A new biomechanical method for objective measurement of spasticity: A preliminary study

The assessment of the various impairments in brain damage including spasticity is important. The purpose of this study was to develop a new biomechanical method based on quantification of velocity reduction (VR) suitable for clinical use. A highly reliable system was developed to apply a constant torque perturbation at the elbow. This system was used to measure the VR in 30 healthy adults and 10 hemiplegic patients. In healthy subjects, the mean VR was 3.02 (SE (standard error) = 0.29). In hemiplegic patients, the mean VR in the impaired arm (81.47, SE= 2.87) was significantly higher than the VR () either in the nonimpaired arm (9.86, SE= 0.92) (WSRT (Wilcoxon Signed Ranks Test): Z = -12.74; p<0.001), or the normal (3.02) p<0.001). The interaction between the associated reaction (AR) and the asymmetrical tonic neck reflex (ATNR) with head away from the impaired arm made a significant higher VR (90.41, SE=3.43) (p<0.001). The correlation between the VR () and the Modified Ashworth Scale scores was significant (Spearman�s rho = 0.77, p<0.001). It is concluded that the quantification of velocity reduction may be used as an objective method of measuring spasticity in neurological conditions. © MA Healthcare Limited 2014

Quality of life in Zahedan elderly population

Introduction: It has been estimated that 335 million elderly, about 13 percent of general population, live in developing countries. It has been predicted that in 2040, this percentage will rise to 20 percent. Psychophysical complains are common in elderly and investigation of quality of life (QOL) in these samples of population is very important. Materials and Methods: This research is a descriptive analytical study carried out to investigate the QOL of elderly residents of Zahedan city. In this study a short form questionnaire (SE 36) of QOL was used. Estimated required number of the samples was 200 that were selected with random cluster sampling. Results: Average age of studied population was 72.3 years and their mean number of children was 6.7. Mean scores of the general health perception, physical activity, physical role function, bodily pain, social function, emotional role function, vitality and mental health were 38.6, 42.7, 36.8, 37.8, 43.9, 45,46.7 and 42.7, respectively. Conclusion: Since currently there are no sound data for elderly QOL in Iran, considering mean QOL score of 50 and standard deviation of 10, all observed QOL scores (in eight dimensions) were low. These findings show importance of attention to QOL in elderly clients

Psychometric properties of the Iranian version of modified polycystic ovary syndrome health-related quality-of-life questionnaire

STUDY QUESTION Can the modified polycystic ovary syndrome health-related quality-of-life questionnaire (MPCOSQ) be validated in Iranian patients with polycystic ovary syndrome (PCOS) to provide an instrument for future outcome studies in these patients? SUMMARY ANSWER We show initial reliability and validity of the Iranian version of the MPCOSQ as a specific instrument to measure health-related quality of life (QOL) in patients with PCOS in Iran. WHAT IS KNOWN ALREADY The prevalence of PCOS in Iran is relatively high and studying QOL in these patients is important. The PCOSQ has previously been translated and validated in Iran but no studies had examined the psychometric properties of the MPCOSQ in Iran. STUDY DESIGN , SIZE, AND DURATION This was a cross-sectional study. After linguistic validation of the Iranian version of MPCOSQ, an expert panel evaluated the items by assessing the content validity index (CVI) and content validity ratio (CVR). Then a semi-structured interview was conducted to assess face validity. Consequently, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to indicate the scale constructs (n 200). In addition, reliability analyses including internal consistency and testretest analysis were carried out. PARTICIPANTS/MATERIALS, SETTING, AND METHODS This study was carried out on women with PCOS (n 200) who attended two private gynecology clinics in Kashan, Iran. Patients were eligible if they met each of the following criteria: 1540 years of age; married; not having non-classic adrenal hyperplasia, thyroid dysfunction and hyperprolactinemia; Iranian; not having problems in speaking or listening; having two of the following Rotterdam diagnostic criteria: (i) polycystic ovaries visualized on ultrasound scan (presence of 12 follicles or more in one or both ovaries and/or increased ovarian volume >10 ml), (ii) clinical signs of hyperandrogenism (the hirsutism score based on the FerrimanGallwey score >7 or obvious acne) and/or an elevated plasma testosterone (normal range testosterone 35 days and/or amenorrhea as the absence of vaginal bleeding for at least 6 months, i.e. 199 days. MAIN RESULTS AND THE ROLE OF CHANCE CVI and CVR scores for MPCOSQ were 0.96 and 0.92, respectively. A six-factor solution (emotional disturbance, weight, infertility, acne, menstrual difficulties and hirsutism) emerged as a result of an EFA and explained 0.64 of the variance observed. The result of the EFA supported the item 'late menstrual period' being placed in the menstrual rather than the emotional subscale. The results of the CFA for six-factor model for MPCOSQ indicated an acceptable fit for the proposed model. Additional analyses indicated satisfactory results for internal consistency (Cronbach's alpha ranging from 0.76 to 0.92) and intraclass correlation coefficients (ranging from 0.71 to 0.92). Moving 'late menstrual period' from the emotional to the menstrual subscale significantly improved the reliability coefficient for both subscales. LIMITATIONS, REASONS FOR CAUTION Study of patients with PCOS attending two private gynecology clinics may limit generalization of the findings to the entire population with PCOS. All patients in this study were married for cultural reasons in Iran. Therefore, the results of the present study have to be interpreted with some caution. WIDER IMPLICATIONS OF THE FINDINGS The Iranian version of the MPCOSQ will fill an important gap in measuring the QOL in patients with PCOS in the research and community settings in Iran. © The Author 2012

Relation between resistance to antipseudomonal β-Lactams and ampC and mexC genes of pseudomonas aeruginosa

Background: In order to select a better antibiotic choice for treatment of Pseudomonas aeruginosa infections, this study was conducted to determine the frequency of resistance to some antipseudomonal β-lactams in P. aeruginosa isolates from patients in Tehran, Iran. In addition, the relation between presence of genes known to be responsible for resistance to β-lactams (ampC, mexC1,2, and mexC3,4 genes) and resistance phenotype among P. aeroginosa isolates was evaluated. Methods: P. aeruginosa strains were isolated and identified by routine methods and PCR for oprL gene. Disk diffusion method was employed to determine the antimicrobial susceptibility pattern according to CLSI recommendations. PCR was used to detect the resistance genes. Results: Among 100 isolates of P. aeruginosa, 82 had ampC, 86 mexC1,2 and 89 mexC3,4 genes and combinations of these genes were seen in most of isolates and only 3 of isolates had none of these genes. Resistance to mezlocillin, cefepime, ceftazidime and piperacillin/ tazobactam was seen in 46, 41, 36 and 29 of isolates, respectively. Significant relation (P value �0.05 by Chi-square or Fisher Exact test) was observed between the presence of ampC gene and resistance to all the studied β-lactams in this study. No relation was observed for mexC genes, although many of isolates containing these two genes were phenotypically resistant. Discussion: This study had shown for the first time, the presence of ampC and mexC genes in significant percent of clinical isolates of P. aeruginosa in Tehran, Iran, and relation between presence of ampC gene and resistance to β-lactams. © 2016, Iran J Pathol. All rights reserved

Health-related quality of life and its relationship with clinical symptoms among Iranian patients with polycystic ovarian syndrome

Background: Polycystic ovarian syndrome (PCOS) has been shown to cause a reduction in Health-related quality of life (HRQOL). Objective: This study examines the extent of different clinical symptoms in PCOS patients on HRQOL. Materials and Methods: A cross-sectional study was undertaken to ascertain the factors related to HRQOL in 200 PCOS patients in Kashan, Iran. Main outcome measures were modified polycystic ovarian syndrome questionnaire (MPCOSQ) and clinical information of PCOS. Major clinical PCOS features including obesity (BMI), excessive body hair (hirsutism score), acne, menstrual cycle disturbances and infertility. Results: Findings showed that the most common HRQOL concern was menstrual irregularities and infertility, followed in descending order by hirsutism, weight, emotion, and acne. Multivariate analysis revealed the menstrual irregularities as a significant predictor of menstruation (p=0.005), emotion (p=0.02) and infertility (p=0.02) subscales of the MPCOSQ. Having of infertility, predicted scores on the infertility subscale (p<0.0001). Hirsutism score was a significant predictor of hirsutism (p<0.0001) and emotion (p<0.0001) subscales. Weight subscale concerns was predicted by BMI (p<0.0001), also, acne was found to be predicted score of acne subscale (p<0.0001). Conclusion: Worsened HRQOL in women with PCOS was related to more menstrual irregularities and infertility than to obesity. The finding suggests a potential for poorer compliance with weight management protocols among affected PCOS patients. © 2013, Research and Clinical Center for Infertitlity. All rights reserved

The Effect of Acupressure at the 3rd Point of liver Channel on Quality of Life of Female Students with Primary Dysmenorrhea in Tehran Teacher Training Center in 2008: A Randomize Clinical Trial

Background and Objectives: Dysmenorrhea affects women’s quality of life; moreover it results in physical, mental, social and economical problems. The aim of this study was to evaluate the effect of acupressure at the third point of liver channel (liv3) on quality of life in female students of Tehran Teaching Training (Tarbiat Moallem) Center with primary dysmenorrhea.Methods: This single-blind randomized clinical trial was conducted on 194 female students of Nasibeh Tarbiat Moallem center in Tehran who had had inclusion criteria. In the first cycle, the severity and duration of pain and quality of life were determined. Therefore, the participants were randomly assigned to either experimental or control group. In the second, third and fourth cycles, acupressure at liv3 and placebo point during 3-7 days before menstruation for 20 minute were carried out. In the fourth cycle, participants completed SF-36 questionnaire after menstruation again. Data-gathering Instruments used in this study included wrong-Baker faces pain scale,Beck-21 questionarre, SF-36 questionnaire, clock, Acuhealth tens pro 900 set, force guage. Data were analyzed with SPSS 16 and x2 test, Man Whitney U, independent and paired test. P values were set as 0.05(p0.05) but there was a significant difference in mean quality of life dimension between two groups in the fourth cycle (p0.05). Moreover, there was no significant difference between two cycles in Role Emotional functioning and social functioning dimensions in experimental group (p>0.05).Conclusion: with regard to the results of this study, acupressure at liv3 point is suggested as useful, effective, cheap and available treatment for primary dysmenorrhea

Psychological investigation in patients with polycystic ovary syndrome

Background: The aim of the present study was to estimate the prevalence of mood disorders and examine a range of predictors for psychological well-being among Iranian women with polycystic ovary syndrome (PCOS).Methods: A cross-sectional study was undertaken to ascertain the factors related to psychological distress in PCOS patients in Kashan, Iran. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). In addition we assessed quality of life using the Short Form Health Survey (SF-36). Socio-demographic details and clinical information of PCOS including obesity (body mass index), excessive body hair (hirsutism score), acne, menstrual cycle disturbances, infertility and endocrine profile also were recorded for each patient.Results: In all 300 women with PCOS were entered into the study. Of these 32 (n =96) showed elevated HADS anxiety while depression was high in 5 (n =15). Quality of life was significantly impaired in women with anxiety (P <0.05), and depression (P <0.001) and in particular, in women with coexistence anxiety and depression (P <0.001) compared with unaffected participants. Compared with the non-depressed PCOS patients, the depressed women had significantly higher menstrual irregularities (P = 0.008). Moreover, we found significant difference in FAI level between the depressed and non depressed (p = 0.05), the anxious and non anxious patients (p < 0.001) compare to non affected PCOS women.Conclusions: The high prevalence of depression and anxiety in this population suggests that initial evaluation of all women with PCOS should also include assessment of mental health disorders. The clinician should further pay attention to background of their patients especially in view of the factors influencing psychological well-being. © 2013 Bazarganipour et al.; licensee BioMed Central Ltd

Predictive factors of health-related quality of life in patients with polycystic ovary syndrome: A structural equation modeling approach

Objective To determine association between health-related quality of life (HRQOL) and psychosexual variables in patients with polycystic ovary syndrome (PCOS). Design Cross-sectional study. Setting Two private gynecology clinics. Patient(s) A sample of 300 women with PCOS were entered into the study and were subdivided into three groups: hyperandrogenism (HA) and PCO morphology; menstrual dysfunction and PCO morphology; menstrual dysfunction and HA and/or PCO morphology. Then each patient completed the following questionnaires: the Hospital Anxiety and Depression Scale, the Body Image Concern Inventory, the Rosenberg Self-Esteem Scale, the Short-Form Health Survey, and the Female Sexual Function Index. Intervention(s) None. Main Outcome Measure(s) Both direct and indirect relationships among clinical symptoms, psychologic status, self-esteem, body image, and sexual function as independent predictors of HRQOL were examined with the use of structural equation modeling analysis. Result(s) The clinical variables and psychologic distress had the strongest indirect relationships with HRQOL in the HA phenotype. The highest effect of PCOS symptoms on HRQOL impairment in patients with menstrual irregularities along with HA and patients with menstrual irregularities along with polycystic ovaries was exerted by clinical variables, poor perception of self-worth, negative body image, and sexual dysfunction. Conclusion(s) In patients with various phenotypes of PCOS, the effects of mediating variables on HRQOL are different. In patients with PCOS, the findings suggest that mediating factors, especially psychologic distress, self-esteem, body image, and sexual function, play an important role and should be taken into consideration and adequately treated if present. © 2013 by American Society for Reproductive Medicine

Sexual functioning among married Iranian women with polycystic ovary syndrome

Background: This study aimed to assess sexual functioning among women with polycystic ovary syndrome (PCOS) in Iran. Materials and Methods: A cross-sectional study was conducted to ascertain factors related to sexual functioning in 300 PCOS patients attending to the private practice centers in Kashan, Isfahan Province, Iran, from May to October 2012. The Female Sexual Function Index (FSFI) was used to measure sexual functioning. Moreover, the socio-demographic details and clinical information of PCOS including obesity, hirsutism, acne, menstrual cycle disturbances, infertility and endocrine profile were recorded for each patient. Results: Overall the prevalence of female sexual dysfunction (FSD) was 16.6. In particular patients indicated poorer sexual functioning for the desire (48.3) and the arousal (44.7) subscales. Multiple logistic regression analysis suggested patients with lower educational level (OR: 2.94; 95 CI: 1.46-5.92) and irregular menstrual status (OR:4.61; 95 CI: 1.93-11) were more likely to report sexual dysfunction. Conclusion: The findings suggest that desire and arousal were the most prevalent sexual disorders reported in this patient population. In addition, findings suggested that women with limited or no formal education and a history of menstrual irregularities were the most likely to report female sexual dysfunction. Further investigations are needed to examine female sexual functioning among women with PCOS, to educate their health care providers, and to develop therapeutic interventions. © 2014 Royan Institute (ACECR). All rights reserved