Proximal femoral excision with interposition myoplasty for cerebral palsy patients with painful chronic hip dislocation

Purpose: Proximal femoral excision is a salvage procedure for painful chronic hip dislocation in cerebral palsy (CP) patients. The primary objective of this article is to describe our experience of an amplified interposition myoplasty, with appropriate peri-operative pain and tone management strategies, in a cohort of non-ambulatory CP patients with painful chronic hip dislocation. Our secondary objective is to present the clinical outcomes of these patients. Methods: We describe our experience in 20 CP patients (25 procedures) at mean 54-month (range 27–169) follow-up with a surgical technique that includes an augmented interposition myoplasty and tone management. The indications for surgery were pain (21 hips), poor sitting tolerance (11) and difficulty with perineal care (8). Results: The mean age was 22 years (range 10–40) with 11 patients Gross Motor Function Classification Scale (GMFCS) IV and 9 patients GMFCS V. Mean length of stay was 13 days (3–35). One procedure required revision at 12 months. Mean pain score improved from 7.8 (5–10) pre-operatively to 2.8 (1–5) post-operatively (p  <  0.001). Sitting tolerance improved in all patients and in 75 % (15) perineal care was easier. Conclusions: Our interposition myoplasty technique with individualised pain/tone management has good outcomes in this cohort of patients with multiple co-morbidities

Migraine Types and Triggering Factors in Children

How to Cite this Article: Nejad Biglari H, Karimzadeh P, Mohammadi Kord-kheyli M, Hashemi SM. Migraine Types and Triggering Factors in Children. Iran J  Child Neurol 2012;6(2):33-38.Objective Migraine is a common problem in children and the mean prevalence of migraine in Europe among 170,000 adults was 14.7% (8% in men and 17.6% in women) and in children and youth (36,000 participants), the prevalences were (9.2% for all, 5.2% in boys and 9.1% in girls) and the lifetime prevalences were (16, 11 and 20%, respectively). To determine the epidemiology of migraine and evaluate migraine triggering factors in children. Materials &amp; Methods Two-hundred twenty-eight children with a maximum age of 12 years who fulfilled the ICHD-II criteria for pediatric migraine were enrolled into the study. Results This study shows that migraine is slightly more common in boys and its peak incidence is between ages 8 and 12 and most patients have three to five headache attacks per month. The pain has a tightening, stabbing or vague quality in about 70% of children with migraine and bilateral headache is slightly more common. The common triggering factors in children migraine were stress, noise, sleeplessness, hunger and light and the common relieving factors were sleep, analgesics, silence, darkness and eating. Conclusion Migraine is a common problem in children with an equal incidence in boys and girls before adolescence and more common in girls after adolescence. ReferencesPowers SW, Andrasik F. Biobehavioral treatment, disability, and psychological effects of pediatric headache. Pediatr Ann 2005;34(6):461-5. Rosenblum RK, Fisher PG. A guide to children with acute and chronic headaches. J Pediatr Health Care 2001;15(5):229-35. Fallahzadeh H, Alihaydari M. Prevalence of migraine and tension-type headache among school children in Yazd, Iran. J Pediatr Neurosci 2011;6(2):106-9. Ayatollahi SM, Khosravi A. Prevalence of migraine and tension-type headache in primaryschool children in Shiraz. East Mediterr Health J 2006;12(6):809-17. Stovner LJ, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain 2010;11(4):289-99. Bille B. A 40-year follow-up of school children with migraine. Cephalalgia 1997;17(4):488-91; discussion 487. Bille B. Migraine and tension-type headache in children and adolescents. Cephalalgia 1996;16(2):78. Bille B. Migraine in childhood and its prognosis. Cephalalgia 1981;1(2):71-5. Lewis DW, Ashwal S, Dahl G, Dorbad D, Hirtz D, Prensky A, et al. Practice parameter: evaluation of children and adolescents with recurrent headaches: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2002;59(4):490-8. Shah UH, Kalra V. Pediatric migraine. Int J Pediatr 2009;2009:424192. Fukui PT, Gonçalves TR, Strabelli CG, Lucchino NM, Matos FC, Santos JP, et al. Trigger factors in migraine patients. Arq Neuropsiquiatr 2008;66(3A):494-9. Neut D, Fily A, Cuvellier JC, Vallée L. The prevalence of triggers in paediatric migraine: a questionnaire study in 102 children and adolescents. J Headache Pain 2012;13(1):61-5. Lewis DW, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache 2004;44(3):230-7. Barabas G, Matthews WS, Ferrari M. Childhood migraine and motion sickness. Pediatrics 1983;72(2):188-90. Holguin J, Fenichel G. Migraine. J Pediatr 1967;70(2):290-7. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;24 (Suppl 1):9-160

Knowledge and attitude toward genetic diseases and genetic tests among pre-marriage individuals: A cross-sectional study in northern Iran

Background: Genetic testing has been widely introduced for many hereditary disorders. While the attitudes towards these facilities have been evaluated in many countries, there are only a few reports on the knowledge of and the orientation among Iranians. Objective: The current study assesses the attitudes and knowledge of pre-marriage individuals toward the availability and use of genetic tests. Materials and Methods: A comprehensive questionnaire was distributed among 408 marrying individuals. The questions addressed the demographic characteristics along the registration of participant’s knowledge, education, and attitude toward genetic testing. The individuals were divided into three groups based on their knowledge: 1) Scored above 80 to 100 were defined as “good” 2) 60 to 80 as “average” 3) less than 60 as “poor” knowledge. Result: Most participants (86%) believed consanguineous marriages increase the risk of genetic diseases; 82.3% knew that thalassemia is a type of genetic disease, only 33.3% could distinguish prenatal diagnosis (PND) from other laboratory tests. The relationship between the participants’ knowledge and their level of education was significant (r = 0.78, p &lt; 0.001), age (r =–0.16, p &lt; 0.01), and urbanity (p &lt; 0.01). A prominent relationship was observed between the knowledge (r = 0.64, p &lt; 0.001) or education (r = 0.62, p &lt; 0.001) and people’s desire to use the genetic tests before the wedding ceremony. No significant correlations were found between the participant’s attitude and their ages/urbanity. Most of the individuals agreed to arrange a genetic counseling before marriage (0.94%). Conclusion: This study revealed that most individuals were interested in using genetic counseling services and genetic tests before marriage

The effectiveness of cognitive behavioral therapy and schema therapy on happiness and mental health of nursing students

Background and aims: Cognitive behavioral therapy and schema therapy are known as two common methods to promote happiness and mental health. This research aimed to investigate the effectiveness cognitive behavioral therapy and schema therapy in improving happiness and mental health of nursing students who referred to counseling center in Islamic Azad university of Mashhad Branch. Methods: This research was a quasi-experimental study with a pre-test and post-test design. The statistical population included all nursing girl students who referred to counseling center in Islamic Azad university of Mashhad Branch in 2014 year. 45 girl students were selected by convenience sampling and randomly assigned to three groups (each group 15 students) included experimental and control groups. The experimental groups educated by cognitive behavioral therapy and schema therapy in 10 sessions (each session for 70 minutes). All of groups completed the questionnaires of happiness (Argyle and Lu) and mental health (Goldberg and Hillier) as the pre-test and post-test. Data were analyzed using SPSS software and multivariate analysis and covariance methods. Results: The findings showed the happiness post-test mean of cognitive behavioral, schema therapy and control groups was (3.78±1.19), (3.67±1.12), and (1.96±0.65) respectivly. Also, the post-test mean of mental health in cognitive behavioral, schema therapy and control groups was (3.23±0.91), (3.12±0.87), and (1.68±0.70) respectivly. Moreover, there was a significant difference among experimental groups, cognitive behavioral therapy and schema therapy with control groups (P<0.005). Conclusion: The results of this study showed that both cognitive behavioral therapy and schema therapy methods can increase happiness and mental health in nursing students. So, it suggests that therapists use these methods to improve happiness and mental health in students

Assessment of Dental Materials’ Catalogs Based on Safety and Protection Items in Dental School of Kerman

Objectives Dental materials are potentially hazardous and can negatively affect the health of patients, dental staff, and the surrounding environment. Thus, it is important to be aware and comply with the information provided in the material safety data sheets (MSDSs). Therefore, it seems necessary to review the dental material safety sheets in order to determine their consistency with the standard safety items required for dental materials. This study aimed to evaluate the MSDSs of dental materials consumed in Kerman Dental School to determine their compliance with the standard safety items. Methods In this cross-sectional study, 106 dental materials were selected from 12 clinical departments of Kerman Dental School. The MSDSs were assessed in order to determine their consistency with the standard safety items. Data were analyzed with SPSS version 21, and t-test was used for statistical analysis. Statistical significance level was set at P&lt;0.05. Results Among the 15 items considered necessary according to the standard MSDSs, the item “necessary measures in case of possible leakage and spillage” had been least frequently stated in the assessed MSDSs. Also, the mean safety score of the materials with MSDSs was significantly higher compared with materials that had no MSDSs(P=0.0001). Conclusion Evaluation of the MSDSs of dental materials consumed in Kerman Dental School regarding the required standard items revealed that they did not meet the defined standard levels

Posteromedial bowing of the tibia: A benign condition or a case for limb reconstruction?

PURPOSE: To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. PATIENTS AND METHODS: In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures. RESULTS: The greatest correction of deformity occurred in the first year of life, but after the age of four years, remodelling was limited. The absolute leg-length discrepancy (LLD) increased throughout growth with a mean 14.3% discrepancy in tibial length. In the lengthening group, mean length gained per episode was 45 mm (35 to 60). Mean duration in frame was 192 days, with a mean healing index of 42.4 days/cm. Significantly higher rates of recurrence in LLD were seen in those undergoing lengthening under the age of ten years (p = 0.046). Four contralateral epiphysiodeses were also performed. CONCLUSION: Posteromedial bowing of the tibia improves spontaneously during the first years of life, but in 20/38 (53%) patients, limb reconstruction was indicated for significant residual deformity and/or worsening LLD. For larger discrepancies and persistent deformity, limb reconstruction with a hexapod external fixator should be considered as part of the treatment options. Level of evidence Level IV (Case series)

Poly (ɛ-caprolactone) nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea

The study aimed to fabricate and characterize a 2-part artificial cornea as a substitute for penetrating keratoplasty in patients with corneal blindness. The peripheral part of the artificial cornea consisted of plasma-treated electrospun poly (ɛ-caprolactone) (PCL) nanofibers, which were attached to a hydrogel disc of polyvinyl alcohol (PVA) as a central optical part. The physical properties of the prepared artificial cornea, including morphology, mechanical properties, light transmittance, and contact angle, were assessed. Cell attachment and proliferation studies were performed on rabbit limbal stem cells. The SEM image of the polymeric system showed that the peripheral part formed a highly porous scaffold that could facilitate tissue biointegration. Assessment of the mechanical properties of the peripheral nanofibrous part and the hydrogel optical part showed suitable elasticity. Young’s modulus values of the electrospun PCL skirt and PVA hydrogel core were 7.5 and 5.3 MPa, respectively, which is in line with the elasticity range of natural human cornea (0.3–7 MPa). The light transmittance of the central part was >85% when measured in the 400–800 nm wavelength range. The plasma-treated PCL nanofibrous scaffold promoted limbal stem cell adhesion and proliferation within 10 days. These results confirmed that the polymeric artificial cornea showed suitable physical properties and good biocompatibility and epithelialization ability

Fertility disorder associated with celiac disease in males and females: fact or fiction?

Abstract Aim: The association between celiac disease and infertility is controversial in the literature