundamental frequency range, Jitter, Shimmer and harmonic to noise ratio in men with functional voice disorder, with or without vocal fold polyp are distinguishable.

Purpose: Since the range of motion dysfunctions disturbs skillful throwing function as one causes of shoulder pain and essential factors of throwing in overarm and underarm throwers’ shoulder, the purpose of this study was to compare dominant and non dominant shoulder range of rotation among volleyball, bowling players and nonathlete women before an injury.Methods: In this non-experimental, cross sectional study, 45 women in 3 equal groups of nonathlete, volleyball and bowling players at the range of 20 to 30 years of age were recruited and their shoulder range of rotation was measured by goniometer. For data analyzing, descriptive statistic such as mean, standard deviation, and for reliability analyzing, Correlation Coefficient were performed. Kolmogorov-smirnov and Leven’s tests for assessing the data normality and groups variance equality, paired T-test for comparing dominant and nondominant sides, One-way ANOVA for comparing shoulder range of rotations among bowling, volleyball players and nondominant women (significant level p<0.05) were also performed.Results: Athletes demonstrated a significant less Internal Rotation (p=0.00) and greater External Rotation (p=0.02) in dominant shoulder compared to nondominant and non-athletes (p=0.00) shoulder. However, there were no significant differences between dominant, nondominant shoulder (p=0.07 volleyball, p=0.30 bowling players) and among groups (p=0/23 nonathletes and volleyball, p=0.07 nonathletes and bowling players) in total range of motion. In addition, no significant difference was found in examining variables between volleyball and bowling players (p=0.80 external, p=0.82 internal, p=0.54 total rotation).Conclusion: According to the role of range of motion in joint injuries rehabilitation, how changing in it before thrower shoulder injuries, challenges the kind of rehabilitation after injuries.In order to study the results, we can say thrower shoulder range of rotation shifts toward greater external and less internal rotation as a result of micro truma that caused by repetitive throwing and these changes that are not related with kind of throwing (overarm or underarm) could be one of the probable causes of athletes’ shoulder pain.

Purpose: To determine the sensitivity, specificity, and predictive value of visual screening examination in students living in urban areas of Iran.Methods: The first grade students of 7 cities of Iran were randomly selected in a population based cross sectional study in 2013 using multistage cluster sampling. After obtaining consent from the students’ parents, examinations including corrected and uncorrected visual acuity, cycloplegic and non-cycloplegic refraction, and cover test were performed for all students by an optometrist. The criterion for visual problem was a cut point of 20.32 or worse for uncorrected visual acuity. In addition, the validity of the uncorrected visual acuity measured in the national screening program, which is recorded in the students’ health profiles, was calculated.Results: Out of total 4157 individuals who were selected for the study, uncorrected visual acuity was measured in 3645 participants. The sensitivity and specificity of uncorrected visual acuity measured in the national screening program was 35.3% (95% CI 29.2%-41.7%) and 93.9% (95% CI 93.04%-94.7%), respectively. The lowest sensitivity was observed in Dezful (19.6%) and the highest was observed in Ardebil (83.3%). The predictive value of the examinations was 28.8% (95% CI 23.6%-34.3%) and the best cut point of uncorrected visual acuity was recorded as 20.25 in the national screening program.Conclusion: The validity of the visual screening program which is performed before the first grade of primary school is very low. It should be noted that since many families trust these examinations, they do not follow up their children’s condition any more based on the results of these examinations. Therefore, the validity of these examinations, especially their sensitivity, should increase through training the examiners or using more specialized methods.

Purpose: Velopharyngeal coarticulation refers to the influence of a nasal consonant on preceding segments or the following segments during continuous speech. Coupling of the nasal resonating space to the oropharyngeal cavity alters the vocal tract formants in complex ways. The purpose of this study was to investigate the effect of nasal coarticulation and /a/ vowel frequency formants in cleft palate Persian speaking children.Methods: In present cross-sectional study, voice samples of 30 cleft palate children ranging 4-12 years were investigated. Participants were asked to repeat /ama/ three times and vowel /a/ after presentation of an auditory model. Afterwards, obtained samples were analyzed using Praat (version 5.3.13) software. Investigating the effect of nasalization on formants of /a/ vowel before and after nasal consonant and comparing with single prolonged /a/, “Bi-variate analysis of variance test” were used.Results: There were no significant differences of fundamental frequency (F0) between /a/ which proceeds nasal consonant and /a/ follows nasal consonant, the before nasal consonant /a/ versus single /a/ and the after nasal consonant /a/ versus single /a/ in normal and cleft palate children (P>0.05). However, findings revealed statistically significant differences of first, second and third formants (F1, F2, F3) between three situations (p<0.001).Conclusions: In the cleft palate children, F1, F2, F3 in /a/ before nasal consonant affected by anticipatory nasal coarticulation and in /a/ after nasal consonant affected by carry-over nasal coarticulation. This study showed nasal coarticulation and nasalization result in decreasing F1, F2, F3 in /a/ vowel.

Purpose: Acute lateral ankle sprains are the most common injuries referred to emergency departments. The purpose of this study was an overview of the balance recovery mechanism to provide a perspicuous understanding of effects of this trauma on the joint for clinicians to prevent further imposition among chronic ankle instability.Methods: The treadmill protocol was used as a dynamic balance test with simulating fall upon 4 posture stabilizer muscles; medialis gastrocnemius / tibialis anterior / vastus medialis (VM) and erector spinae in L3 during sudden acceleration in base of support/ in two sides of the body (involved/ uninvolved as left and right) in sudden acceleration in forward and backward directions upon 20 adult women in two groups (10 LAS subjects with the mean of age; 23.9 ± 2.03 yrs and 10 normal subjects with the mean of age; 26.4 ± 3.2 yrs). The data of (electromyography) were assessed by using one- way repeated measures 2×2×4 ANOVA and multivariate test (P<0.05).Results: The results showed a significant interaction in muscle by direction. Significantly higher TA activity was shown in LAS group compared to normal group in forward direction. Significantly higher MG activity in right side of body was demonstrated in normal group than LAS group in backward direction. These findings suggest that by comparison of two sides of the body in two directions for 4 muscles electromyography activation/ significantly symmetric in LAS group than normal group was observed.Conclusion: Acute ankle instability with alternation in neuromusculoskeletal system may affect the dynamic balance control in patient with lateral ankle sprains.

Purpose: Hospital information systems (HIS) are considered prerequisites for the efficient delivery of high quality health care in hospitals. A dialogue is suitable, if it supports the users to realize their tasks effectively and efficiently. Only those parts of the software are presented, which are necessary to fulfill the task.Methods: This is a descriptive cross- sectional study. The hospitals which have hospital information systems in Tehran were selected. Then, between these hospitals, depends on companies providing these systems, one hospital was randomly selected. Finally, it was surveyed hospital information systems usability form viewpoint of department secretaries, the nurses and para units users through the standard questionnaire of IsoMetric 9241/10. Data analysis was performed using descriptive tests by SPSS statistical Software.Results: Findings showed that the means of suitability for the task was 3.04 from 5, with respect to users view. Suitability for the task was rated low especially by Para clinic users (2.96) while secretaries (3.03) and nursing staff (3.13) gave the better ratings, but being far from good.Conclusion: It seems that developers of HIS should pay more attention to the following criteria in the software development life cycle: The software should not force user to perform tasks that are not related to his actual work. I am able to adjust the presentation of results to my various work requirements. The important commands required to perform my work are easy to find.