Middle East Journal of Rehabilitation and Health

Research Article

19/4/2016

Elderly’s Quality of Life in Daycare and Boarding Nursing Homes in Semnan, Iran

Alliakbar Pahlavanian, Mina Sadat Mirshoja, Ziaeddin Safavi-Farokhi, Zahra Ahmadizadeh, Massoumeh Rasoulzadeh

Results: On the basis of SF-36 test and comparing various aspects of quality of life among the elderlies residing in boarding and daycare nursing homes, significant differences were observed in domains of quality of life, including physical restrictions (P < 0.001), restrictions in psycho-emotional function (P < 0.001), energy and fatigue (P < 0.008), psycho-emotional function (P < 0.001), social function (P < 0.001), physical pain (P < 0.001), and public health (P < 0.01). However, the difference was not significant in physical function (P = 0.437).

Conclusions: The results showed that the elderlies living in daycare centers had better qualities of lives physically and mentally. Therefore, to improve their qualities of lives in two general physical and mental domains, items such as providing family communications inside or outside the nursing homes as well as planning to fulfill mental and psychological needs besides physical issues like mobility and balance should be considered.

Research Article

16/4/2016

Research Priority of Clinical Linguistics in Iran

Hourieh Ahadi

Research Article

1/3/2016

Quality of Life in Patients With Chronic Schizophrenia in Semnan, Iran

Shamsi Jamali, Afsaneh Abri, Mina Sadat Mirshoja, Behnaz Behnam, Majid Mir Mohammadkhani

Case Report

20/2/2016

An Infant With Non-Ketotic Hyperglycemia: A Case Report

Navid Danaei, Shamsollah Nooripour

Introduction: Glycine encephalopathy, also known as non-ketotic hyperglycinemia (NKH) represents a disorder characterized by elevated concentrations of glycine in all body tissues, especially in plasma and cerebrospinal fluids (CSF). NKH is caused by deficiency in the glycine cleavage system (GCS). Most glycine encephalopathy cases occur during the neonatal period. The current report presents a case of NKH neonatal intractable seizures. Evaluating a sick neonate who presents with hypotonia, encephalopathy, and seizures is a diagnostic challenge; a high index of suspicion for timely diagnosis and treatment could prevent severe complications.

Case Presentation: The patient was a four-day-old baby girl in Iran admitted to the hospital due to hypotonia, lethargy and seizures. On the third day after discharge, the baby gradually lost the ability to suck milk and got sleepy and finally suffered from organ jump and seizures. Sepsis and antibiotics phenytoin tests were conducted and in metabolic testing, high level of glycine in blood and urine was reported and the patient was treated with sodium benzoate dextromethorphan and L-carnitine, after the start of the treatment, seizures and neurologic symptoms and alertness of the baby improved. The patient was discharged by continuing treatment after two weeks with seizure control, improved sucking reflexes and grasp.

Conclusions: Since most of the symptoms of metabolic diseases in newborns are same as the signs of sepsis or other common diseases of this period, and also early diagnosis and treatment of these illnesses, especially in diseases such as hyperglycemia, can be influential in neural function of babies, it calls for serious attention and clinical vision of the doctors to stop mortality caused by such diseases by early consideration of serious complications.

Case Report

23/4/2016

The Impact of the Sensory Integration Approach on Positive and Negative Symptoms in a Patient With Non-Paranoid Schizophrenia: A Case Report

Jinoos Jadidi, Mina Sadat Mirshoja

Introduction: One of the problems that people with schizophrenia face is the inability to understand and interpret the sensory input from the environment. This report aims to describe the effects of the sensory integration approach on non-paranoid schizophrenia. The treatment involved eight sessions held 3 days a week and lasting 45 minutes each. The patient had a defined Iranians form social relationships schizophrenia evaluated and treatment. Sensory integration therapy in these patients focused on the following elements: vestibular and proprioceptive senses, exercises to improve walking, improving upper extremity coordination and movement, writing activities, cognitive skills, activities of daily living, and family therapy.

Case Presentation: The subject (A.H.) was a 32-year-old male graduate student with no history of previous hospitalization. His diagnosis was schizophrenia. The reason for his hospitalization was that he was angry and violent toward his family. In addition, the patient had limited verbal and nonverbal skills, issues with self-control, and restricted community involvement. The results of the patient’s treatment for schizophrenia was assessed via a questionnaire on social skills.

Conclusions: After eight sessions, increased awareness of the environment, improved posture and gait pattern, improved motivation and enjoyment, improved patient tolerance, improved appearance and personal hygiene, loss of purposeful behavior, a realistic plan of action every day, improved attention span, improved decision-making skills, and improved community involvement and coping skills were achieved. The environment is rich in sensory stimuli. The integration and processing of each individual senses creates different behavioral responses. The results showed that a sensory integration approach combined with drug therapy is an effective treatment for patients with schizophrenia.

Case Report

28/3/2016

Unani Treatment Decreased Fibrosis and Improved Liver Functions in Decompensated Cirrhosis of Liver: A Case Series

Mohammad Akhtar Siddiqui, Shabnam Ansari

At present, liver transplantation remains the only curative option for the patients with cirrhosis and end-stage liver diseases. The survival rate and recurrent diseases remain the major issues in the patient post-transplantation. Unani medicine is one of the oldest traditional systems of medicine which has been treating chronic liver diseases and cirrhosis (Talayyaful-Kabid) for centuries. The current study aimed to assess the impact of Unani treatment on decompensated cirrhosis and collect data to warrant further clinical trials. Authors conducted a case series on five patients with decompensated cirrhosis and portal hypertension. The disease was confirmed through FibroScan and ultrasound and treated with Unani treatment orally for seven months. Results were evaluated based on FibroScan, liver function test (LFT), EuroQol-5D (EQ5D), Child-Pugh and TTO-TIME (trade-off question). Significant improvements in LFT, fibrosis and quality of life were achieved in the studied patients. The literature related to the herbal constituents of chief medicines used to treat in this case was reviewed. The herbs proved their potential anti-oxidative, anti-inflammatory, hepato-protective, immuno-modulator and antiviral activities, suggesting plausible mechanisms of action in the cases. The preliminary findings indicated the potential therapeutic role of Unani treatment in decompensated cirrhosis. Clinical trials should be conducted to explore further therapeutic potential of Unani treatment in decompensated cirrhosis.

Review Article

23/4/2016

Treatment of Scoliosis-Evidence and Management (Review of the Literature)

Hans-Rudolf Weiss, Deborah Turnbull, Nicos Tournavitis, Maksym Borysov

Context: Scoliosis is a three-dimensional deformity of the spine and trunk which includes lateral deviation, rotation, and a disturbance of the sagittal profile. Treatment is indicated for scoliosis because it may lead to negative consequences with regard to the quality of life and other health issues for some patients. The purpose of this review was to gather current, up-to-date information, and to search the recent articles on scoliosis for evidence of the different modes of treatment.

Conclusions: There is a high level of evidence for the conservative treatment of scoliosis, but there are varying levels of success in the different approaches. The better the correction of the curve, the better the end result and outcome for the patient. This is supported by the current evidence reviewed in this paper. Physiotherapy and bracing should be used and, specifically, those approaches using high corrective methods. Spinal fusion surgery is not supported by the current evidence. According to the literature, the long-term complications of surgery for scoliosis far outweigh the consequences of untreated scoliosis.

Research Article

2/4/2016

Validity and Reliability of the Persian Version of the Disability Assessment for Dementia Scale

Hamid Soltani Zangbar, Afsoon Hassani Mehraban, Malahat Akbarfahimi, Fatemeh Mohammadian Rasanani

Objectives: one the most important factor in determining the severity of dementia in the area of activities of daily living is disability assessment for dementia (DAD) scale, which is not available in Persian and there is no validity and reliability report for it in Iranian community. Therefore, the aim of this study was to provide a Persian version of the valid and reliable DAD scale to assess functional disability in patients with dementia of Alzheimer type within the scope of everyday living activities.

Patients and Methods: After the permission from the developer of the original scale, we translated the English version to Persian according to the international quality of life assessment (IQOLA) approach. To review the clarity and the necessity of the items translated, content validity index (CVI) and content validity ratio (CVR) methods were applied. Also, to assess the reliability of the scale, test-retest and inter-rater reliability techniques were used. The internal consistency of the items was also measured using the Cronbach’s alpha coefficient.

Research Article

13/3/2016

Somatic Mutation in Immunoglobulin Gene Variable Region in Patients With Chronic Lymphoid Leukemia and Its Influence on Disease Prognosis

Sanambar Sadighi, Issa Jahanzad, Mohammad Ali Mohagheghi, Mahdieh Shokrollahi Barough, Mohammad Hojjat-Farsangi, Kazem Zendehdel, Parviz Kokhaei

Background: Chronic lymphocytic leukemia (CLL) is a common blood cancer in people aged over 40. In addition to clinical and pathologic staging and blood tests, immunoglobulin variable heavy chain (IgVH) mutation analysis is a relevant prognostic factor for CLL. Finding the most prevalent mutation type and conducting a molecular analysis of immunoglobulin in the majority of the patients can contribute to identifying the disease pattern.

Patients and Methods: Patients with CLL were randomly selected from patients referred to Imam Khomeini hospital, Tehran, Iran. All patients underwent a clinical staging of the disease and had flow cytometric analysis performed on their blood samples. The panels of cell surface markers used for the diagnosis of chronic lymphoid leukemia include CD19, CD3, CD23, CD10, and CD5. The diagnosis confirmed a minimum of 20% positive expression of dual CD5 and CD19 markers. Genomic DNA was then extracted from the patients’ blood and IgVH mutation analysis was conducted with pGEM-T (easy vector) cloning kit followed by IgVH sequencing.

Results: Study patients were 42 to 80 years old, with their mean age of 62 (SE = 1.87) years. About 73% of them were male. The mean white blood cell (WBC) count, lymphocytes percentage, average hemoglobin level, and platelet count were 56,000/µL, 85%, 12 g/dL, and 150,000/µL, respectively. According to their molecular analysis, 38.9% of patients were unmutated and 61.1% showed mutation in the variable heavy chain locus. The most common mutation had occurred in IgVH3 allele (66.66%). The mean overall survival rate of patients, mutated and unmutated, was, respectively, 39 (95% CI, 32 to 46) and 31 (95% CI, 26 to 36) months (P = 0.4). Binet stage had statistically significant relationship with patients’ survival (P = 0.02).

Conclusions: According to this study, IgVH3 mutation was found to be prevalent (Although a correlation was found to exist between the patients’ survival and IgVH mutation, it was not statistically significant). We can conclude that clinical methods are still valuable to predict the prognosis of patients with CLL. Given the high cost and need for specialized laboratory, determining the cost and value of examining immunoglobulin heavy chain mutations and types of mutation such as IgVH3 are necessary in further studies.

Research Article

9/4/2016

Influence of Inward Pressure of the Transducer on Thickness and Echo Intensity of the Rectus Femoris Muscle During Ultrasonography

Hiroshi Ishida, Tadanobu Suehiro, Susumu Watanabe

Background: Muscle ultrasonography (US) can be used to evaluate muscle quantity and quality affected by a neuromuscular disease and aging. The evaluation of muscle thickness and echo intensity using US are useful ways of estimating muscle mass and composition. During US, diligent attention to steadying the position, orientation, and inward pressure of a transducer is required; however, little is known about the quantitative influence of different inward pressures of the transducer on muscle thickness and echo intensity during US.

Case Report

26/3/2016

Surgical Management of an Ovarian Bilateral Multiple Dermoid Cyst During Pregnancy: A Case Report Study

Sanam Moradan

Introduction: Most ovarian dermoid cysts occur during the reproductive age and therefore could occur during pregnancy. They are present in 0.03% of pregnancies and the risk of torsion during pregnancy is approximately 8%. They are bilateral in approximately 10% of cases. Diagnosis is usually made by ultrasound imaging. An ovarian cystectomy is almost always possible, even if it appears that only a small amount of ovarian tissue remains. Intraoperative spill of tumor contents may be a cause of complications.

Case Presentation: A 28-year-old, pregnant, primipara female with gestational age 20 weeks + four days where referred to with complaint of pelvic mass that was incidentally reported in sonography where referred to the hospital. She had undergone intact removal (without spillage) of cysts during pregnancy by laporotomy and histopathologic report confirmed bilateral, multiple, benign and dermoid cyst. She was discharged without any complication on the second day after operation. She had an uneventful pregnancy and a cesarean delivery with alive, normal, female fetus at 38 weeks of gestation because of breech presentation.

Review Article

1/3/2016

Probiotics and Inflammatory Pain: A Literature Review Study

Vida Nazemian, Mahdi Shadnoush, Homa Manaheji, Jalal Zaringhalam

Context: Inflammatory pains caused by direct stimulation of nociceptors are altered by release of inflammatory mediators, cytokines and chemokines and also gut microbiota. A substantial clinical evidence supports the pivotal role of probiotics in the betterment of inflammatory disorders symptoms such as pain. Therefore, this study aimed to review the potential anti-inflammatory and analgesic roles of usual probiotic compounds in animal and human disorders.

Results: In this study, we reviewed most of the existing papers on probiotics especially focused on inflammation and pain. Our review showed that probiotics offer many advantages including toxin receptors elimination, supporting the repair of hyper permeable epithelial barriers, interfering with infections and immune system reinforcement. It was revealed that there is a close correlation between the expression of cytokines and opioid receptors in the process of inflammatory pain and probiotics have notable effects on cytokines and opioid receptors expression. Probiotics can stimulate the differentiation and activity of important immune cells (e.g. T cells), subsequently increase production of anti-inflammatory cytokines and mu-opioid receptors and decrease levels of proinflammatory cytokines.

Case Report

13/3/2016

An Unusual Os Trigonum Syndrome Case Secondary to Car Accident: A Case Report

Vildan Binay Safer, Umut Safer, Levent Kaya

Research Article

20/4/2016

Translation and Validation of Two Subscales of Independent Living Scales in the Elderly Iranians

Narges Shafaroodi, Faeze Alvandi, Agha Fateme Hosseini

Materials and Methods: The translation of the two subscales, money management subscale and home management and transportation, were analyzed by experts to develop the final version of each. Afterwards, the face validity, content validity ratio (CVR) and content validity index (CVI) methods were examined. To assess the reliability of the subscales, test-retest reliability techniques were used. The internal consistency of the items was measured using Cronbach’s alpha coefficient.

Results: The simplicity, relevance, clarity and the necessity of the translated items were acceptable, based on the CVI and CVR scores. Face validity was also acceptable with respect to agreement rate (> 80%), as well as the impact score (> 1.5) for all items. Test-retest reliability was acceptable with respect to the intraclass correlations (ICC) and the standard error of the mean (SEM) scores (ICC = 0.92, SEM = 1.39 for money management; ICC = 0.95, SEM = 0.941 for home management and transportation). Cronbach’s alpha coefficients were 0.80 and 0.74 for money management, and home management and transportation, respectively.

Research Article

9/4/2016

Comparison of Trunk Stabilization Exercises Using a Gym Ball and Conventional Back Care Exercises for Patients With Chronic Lower Back Pain

Hashim Ahmed, Amir Iqbal, M Abu Shaphe

Patients and Methods: Thirty male subjects with chronic LBP were randomly assigned to two groups. The experimental group received trunk stabilization exercise using a gym ball whereas the control group received conventional back care exercises for six weeks. The abdominal muscle endurance, pain intensity, and functional disability were measured using pressure biofeedback, visual analogue scale (VAS), and modified Oswestry disability questionnaire (MODQ), respectively. All the measurements were taken at baseline and during week two, four and six.

Results: The results of the study demonstrated significant improvements in abdominal muscle endurance and reduction in VAS and MODQ score of both groups (P = 0.001). The trunk stabilization exercise group showed greater gains in abdominal muscle endurance during weeks two to six compared to the conventional back care exercise group (P < 0.05). In addition, the trunk stabilization exercise group showed greater reduction in the VAS score (P = 0.035) and MODQ score (P = 0.001) at week six compared to the conventional back care exercise group.

Case Report

27/4/2016

The Use of Operant Methods to Evaluate Interventions for Patients With Myalgic Encephalomyelitis

Leonard A Jason, Elizabeth K Kidd, Abigail A Brown, Stephanie McManimen, Rachael Korinek, Joey Tuan

Research Article

2/4/2016

Short-Term Effects of the Stage-Matched Multicomponent Lifestyle Intervention on Weight Control

Gulnaz Karatay, Yeliz Akkus, Nevzat Demirci, Baris Ozturk

Middle East Journal of Rehabilitation and Health: Apr 2016, 3 (2), 17 articles.