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Mohsen Sheykhhasan , Mohsen Nikbakht , Mahdieh Ghiasi ,
Volume 74, Issue 11 (2-2017)
Volume 74, Issue 11 (2-2017)
Abstract
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Intervertebral disks (IVD) acts as shock absorber between each of the vertebrae in the spinal column by keeping the vertebrae separated when the shock caused by the action. They also serve to protect the nerves that run down the middle of the spine and intervertebral disks. The disks are made of fibrocartilaginous material. The outside of the disk is made of a strong material called the annulus fibrosus. Inside this protective covering is a jelly-like substance known as mucoprotein gel. This interior is known as the nucleus pulposus. The nucleus pulposus consists of large vacuolated notochord cells, small chondrocyte-like cells, collagen fibrils, and aggrecan, a proteoglycan that aggregates by binding to hyaluronan. Attached to each aggrecan molecule are glycosaminoglycan (GAG) chains of chondroitin sulfate and keratan sulfate. Intervertebral disks degeneration is frequently associated with low back and neck pain, which accounts as a disability. Despite the known outcomes of the Intervertebral disks degeneration cascade, the treatment of IVD degeneration is limited in that available conservative and surgical treatments do not reverse the pathology or restore the IVD tissue. Regenerative medicine for IVD degeneration, by injection of Intervertebral disks cells, chondrocytes or stem cells, has been extensively studied in the past decade in various animal models of induced IVD degeneration, and has progressed to clinical trials in the treatment of various spinal disease. Despite preliminary results showing positive effects of cell-injection strategies for IVD regeneration, detailed basic research on Intervertebral disks cells and their niche demonstrates that transplanted cells are unable to survive and adapt in the avascular niche of the IVD. For this therapeutic strategy to succeed, the indications for its use and the patients who would benefit need to be better defined. To surmount these obstacles, the solution will be identified only by focused research, both in the laboratory and in the clinic. In present paper, the potential utilization of different adult stem cells for intervertebral disc regeneration has been reported. Bone marrow mesenchymal stem cells, adipose tissue derived stem cells, synovial stem cells and committed IVD cells have been studied for this purpose either in vitro or in vivo. |
Mahtab Zeinalzadeh , Yousefreza Yousefnia Pasha , Zinatossadat Bouzari , Mohadese Mahdavi , Mojgan Naeimi Rad,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Clomiphene citrate is very successful in inducing ovulation; there is usually a discrepancy between ovulation and pregnancy rate. If treatment is started early in the cycle this negative effect is reduced. The aim of this study was to investigate the effect of the time of administration of clomiphene citrate on follicular growth, endometrial thickness and ovulation and pregnancy rates in PCOS (Polycystic ovary syndrome) patients.
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Methods: This randomized controlled trial study was performed on 115 PCOS (Polycystic ovary syndrome) women in Fateme Zahra Fertility and Infertility Research Health Center in April 2012. Patients randomly divided into two groups. Patients in the early group (No. 55) received 100 milligrams of clomiphene citrate tablet daily starting the next day after finishing medroxyprogesterone acetate tablet for 5 day, whereas the patient in the late group (No. 60) received 100 milligrams of clomiphene citrate tablet daily for 5 day starting on day 3 of the menstrual cycle. Then on follicular growth, endometrial thickness and ovulation and pregnancy rates by SPSS software, version 16 (Armonk, NY, USA) were compared in two groups. Results: 36.4% of patients of early administration of clomiphene and 60% of patients in the later administration of Clomiphene were able to build dominant follicle. This difference was statistically significant (P<0.011). There was no statistically significant difference between the two groups on age, body mass index, duration of infertility. Findings showed that in the early group 14 (63.6%) and in the late groups 8 (36.4%) women who made dominant follicle, were pregnant. There was significant difference between these two groups (P<0.001). But, in the number of follicles, endometrial thickness and pregnancy rate, there were no significant difference. In the early administration of clomiphene, the pregnancy rate was 25.5%. However in the later administration of clomiphene it was 13.3% (P=0.882). Conclusion: According to the results of this study, if the dominant follicle was made, with administration of clomiphene citrate in luteal phase the incidence of successful pregnancy is higher. |
Majid Kermani , Mohsen Dowlati , Ahmad Jonidi Jafari , Roshanak Rezaei Kalantari ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Air pollution, especially the phenomenon of dust and particulate matter can cause mortality of many civilians, and causes various diseases including cardiovascular and respiratory diseases. One of the major pollutants in the air is particulate matter that concentration has increased over recent years. So, present study with aim of Quantification Health Endpoints Attributed to particulate matter in Tehran, Capital of Iran during the past decade (2005-2014) by AirQ software, version 2.2.3 (WHO European Centre for Environment and Health) was performed.
Methods: This study is a descriptive-analytic investigation. The process of performance this study lasted 12 months. Subject of this the study and research was in Environmental Health Engineering Department of Iran University of Medical Sciences. Exact data of every hour pollutants were taken from Department of environmental (DOE) Islamic Republic Iran and Air Quality Control Company of Tehran. Then validated according to the World Health Organization (WHO) guidelines and Statistical parameters for quantifying health effects were calculated in excel software. Finally, assessment of cases total mortality, cardiovascular mortality, respiratory mortality and cardiovascular disease and respiratory disease, with AirQ software was performed.
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Results: The results of this study showed that the number of total mortality, cardiovascular mortality and respiratory mortality caused by exposure to Particulate matter smaller than 10 microns (PM10) in the past decade is 11776, 12121 and 33066 cases respectively. Also the total number of hospital admission due to cardiovascular disease and respiratory disease in the past decade is 20990 and 54352 cases in 2005-2014 years. Conclusion: According to the results of this study, during the last decade the level of air pollution and Concentration of pollutants in Tehran Increased. Effects and health consequences due to exposure to Particulate matter smaller than 10 microns (PM10) in Tehran Metropolis Is very severe and increased mortality and cardiovascular and respiratory diseases among the citizens of Tehran. |
Aisa Rassoli , Malikeh Nabaei , Nasser Fatouraee , Ghaemeh Nabaei ,
Volume 75, Issue 1 (4-2017)
Volume 75, Issue 1 (4-2017)
Abstract
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Background: Brain hypothermia by reducing the temperature of the cerebrospinal fluid is done by a cooling pad in the thoracic region and protect brain from the ischemic injuries. Along with the spinal cord, the brain is an essential partner in the central nervous system, and similarly, it is surrounded and protected from the bony skull and from shock by cerebrospinal fluid. The brain analyzes information that is both internal and external to the body, transforms the information into sensations, and stores them as memories. So in this study we investigated the brain hypothermia by finite element modeling. Methods: To investigate this phenomenon, in this study a numerical model of the head with respect to the structure of brain tissue and its contribution to heat transfer is presented in the fluid lab of the Amirkabir University of Tehran in January of 2016. In this model, Pennes's bioheat equation and finite element analysis has been used to predict temperature distribution in the brain tissue. The model geometry is designed in two state without considering the ventricles of the brain that are involved in the production of cerebrospinal fluid and with considering cerebrospinal fluid. So, in the second case, the cerebrospinal flow is considered as a heat transfer factor. Results: We concluded that with cooling about 5 °C, in the first model without considering the ventricles, the gray matter temperature is reduced by about 4 °C and there is no change in white matter temperature. In the second model temperature distribution became more asymmetric. The temperature reduced about 3 °C in the corners. However, the temperature reduction at the edge of brain tissue and near cerebrospinal fluid were about 0.5 °C. |
Conclusion: It was observed that in the case of ischemia, the temperature drop was higher than normal. So, during brain injuries to prevent serious damage, the brain metabolism can be reduced by cooling the spinal fluid.
Javad Hashemi , Zahra Hesari , Ali-Reza Golshan ,
Volume 75, Issue 1 (4-2017)
Volume 75, Issue 1 (4-2017)
Abstract
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Background: Nowadays, chronic kidney disease (CKD) is known as an epidemic disease all around the world. Chronic kidney disease considered as a serious health problem with numerous side effects, including complications progressive in reducing glomerular filtration rate (GFR), imbalances in the homeostasis of the body and decreased quality of life and finally an increase in mortality due to cardiovascular problems. End-stage renal disease leads to hypocalcemia and hyperphosphatemia, that as a result of, parathyroid hormone (PTH) will increased that secondary hyperparathyroidism will occurred eventually. So it is essential to routine examination of electrolytes in these patients. The current study have been done to determine the electrolytes in saliva as a non-invasive sample in hemodialysis patients in order to the saliva to be presented as an appropriate samples for clinical laboratories. Methods: In the present case-control study that has been performed at Imam Ali Hospital, Bojnord, North Khorasan Province, Iran, in the summer of 2016, 44 hemodialysis patients and 44 aged, gender and body mass index (BMI) matched healthy controls were selected and then their cell count, Hb, HCT, iron, ferritin, total iron binding capacity (TIBC), glucose, CRP, triglycerides, cholesterol, urea, creatinine, calcium, phosphorus, potassium and PTH were measured. Results: Calcium and phosphorus were higher in hemodialysis patients in comparison to the control group. Furthermore, there are not any significant relationship between levels of calcium, phosphorus and potassium in both serum and saliva samples. In addition, we observed the positive relationship between PTH in serum as well as phosphorus and potassium in the saliva. Conclusion: The findings of current study have been shown that salivary levels of calcium and phosphorus in hemodialysis patients is higher than healthy people, therefor could be a non- invasive suitable marker for diagnosis. In addition, blood PTH levels in hemodialysis patients is associated with salivary levels of phosphorus and potassium, so, perhaps these parameters marked PTH's representative in the blood with further investigation of saliva’s electrolytes. |
Leila Asefkabiri , Abbas Alibakhshi , Seyed-Hassan Emami-Razavi , Mahtab Mohammadifard , Alireza Abdollahi ,
Volume 75, Issue 3 (6-2017)
Volume 75, Issue 3 (6-2017)
Abstract
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Background: Hypocalcemia is one of the most prevalent complications following total thyroidectomy. Over recent years, in addition to hormone parathyroid hormone (PTH), vitamin D has been also studied as a factor causing post-total thyroidectomy hypocalcemia. This survey seeks to study the relationship between the serum level of vitamin D before surgery and during post-total thyroidectomy hypocalcemia. Methods: A group of 57 patients volunteering for total thyroidectomy were studied on Vali-e-Asr Hospital, Tehran, Iran, from March 2013 to March 2015. In all these patients, pre-surgery calcium, vitamin D and parathyroid hormone (PTH) as well as the level of calcium during the post-surgery first two days were measured. Based on objectives of this study, the relationship be-tween pre-surgery vitamin D level and post-surgery hypocalcemia was examined. Results: The average age of patients participating in the survey was 24.1±13.3. They included 19 women (33.3%) and 38 men, total of 40 patients (70.2%). Their average post-surgery calcium level was 9.2±0.77 milligrams per deciliters (mg/dl) and their average vitamin D content before the surgery was 42±12.1 nanomole per liter (nmol/l). The average calcium level before the surgery and the first post-surgery day were meaningfully different in terms of statistics (P<0.001). In terms of vitamin D, 37 patients (64.9%) had pre-surgery vitamin D deficiency and 20 patients (35.1%) had vitamin D insufficiency. Of 37 patients with pre-surgery vitamin D deficiency, 26 were diagnosed with post-surgery first-day hypocalcemia and of 20 patients with vitamin D insufficiency, 14 suffered post-surgery first-day hypocalcemia. This difference was not statistically meaningful (P>0.001). Of 37 patients with pre-surgery vitamin D deficiency, 31 suffered post-surgery second-day hypocalcemia and of 20 patients with vitamin D insufficiency, 18 suffered second-day hypocalcemia. This difference was not statistically meaningful either (P>0.001). Conclusion: The current study showed that the serum level of vitamin D before total thyroidectomy does not have any role in the occurrence of post-surgery hypocalcemia which is almost common after this type of surgery. |
Ali Mohammad Mosadeghrad , Ensieh Ashrafi ,
Volume 75, Issue 3 (6-2017)
Volume 75, Issue 3 (6-2017)
Abstract
Background: Patient satisfaction is an important indicator of healthcare quality and effectiveness. Quality management as an organizational strategy enhances the quality of hospital services through continuously improving hospital structures and processes. This study aimed to examine the impact of quality management on patient satisfaction.
Methods: A participatory action research was conducted in respiratory intensive care unit, at Labafinejad hospital, Tehran, Iran, in 2013. A quality improvement team was established. Operational processes were improved using a quality management model. The quality improvement team standardized processes, identified quality goals for the processes and improved them until achieved quality goals. Patients’ satisfaction data was collected before and after the intervention using a valid and reliable questionnaire.
Results: Patients’ satisfaction was 75 percent at the beginning of the study. Patients were mostly dissatisfied with the nutrition services, amenities, lack of attention to their personal needs and lack of involving them in their treatment processes. An action plan was developed for improving patient satisfaction. After the quality management intervention, patient satisfaction reached to 81 percent at the end of this study. The quality management model improved the quality of services by 54.5 percent and consequently increased patient satisfaction by 7.2 percent. Almost half of the patients at the beginning of this study were definitely willing to recommend the hospital to their friends and relatives. This figure increased to 76 percent. The rest of patients stated that they may recommend the hospital to others.
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Conclusion: Implementing an appropriate quality management model appropriately in a supportive environment helps improve the quality of services and enhance patient satisfaction and loyalty. |
Rhoghaye Tighnavard Bejarbane , Roshanak Daie Ghazvini , Shahram Mahmoudi , Reza Soltani Moghaddam, Mahin Safara, Heidar Bakhshi , Parivash Kordbacheh ,
Volume 75, Issue 5 (8-2017)
Volume 75, Issue 5 (8-2017)
Abstract
Background: Keratomycosis is a fungal infection of the cornea which could be sight-threatening and even causes eye loss. Considering the high humidity and the dominance of agriculture as important predisposing factors of keratomycosis in north of Iran, this study was carried out for diagnosis of fungal keratitis in patients with corneal lesions in Rasht, Gilan province, Iran.
Methods: This descriptive cross-sectional study was conducted from July 2015 to November 2016 on 56 patients with corneal lesion suspected to keratomycosis and referred to eye emergency ward of Amiralmomenin hospital, Rasht, Iran. Corneal scraping was performed in all cases and specimens were subjected to direct examination and culture. Only colonies grown in sites of corneal scraping inoculation were considered significant. Fungal isolates were identified according to their macroscopic features of colonies and microscopic characteristics in slide cultures. Data were analyzed in SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and P<0.05 was considered significant.
Methods: This descriptive cross-sectional study was conducted from July 2015 to November 2016 on 56 patients with corneal lesion suspected to keratomycosis and referred to eye emergency ward of Amiralmomenin hospital, Rasht, Iran. Corneal scraping was performed in all cases and specimens were subjected to direct examination and culture. Only colonies grown in sites of corneal scraping inoculation were considered significant. Fungal isolates were identified according to their macroscopic features of colonies and microscopic characteristics in slide cultures. Data were analyzed in SPSS software, version 21 (IBM SPSS, Armonk, NY, USA) and P<0.05 was considered significant.
| Results: The patients included 42 (75%) men and 14 (25%) women with the mean age of 49.5 years (9 to 90 years). Positive culture was observed in 9 cases but, only in one of these patients direct examination was positive and fungal elements were seen in 10% KOH preparation. Though, fungal keratitis was confirmed in 9 (16%) patients including seven (77.8%) men and two (22.2%) women. The majority of cases (88.9%) had a history of corneal trauma with plants and they were mainly farmer. According to statistical analysis, there was a significant association between corneal trauma and keratomycosis (P=0.007). The most common etiologic agents were Fusarium spp. (n: 4, 44.4%), followed by Aspergillus flavus (n: 2, 22.2%), Penicillium sp. (n: 1, 11.1%), Acremonium sp. (n: 1, 11.1%), and Cladosporium sp. (n: 1, 11.1%) respectively. Conclusion: In the presence of sufficient predisposing factors such as corneal injuries caused by plants, keratomycosis could be caused by a variety of fungi. Furthermore, low sensitivity of direct examination in this study, revealed the necessity of culture in diagnosis of keratomycosis. |
Neda Norouzi , Mortaza Bonyadi , Esmaeil Babaei , Mohammad Hossein Jabbarpour Bonyadi ,
Volume 75, Issue 5 (8-2017)
Volume 75, Issue 5 (8-2017)
Abstract
Background: Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world and is characterized by progressive degeneration of the retinal pigment epithelium and secondary photoreceptor loss, resulting in visual loss. Etiological research suggests that age related macular degeneration is a complex disease, caused by the interactions of several genetic and environmental factors. Polymorphisms in genes encoding the alternative complement pathway, complement factor I (CFI), are associated with the risk for age related macular degeneration. The purpose of this investigation was studying of complement factor I p.Gly119Arg (C.355G>A) polymorphism with age related macular degeneration in the population living in Tehran, Iran.
Methods: This case-control study was conducted at Tabriz University from June 2015 to June 2016. In this study the association of p.Gly119Arg polymorphism in complement factor I gene was investigated in 150 patients suffering from age-related macular degeneration and 150 healthy age, sex and ethnicity matched unrelated people as control group. Both of the case and control groups were originated from the population living in Tehran. Genotypes of both groups were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and data was analyzed the Chi-square test in 2x2.Contingency table.
Methods: This case-control study was conducted at Tabriz University from June 2015 to June 2016. In this study the association of p.Gly119Arg polymorphism in complement factor I gene was investigated in 150 patients suffering from age-related macular degeneration and 150 healthy age, sex and ethnicity matched unrelated people as control group. Both of the case and control groups were originated from the population living in Tehran. Genotypes of both groups were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and data was analyzed the Chi-square test in 2x2.Contingency table.
| Results: Investigation of the association of p.Gly119Arg polymorphism in complement factor I gene with age related macular degeneration showed that there are statistically significant differences between patients and controls in genotype and allele frequencies of this polymorphism (P=0.005 and OR=6.68 in TT, P=0.04 and OR=0.61 in CC, P=0.03 and OR=1.76 in T, P=0.04 and OR=0.56 in C). Therefore CC, TT genotypes and C, T alleles were significantly associated with age related macular degeneration. |
Conclusion: This study showed a significant association between this polymorphism p.Gly119Arg (C.355G>A) complement factor I gene and age related macular degeneration disease in the population living in Tehran (P<0.05). Our data suggests that this locus polymorphism is not as rare in our studied population as previously reported from different population.
Parviz Saleh , Kian Alipasandi, Mohammadamin Rezazadehsaatlou , Negar Azizi , Amin Abdi Raad ,
Volume 75, Issue 6 (9-2017)
Volume 75, Issue 6 (9-2017)
Abstract
Background: Urinary tract infections are very common in patients with high blood pressure. Hypertensive patients experience an average of three times of urinary tract infection per year. Blood pressure control is very important for preventing complications and also for identifying high-risk groups. Since, there is no national related study in this regard, the present study was conducted to investigate the effect of chronic hypertension on the incidence and recurrence of urinary tract infections.
Methods: In this case-control study, the required data were collected from outpatient cases referring to Taleghani Hospital and Sina Hospital related to Tabriz University of Medical Sciences in Tabriz city, Iran. Data needed for the control group included patients accompanying patients who had no symptoms of urinary tract infection and with no history of blood pressure.
Methods: In this case-control study, the required data were collected from outpatient cases referring to Taleghani Hospital and Sina Hospital related to Tabriz University of Medical Sciences in Tabriz city, Iran. Data needed for the control group included patients accompanying patients who had no symptoms of urinary tract infection and with no history of blood pressure.
| Results: 60 patients with urinary tract infections were examined: 57 (47.5%) of the subjects were men and 63 (52.5%) women. There was a significant relationship between the rate of red blood cell deposition in the first hour and systolic blood pressure. There was no significant correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients. |
Conclusion: According to the results of the present study, there was a significant difference in systolic blood pressure in patients ESR 1 hour (red blood cell deposition rate in the first hour) with hypertension in case and control groups. There was a significant correlation between the ESR of the first hour and systolic blood pressure in the study, so that with an increase in ESR 1h, the systolic blood pressure increased in the examined patients, however, no significant correlation was found between ESR 1hour and diastolic blood pressure. Also, there was no meaningful correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients. There was no significant correlation between systolic and diastolic blood pressure and age.
Mohammad Molavi , Rasoul Yousefi Mashouf , Mohammad Yousef Alikhani , Hassan Mahmoudi , Alireza Zamani , Fariba Keramat , Sara Soleimani Asl ,
Volume 75, Issue 6 (9-2017)
Volume 75, Issue 6 (9-2017)
Abstract
Background: Brucellosis is a systemic infection caused by gram-negative coccobacilli and facultative intracellular bacteria of the genus brucella. Brucellosis is a bacterial disease common to humans and livestock. Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. The humoral and cellular immunity plays an important role in brucellosis. The effect of phagocytosis and cellular immunity has been demonstrated in brucellosis. The effect of cupping as a therapeutic method on bacterial diseases has been demonstrated. By considering this fact that cupping is an effective method on host immune system functions and has potential effect to regulate the inflammatory reactions.
Methods: This experimental study was carried out on 48 rats in 6 groups (48 rats were divided into 6 groups) during the first 6 months from January 2015 to July 2016 in the laboratory of microbiology and animal of Hamedan University of Medical Sciences. The rats were infected through the injection of Brucella melitensis with plenty 5×105 (cfu/ml) of bacteria. After a week, in order to approve the accuracy of the infection in the studied rats inoculated with coombos Brucella melitensis, Wright test, 2-Mercaptoethanol test and Coombs' Wright test were used. The rats were then treated with cupping method in their sacral area. IFN-γ was measured using enzyme-linked immunosorbent assay. And the study of tissues using hematoxylin and eosin (H&E) Staining.
Results: The results of this study showed that cupping leads to an increase in the mean serum level of interferon-gamma. The histopathological study of liver tissue showed that the radial arrangement was not observed in the infected group with brucellosis and the cells were acidophilus. While, the radial arrangement was observed in treated rats with cupping, but it was not complete. The number of enlarged sinusoids were reduced. But, cell infiltration was observed.
Conclusion: This study showed that cupping can increase serum level of IFN-γ, and thus help to the clearance of disease and improvement of injury in the brucellosis animals lab.
Methods: This experimental study was carried out on 48 rats in 6 groups (48 rats were divided into 6 groups) during the first 6 months from January 2015 to July 2016 in the laboratory of microbiology and animal of Hamedan University of Medical Sciences. The rats were infected through the injection of Brucella melitensis with plenty 5×105 (cfu/ml) of bacteria. After a week, in order to approve the accuracy of the infection in the studied rats inoculated with coombos Brucella melitensis, Wright test, 2-Mercaptoethanol test and Coombs' Wright test were used. The rats were then treated with cupping method in their sacral area. IFN-γ was measured using enzyme-linked immunosorbent assay. And the study of tissues using hematoxylin and eosin (H&E) Staining.
Results: The results of this study showed that cupping leads to an increase in the mean serum level of interferon-gamma. The histopathological study of liver tissue showed that the radial arrangement was not observed in the infected group with brucellosis and the cells were acidophilus. While, the radial arrangement was observed in treated rats with cupping, but it was not complete. The number of enlarged sinusoids were reduced. But, cell infiltration was observed.
Conclusion: This study showed that cupping can increase serum level of IFN-γ, and thus help to the clearance of disease and improvement of injury in the brucellosis animals lab.
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Hanieh Sharifian , Zahra Mollabashi ,
Volume 75, Issue 7 (10-2017)
Volume 75, Issue 7 (10-2017)
Abstract
Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound) and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore) in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.
Mohammadreza Aflatoonian , Mehrdad Khatami , Iraj Sharifi , Shahram Pourseyedi , Mansour Khatami , Hajar Yaghobi , Mahin Naderifar ,
Volume 75, Issue 8 (11-2017)
Volume 75, Issue 8 (11-2017)
Abstract
Background: Nanoparticles are particles that have at least one dimension between 1 and 100 nanometers. Nanoparticles are a new generation of antimicrobial agents. Nanoparticles with antimicrobial activity, especially as a new class of biomedical materials for use in increasing the level of public health in daily life have emerged. Zinc oxide nanoparticles have attracted a great attention due to the variety of their applications in medical science. The aim of this study was to evaluate and compare the antimicrobial activity of zinc oxide nanoparticles synthesized by green method.
Methods: This experimental study was done in 2017, from March to September in the Bam Research Center of University of Medical Sciences Kerman, Iran. Green synthesis of zinc oxide nanoparticles was investigated using cumin seeds. The physicochemical characteristics of synthesized nanoparticles were studied by UV-visible ultraviolet spectrometer (Analytik Jena AG, Germany), X-ray diffraction and transmission electron microscope (TEM) (Carl Zeiss, Germany). Broth microdilution method was used to investigate the antimicrobial activity of zinc oxide nanoparticles. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these nanoparticles were determined for Pseudomonas aerogenes and Enterococcus faecalis strains.
Results: The UV-visible ultraviolet spectroscopy showed an absorption peak in the range of 370 nm. Transmission electron microscopy shows the synthesis of zinc oxide nanoparticles, mostly spherical, with a size less than 50 nm. Minimum inhibitory concentration of zinc oxide nanoparticles against P. aerogenes and E. faecalis strains was determined at 6.25 and 12.5 μg/ml, respectively. Both bacteria were sensitive to zinc oxide nanoparticles. This sensitivity was higher for gram-negative bacteria.
Conclusion: Zinc oxide nanoparticles were produced using Iranian natural resources and our results showed significant antibacterial activity. Nanotechnology creates materials with novel properties every day, and creates new hope for improving environmental pollution. These nanoparticles can be used as a new generation of antimicrobial agents in various medical disciplines. For example, toothpaste containing zinc nanoparticles can be produced and prescribed for patients with immune deficiency to prevent the growth of microbial pathogens in the mouth and its transmission to the patient's body.
Methods: This experimental study was done in 2017, from March to September in the Bam Research Center of University of Medical Sciences Kerman, Iran. Green synthesis of zinc oxide nanoparticles was investigated using cumin seeds. The physicochemical characteristics of synthesized nanoparticles were studied by UV-visible ultraviolet spectrometer (Analytik Jena AG, Germany), X-ray diffraction and transmission electron microscope (TEM) (Carl Zeiss, Germany). Broth microdilution method was used to investigate the antimicrobial activity of zinc oxide nanoparticles. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of these nanoparticles were determined for Pseudomonas aerogenes and Enterococcus faecalis strains.
Results: The UV-visible ultraviolet spectroscopy showed an absorption peak in the range of 370 nm. Transmission electron microscopy shows the synthesis of zinc oxide nanoparticles, mostly spherical, with a size less than 50 nm. Minimum inhibitory concentration of zinc oxide nanoparticles against P. aerogenes and E. faecalis strains was determined at 6.25 and 12.5 μg/ml, respectively. Both bacteria were sensitive to zinc oxide nanoparticles. This sensitivity was higher for gram-negative bacteria.
Conclusion: Zinc oxide nanoparticles were produced using Iranian natural resources and our results showed significant antibacterial activity. Nanotechnology creates materials with novel properties every day, and creates new hope for improving environmental pollution. These nanoparticles can be used as a new generation of antimicrobial agents in various medical disciplines. For example, toothpaste containing zinc nanoparticles can be produced and prescribed for patients with immune deficiency to prevent the growth of microbial pathogens in the mouth and its transmission to the patient's body.
Farzad Firouzi Jahantigh, Iraj Najafi , Maryam Ostovare ,
Volume 75, Issue 10 (1-2018)
Volume 75, Issue 10 (1-2018)
Abstract
Background: Peritoneal dialysis is one of the most commonly used treatment methods for the patients with end stage renal failure. In recent years, the mortality rate of patients under this treatment has decreased; however, long-term survival is still an important challenge for health systems. The present study aimed to predict the survival of continuous ambulatory peritoneal dialysis patients.
Methods: In this retrospective study, according to the difference of relative importance of demographic characteristics, laboratory data, dialysis adequacy parameters and nutritional status in various patients, the factors affecting the survival of peritoneal dialysis patients have been identified by random forest algorithm. Then, the clinical and laboratory data of patients undergoing continuous ambulatory peritoneal dialysis treatment were evaluated retrospectively from July 1996 to April 2014 in 18 peritoneal dialysis centers, using multi-class one against all support vector machine (OAA-SVM) and multi-space mapped binary tree support vector machine (MBT-SVM) algorithms.
Results: 3097 patients were studied with the mean age of 50.63±15.67 years and average follow-up time of 24.48±19.13 months. The results of the random forest algorithm have identified 35 factors as the most important predictors of peritoneal dialysis patient’s survival. Then, the prediction of peritoneal dialysis patients’ survival status was evaluated using one against all support vector machine and multi-space mapped binary tree support vector machine algorithms in 5 classes of patients including “still on peritoneal dialysis”, “transferred to hemodialysis”, “received a kidney transplant”, “died” and “improved kidney function”. The reliability of survival prediction algorithms were 51.99% and 89.57% respectively.
Conclusion: An accurate prediction model would be a potentially useful way to evaluate patients’ survival at peritoneal dialysis that increased clinical scrutiny and timely intervention could be brought to bear. So, in this research, the multi-space mapped binary tree support vector machine algorithm has a high precision in predicting the survival of continuous ambulatory peritoneal dialysis patients considering multiple evaluation indices and different class distribution functions.
Methods: In this retrospective study, according to the difference of relative importance of demographic characteristics, laboratory data, dialysis adequacy parameters and nutritional status in various patients, the factors affecting the survival of peritoneal dialysis patients have been identified by random forest algorithm. Then, the clinical and laboratory data of patients undergoing continuous ambulatory peritoneal dialysis treatment were evaluated retrospectively from July 1996 to April 2014 in 18 peritoneal dialysis centers, using multi-class one against all support vector machine (OAA-SVM) and multi-space mapped binary tree support vector machine (MBT-SVM) algorithms.
Results: 3097 patients were studied with the mean age of 50.63±15.67 years and average follow-up time of 24.48±19.13 months. The results of the random forest algorithm have identified 35 factors as the most important predictors of peritoneal dialysis patient’s survival. Then, the prediction of peritoneal dialysis patients’ survival status was evaluated using one against all support vector machine and multi-space mapped binary tree support vector machine algorithms in 5 classes of patients including “still on peritoneal dialysis”, “transferred to hemodialysis”, “received a kidney transplant”, “died” and “improved kidney function”. The reliability of survival prediction algorithms were 51.99% and 89.57% respectively.
Conclusion: An accurate prediction model would be a potentially useful way to evaluate patients’ survival at peritoneal dialysis that increased clinical scrutiny and timely intervention could be brought to bear. So, in this research, the multi-space mapped binary tree support vector machine algorithm has a high precision in predicting the survival of continuous ambulatory peritoneal dialysis patients considering multiple evaluation indices and different class distribution functions.
Ali Mohammad Mosadeghrad , Mahnaz Afshari ,
Volume 75, Issue 10 (1-2018)
Volume 75, Issue 10 (1-2018)
Abstract
Background: Hospitals are dealing with unlimited demands and limited resources. Hospital managers should use appropriate strategies to improve quality of services, enhance patients’ satisfaction and increase financial resources. This study aimed to examine the impact of quality management.
Methods: A participatory action research was used for the intervention on income of operating theatre in Vali-e-Asr Hospital in Tehran University of Medical Sciences, between March and September 2014. A quality improvement team was established and improved operational processes of the operating theatre department of the hospital using Mosadeghrad’s ten-step quality management model. The quality improvement team standardized processes, identified goals for the processes and improved them until achieved the goals. Accordingly, an action plan was developed and implemented for increasing the income of the operating theatre department. Income data of the operating theatre department were obtained for a 6-month period in 2014, and were compared with a control 6-month period in 2013.
Results: Implementing quality management increased the number of surgeries by 14.96 percent, decreased cancelled surgeries by 14.6 percent and reduced bill deductions imposed by health insurance companies by 44.9 percent. As a result, the operation theatre department income has increased by 68.8 percent (P=0.028). Some of solutions used for increasing the income were as standardizing and improving working processes, removing unnecessary activities, empowering staff; increasing department’s working hours, on time visit of patients by doctors and surgeons, reducing surgery cancellations, increasing number of patients, reducing deductions applied by the health insurance companies and training staff and patients.
Conclusion: Implementing an appropriate quality management model appropriately helps improve quality of services and enhance hospital departments’ income.
Methods: A participatory action research was used for the intervention on income of operating theatre in Vali-e-Asr Hospital in Tehran University of Medical Sciences, between March and September 2014. A quality improvement team was established and improved operational processes of the operating theatre department of the hospital using Mosadeghrad’s ten-step quality management model. The quality improvement team standardized processes, identified goals for the processes and improved them until achieved the goals. Accordingly, an action plan was developed and implemented for increasing the income of the operating theatre department. Income data of the operating theatre department were obtained for a 6-month period in 2014, and were compared with a control 6-month period in 2013.
Results: Implementing quality management increased the number of surgeries by 14.96 percent, decreased cancelled surgeries by 14.6 percent and reduced bill deductions imposed by health insurance companies by 44.9 percent. As a result, the operation theatre department income has increased by 68.8 percent (P=0.028). Some of solutions used for increasing the income were as standardizing and improving working processes, removing unnecessary activities, empowering staff; increasing department’s working hours, on time visit of patients by doctors and surgeons, reducing surgery cancellations, increasing number of patients, reducing deductions applied by the health insurance companies and training staff and patients.
Conclusion: Implementing an appropriate quality management model appropriately helps improve quality of services and enhance hospital departments’ income.
Mohammad Mehdi Saghafi, Mohammad Javad Fatemi , Tooran Bagheri , Mohammad Hasan Hablolvarid, Mitra Niazi, Mohsen Saberi, Shirin Araghi ,
Volume 75, Issue 11 (2-2018)
Volume 75, Issue 11 (2-2018)
Abstract
Background: Burns is a major health problem due to severe side effects and limited financial resources. Some herbs are cheap and available, such as Arnebia euchroma can be effective treatment of burn wounds and reduce recovery time. The aim of this study was to evaluate the effect of Arnebia euchroma ointment on healing of deep second-degree burn wound in rats.
Methods: This experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.
Results: Results showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.
Conclusion: It seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.
Methods: This experimental study was conducted in animal laboratory of Hazrat Fatemeh Hospital in 2015, Tehran. In this study 24 male Sprague-Dawley rats weighing approximately 300 to 350 g were selected. After general anesthesia, back of each rat was shaved with clipping device. Then second-degree burn with the area of 2×4 cm was induced on them. Rats were randomly divided into 2 groups, 12 in each. The surface of the wound in the first group was covered with Arnebia euchroma ointment and in the second group with Vaseline. Dressing was done daily until complete recovery and the wound healing process was monitored by photographing every five days. On day 20, the samples were sent for pathological evaluation of the amount of collagen and inflammatory cells.
Results: Results showed that, during days from 5 to 15 the extent of the wounds reduced in both groups (P= 0.000). The reduction of wound size was significantly higher in Vaseline group compared to Arnebia euchroma ointment group (P= 0.040). The results of the pathological examination showed no significant difference in the amount of collagen and inflammatory cells in the two groups.
Conclusion: It seems Arnebia euchroma ointment to some extent reduced the extent of the wound especially in superficial burns compared to other dressings. However, it is better to conduct more similar studies with a larger sample size and different method and change in timing of dressing.
Atiyeh Vatanchi , Leila Pourali , Mona Jafari ,
Volume 76, Issue 2 (5-2018)
Volume 76, Issue 2 (5-2018)
Abstract
Background: Laparoscopy is an acceptable procedure for cholecystitis in pregnancy. Laparoscopic complications during pregnancy can be unique. Uterine perforation is a rare complication during laparoscopy of pregnant women. Acquaintance with this complication can help surgeons and gynecologist to manage these patients properly. We will report a case of uterine perforation during laparoscopy.
Case presentation: Our patient was a 24-year pregnant woman with gestational age of 28 weeks. She had nausea and vomiting and right upper quadrant tenderness, she was admitted in surgery ward on January 2017 in an academic hospital in Mashhad and candidate for laparoscopic cholecystectomy with diagnosis of cholecystitis. Her fundal height was 28 centimeters. Laparoscopy was done with Hasson technique and three punctures. During abdominal trocar insertion uterine perforation occurred. Amniotic fluid leaked in the abdomen. Perforation repaired immediately and then cholecystectomy was done. Fetal heart rate was normal. After surgery according to stable vital signs and absence of bleeding and contraction, the patient was transferred to the midwifery department. The patient received one course of betamethasone for fetal lung maturation. Antibiotic therapy initiated. During the hospitalization, the patient was monitored daily for vital signs (fever and tachycardia), uterine contraction, vaginal bleeding and vaginal bleeding. Daily fetal heart monitoring was performed. After close prenatal care cesarean section was done in 38 weeks of pregnancy and a healthy baby was born with appropriate Apgar score.
Conclusion: Laparoscopy in pregnant women is usually safe. Pregnancy-specific complications such as uterine injury are not common, but with a series of precautions before and during surgery. These complications can be reduced. Uterine perforation during laparoscopy if properly managed is usually not associated with significant risk.
Case presentation: Our patient was a 24-year pregnant woman with gestational age of 28 weeks. She had nausea and vomiting and right upper quadrant tenderness, she was admitted in surgery ward on January 2017 in an academic hospital in Mashhad and candidate for laparoscopic cholecystectomy with diagnosis of cholecystitis. Her fundal height was 28 centimeters. Laparoscopy was done with Hasson technique and three punctures. During abdominal trocar insertion uterine perforation occurred. Amniotic fluid leaked in the abdomen. Perforation repaired immediately and then cholecystectomy was done. Fetal heart rate was normal. After surgery according to stable vital signs and absence of bleeding and contraction, the patient was transferred to the midwifery department. The patient received one course of betamethasone for fetal lung maturation. Antibiotic therapy initiated. During the hospitalization, the patient was monitored daily for vital signs (fever and tachycardia), uterine contraction, vaginal bleeding and vaginal bleeding. Daily fetal heart monitoring was performed. After close prenatal care cesarean section was done in 38 weeks of pregnancy and a healthy baby was born with appropriate Apgar score.
Conclusion: Laparoscopy in pregnant women is usually safe. Pregnancy-specific complications such as uterine injury are not common, but with a series of precautions before and during surgery. These complications can be reduced. Uterine perforation during laparoscopy if properly managed is usually not associated with significant risk.
Ziba Aghsaiefard , Ziba Hossenifard , Reza Alizadeh , Tayeb Ramim ,
Volume 76, Issue 4 (7-2018)
Volume 76, Issue 4 (7-2018)
Abstract
Background: The role of high levels of parathyroid hormone in the development of anemia either directly or by mediating mechanisms is unclear, and there is a controversy about the pathophysiological role of parathyroid hormone (PTH) in the development and intensification of anemia associated with renal disease. The aim of this study was to investigate the relationship between anemia and parathyroid hormone and dialysis adequacy in chronic hemodialysis patients.
Methods: A cross-sectional study was performed in patients undergoing dialysis in Soodeh Hemodialysis Center, Vavan city, Tehran province, Iran, in two years (September 2013 to September 2015). Patients with age>18 years who underwent dialysis for at least three months were enrolled. Anemia was calculated based on the absolute amount of hemoglobin, hematocrit, and the percentage of patients who achieved the hemoglobin treatment goal of more than 11 g/dL. Parathyroid hormone levels were measured intact PTH and enzyme immunoassay (EIA) method.
Results: 176 patients who had entry criteria participated in this study. Patients included 102 males (58%) and 74 women (42%). The mean age of the patients was 54.14±13.98 years (18-85 years). The mean weight of patients was 68.07±14.17 kg (36-120 kg). 23 (13.1%) of the patients had a previous history of kidney transplantation. Of the 176 patients, only one had a history of parathyroidectomy (0.6%). The mean dialysis time in the patients was 6.38±5.29 years (1-28 years). The type of dialysis access in 132 patients (75%) was AV fistula and in 44 patients (25%) was Shaldon catheter. The mean erythropoietin intake of patients was 10,000 units per week. The mean of hemoglobin, hematocrit and PTH were 10.73 g/dl 33.6% and 403 pg/ml, respectively.
Conclusion: The findings of the study showed that there was no significant correlation between hemoglobin and hematocrit levels with parathyroid hormone levels and dialysis adequacy. Increased levels of serum iron, total iron binding capacity (TIBC) and resistance to erythropoietin were associated with a decrease in hematocrit levels due to decreased hemoglobin levels and resistance to erythropoietin.
Methods: A cross-sectional study was performed in patients undergoing dialysis in Soodeh Hemodialysis Center, Vavan city, Tehran province, Iran, in two years (September 2013 to September 2015). Patients with age>18 years who underwent dialysis for at least three months were enrolled. Anemia was calculated based on the absolute amount of hemoglobin, hematocrit, and the percentage of patients who achieved the hemoglobin treatment goal of more than 11 g/dL. Parathyroid hormone levels were measured intact PTH and enzyme immunoassay (EIA) method.
Results: 176 patients who had entry criteria participated in this study. Patients included 102 males (58%) and 74 women (42%). The mean age of the patients was 54.14±13.98 years (18-85 years). The mean weight of patients was 68.07±14.17 kg (36-120 kg). 23 (13.1%) of the patients had a previous history of kidney transplantation. Of the 176 patients, only one had a history of parathyroidectomy (0.6%). The mean dialysis time in the patients was 6.38±5.29 years (1-28 years). The type of dialysis access in 132 patients (75%) was AV fistula and in 44 patients (25%) was Shaldon catheter. The mean erythropoietin intake of patients was 10,000 units per week. The mean of hemoglobin, hematocrit and PTH were 10.73 g/dl 33.6% and 403 pg/ml, respectively.
Conclusion: The findings of the study showed that there was no significant correlation between hemoglobin and hematocrit levels with parathyroid hormone levels and dialysis adequacy. Increased levels of serum iron, total iron binding capacity (TIBC) and resistance to erythropoietin were associated with a decrease in hematocrit levels due to decreased hemoglobin levels and resistance to erythropoietin.
Fahimeh Kalbkhani , Mohammad Reza Sam ,
Volume 76, Issue 6 (9-2018)
Volume 76, Issue 6 (9-2018)
Abstract
Background: Using natural compounds with low toxicity on normal cells and high efficacy on malignant cells is highly appreciated for treatment of colorectal cancer (CRC). In the present study, the effect of fish-oil derived eicosapentaenoic acid (EPA) on the cell number, cell proliferation rate and caspase-3 enzyme activity in LS174T human colorectal cancer cell line was investigated.
Methods: This experimental study was performed in cell culture lab, Institute of Biotechnology, affiliated to the Urmia University, Urmia, Iran from April to September 2017. LS174T colorectal cancer cells at a density of 5×105 cells per well were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS) and kept at 37 °C in a humidified incubator with 5% CO2 for 24 hours. Thereafter, the cells were treated with 50, 100, 150 and 200 μmol EPA for 48 hours and cell numbers were counted using neobauer chamber and caspase-3 activities were measured by performing the caspase-3 colorimetric assay (Abcam, Cambridge, MA, USA). Furthermore, 5×103 LS174T colorectal cancer cells were cultured and treated with the above-mentioned EPA concentrations for 24, 48 and 72 hours, after which cell proliferation rate was evaluated by WST-1 proliferation assay (Roche Diagnostics, Mannheim, Germany).
Results: Treatment of LS174T colorectal cancer cells with 50, 100, 150 and 200 μmol EPA decreased the number of cells in a dose-dependent manner. We also found that treatment of malignant cells with increasing EPA concentrations (50 to 200 μmol) significantly decreased cell proliferation in a dose and time dependent manner. After a 72 hours treatment of LS174T cells with 200 μmol EPA, cell proliferation was calculated to be 30.3% compared to untreated control cells. Following 48 hours treatment, caspase-3 activity increased with increasing EPA concentrations in which at 200 μmol EPA, caspase-3 activity increased by 3.4 fold compared to untreated control cells.
Conclusion: Fish-oil derived eicosapentaenoic acid as a safe compound decreases the number of colorectal cancer cells and their proliferation rate and activates caspase-3 enzyme, as an executor protein in apoptosis.
Methods: This experimental study was performed in cell culture lab, Institute of Biotechnology, affiliated to the Urmia University, Urmia, Iran from April to September 2017. LS174T colorectal cancer cells at a density of 5×105 cells per well were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS) and kept at 37 °C in a humidified incubator with 5% CO2 for 24 hours. Thereafter, the cells were treated with 50, 100, 150 and 200 μmol EPA for 48 hours and cell numbers were counted using neobauer chamber and caspase-3 activities were measured by performing the caspase-3 colorimetric assay (Abcam, Cambridge, MA, USA). Furthermore, 5×103 LS174T colorectal cancer cells were cultured and treated with the above-mentioned EPA concentrations for 24, 48 and 72 hours, after which cell proliferation rate was evaluated by WST-1 proliferation assay (Roche Diagnostics, Mannheim, Germany).
Results: Treatment of LS174T colorectal cancer cells with 50, 100, 150 and 200 μmol EPA decreased the number of cells in a dose-dependent manner. We also found that treatment of malignant cells with increasing EPA concentrations (50 to 200 μmol) significantly decreased cell proliferation in a dose and time dependent manner. After a 72 hours treatment of LS174T cells with 200 μmol EPA, cell proliferation was calculated to be 30.3% compared to untreated control cells. Following 48 hours treatment, caspase-3 activity increased with increasing EPA concentrations in which at 200 μmol EPA, caspase-3 activity increased by 3.4 fold compared to untreated control cells.
Conclusion: Fish-oil derived eicosapentaenoic acid as a safe compound decreases the number of colorectal cancer cells and their proliferation rate and activates caspase-3 enzyme, as an executor protein in apoptosis.
Hojjatollah Foroutani , Noureddin Nakhostin Ansari , Nakhostin Ansari , Shohreh Jalaei ,
Volume 76, Issue 7 (10-2018)
Volume 76, Issue 7 (10-2018)
Abstract
Background: It is important to use reliable, valid, and responsive instruments to assess the treatment outcomes. The functional rating index (FRI) is a patient reported outcome measure to assess the pain and function in patients with neck and low back pain. The FRI has been translated and culturally adapted into Persian language. The purpose of this study was to investigate the responsiveness of Persian functional rating index in patients with chronic non-specific neck pain (CNSNP).
Methods: The adult patients with CNSNP recruited from Shariati Hospital in Tehran and filled the Persian functional rating index (PFRI), Persian neck disability index (PNDI), and pain numerical rating scale (NRS) before and after 10 physiotherapy sessions, from March to July 2017. The patients completed the global rating change scale after treatment. For statistical analyses, the effect size (ES), standardized response mean (SRM), Guyatt response index (GRI) were used. The Spearman or Pearson test was used for correlation analyses. The area under the receiver operating curve (ROC) and minimal clinically important difference (MCID) were calculated.
Results: In this study, 30 patients (female 17) with a mean of age 45.6 years [standard deviation (SD) 13.8] participated. The mean duration of neck pain was 14.7 months (SD 12.8). Significant strong and moderate correlations were identified between PFRI with PNDI and GRC scores (r= 0.78 and r= 0.69). The respective ES and SRM values were 0.73 and 0.78 for PFRI. The GRI was 5.58. The AUC was 0.89 (P= 0.001). MCID was 11.7%.
Conclusion: This study confirms that the Persian functional rating index is responsive for assessing disability in Persian speaking patients with chronic non-specific neck pain.
Methods: The adult patients with CNSNP recruited from Shariati Hospital in Tehran and filled the Persian functional rating index (PFRI), Persian neck disability index (PNDI), and pain numerical rating scale (NRS) before and after 10 physiotherapy sessions, from March to July 2017. The patients completed the global rating change scale after treatment. For statistical analyses, the effect size (ES), standardized response mean (SRM), Guyatt response index (GRI) were used. The Spearman or Pearson test was used for correlation analyses. The area under the receiver operating curve (ROC) and minimal clinically important difference (MCID) were calculated.
Results: In this study, 30 patients (female 17) with a mean of age 45.6 years [standard deviation (SD) 13.8] participated. The mean duration of neck pain was 14.7 months (SD 12.8). Significant strong and moderate correlations were identified between PFRI with PNDI and GRC scores (r= 0.78 and r= 0.69). The respective ES and SRM values were 0.73 and 0.78 for PFRI. The GRI was 5.58. The AUC was 0.89 (P= 0.001). MCID was 11.7%.
Conclusion: This study confirms that the Persian functional rating index is responsive for assessing disability in Persian speaking patients with chronic non-specific neck pain.
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