Diffuse Multifocal Bilateral Dysembryoplastic Neuroepithelial Tumor: A Very Unusual Case Report

Dysembryoplastic neuroepithelial tumor (DNT) considered as a benign cortical Glioneuronal neoplasm of children or young adults, typically present with drug-resistant focal epilepsy. DNTs are usually located in the temporal lobe but can found in any part of the supratentorial brain cortex. Multifocal DNTs have rarely reported. Here we present an eight years old boy with two years follow up, having a somewhat stable diffuse multinodular DNT of the most significant spatial extent that may have reported, involving cortical and subcortical left temporo-occipital lobe, bilateral basal ganglia and thalamus, presenting with headache, short stature, and behavioral disorder

The effect of moisture content, particle size and consolidation stress on flow properties of vermicompost

 Physical properties of granular solids are essential to design appropriate, efficient, and economic bulk solids handling and storage equipment.  Flow of vermicompost is often restricted by caking and bridging, which occurs during transportation and storage.  This problem could be due to a number of factors including storage moisture, temperature, particle size, and consolidation stress.  There is lack of study on the effect of the mention factors simultaneously on flow index, cohesive strength and angle of internal friction of vermicompost.  The aims of this work were to discuss the primary factors affecting flowability of vermicompost as granular solids and powders, as well as using shear testing methodologies for this biomass material.  The experiments were conducted on samples selected from a wormy culture farm, Karaj, Iran, by Jenike’s shear cell technique.  The data was statistically analyzed using the three factors completely randomized design to study the effects of particle size, moisture content and consolidation stress on vermicompost flow properties.  The results showed that a significant difference between the flow index values at different stress levels.  Greater moisture content and smaller particle size caused poor flowability of vermicompost.  Increasing the moisture content and decreasing the particle size from 1.18 to 0.3 mm, the vermicompost reduced its flowability from free flowing at moisture content of 25% (w.b.) to cohesive at moisture content of 35% (w.b.).   Keywords: biomass flowability, flow index, shear test, vermicompost

Decision-Making Process in Patients with Thoracolumbar and Lumbar Burst Fractures with Thoracolumbar Injury Severity and Classification Score Less than Four

Study DesignCross-sectional.PurposeTo develop a strategy to determine a sound method for decision-making based on postoperative clinical outcome satisfaction.Overview of LiteratureThe ideal management of thoracolumbar and lumbar burst fractures (TLBF) without neurological compromise remains controversial.MethodsThis was a prospective study. Patients with thoracolumbar injury severity and classification score (TLICS) <4 were treated nonoperatively, with bed rest and bracing until the pain decreased sufficiently to allow mobilization. Surgery was undertaken in patients with intractable pain despite an appropriate nonoperative treatment (surgery group). The Oswestry disability index (ODI) measure was observed at baseline and at the last follow-up. Clinically success was defined at least a 30% improvement from the baseline ODI scores in both the conservative and surgery groups. All case records were assessed for gender, age, residual canal and angulations at the site of the fracture in order to determine which patients benefited from surgery or conservative treatment and which did not.ResultsIn all 113 patients with T11–L5, TLBFs were treated. The patients' mean age was 49.2 years. Patients successfully completed either nonoperative (n=99) or surgical (n=14) treatment based on ODI. Clinical examinations revealed that all of the patients had intact neurology. The mean follow-up period was 29.5 months. There was a significant difference between the two groups based on age and residual canal. The mean ODI score significantly improved for both groups (p <0.01). According to the findings, a decision matrix was proposed.ConclusionsThe findings confirm that TLICS <4, age, and residual canal can be used to guide the treatment of TLBF in conservative decision-making

Tumors of the Central Nervous System: An 18-Year Retrospective Review in a Tertiary Pediatric Referral Center

How to Cite This Article: Aghayan Golkashani H, Hatami H, Farzan A, Mohammadi HR, Nilipour Y, Khoddami M, Jadali F. Tumors of the Central Nervous System: An 18-Year Retrospective Review in a Tertiary Pediatric Referral Center. Iran J Child Neurol. Summer 2015;9(3):24-33. AbstractObjectiveFew studies exist on the demographics and trends of pediatric central nervous system (CNS) tumors in Iran. In this study, we retrospectively reviewed all cases with confirmed CNS tumors admitted to Mofid Pediatric Hospital, Tehran, Iran during the last 18 years.Materials &amp; MethodsData on gender, age of diagnosis, pathologic classification and tumor location were extracted from the available medical records. We used the last version of International Classification of Childhood Cancer.ResultOverall, 258 (81.9%) brain tumors and 57 (18.1%) spinal tumors were identified.Our subjects comprised of 147 (46.7%) female and 168 (53.3%) male children.More male dominancy was observed in brain tumors with a male to female ratio of 1.2 compared with 1.03 of spinal tumors. Malignant CNS tumors were most common in 1-4 yr age group. The four most common brain tumors in our subjects were astrocytomas, medulloblastoma, ependymoma and craniopharyngioma.Overall, 53.1% of the brain tumors were supratentorial. Gliomas, PNET and neuroblastma were the most frequent primary spinal tumors in our study. We observed an increasing trend for both brain and spinal tumors that was more remarkable in the last 5 years.ConclusionOur results are comparable with similar single center studies on CNS tumors during childhood. The observed disparities could be attributed to the single center nature of our study and geographical, environmental and racial variations in pediatric CNS tumors. The increasing trend of both brain and spinal tumors could warrant further investigations at provincial and national levels to investigate probable contributing environmental risk factors.

Role of the Self-Administered, Self-Reported History Questionnaire to Identify Types of Lumbar Spinal Stenosis: A Sensitivity Analysis

Study DesignCase-control design.PurposeTo evaluate the role of the self-administered, self-reported history questionnaire (SSHQ) in identifying types of lumbar spinal stenosis (LSS).Overview of LiteratureDiagnosis of types of LSS is controversial.MethodsA total of 235 patients with LSS were asked to respond to the SSHQ. All of these patients recovered following surgical treatment. The classification of LSS patients was based on history, physical examinations, and imaging studies. It is considered to be the gold standard. Radicular and neurogenic claudication types of LSS were based on the SSHQ developed by Konno et al. Two categories of LSS were determined based on the SSHQ tool and gold standard. Finally, a sensitivity analysis was carried out to evaluate the diagnostic value of the SSHQ.ResultsThe mean age of patients was 59.4 years. According to the criteria for gold standard, patients were diagnosed with the radicular type (n=103), and neurogenic claudication type (n=132). The questionnaire had desirable sensitivity, specificity, and accuracy in categorizing the two types of LSS: 97.8%, 66.6%, and 96.8% for the radicular type, and 97.0%, 80.0%, and 95.7% for the neurogenic claudication type.ConclusionsOur findings indicate that the SSHQ is a reliable and a valid measure and it may be a clinical diagnosis support tool for identifying patients with two types of LSS

Lumbar Spinal Canal Stenosis Classification Criteria: A New Tool

Study DesignCase-control study.PurposeTo design a new tool for classifying lumbar spinal canal stenosis (CLSCS).Overview of LiteratureGrading of patients with lumbar spinal canal stenosis (LSCS) is controversial.MethodsThe Oswestry disability index (ODI) and the neurogenic claudication outcome score (NCOS) were recorded. Four parameters, which indicate the severity of LSCS disease, including Hufschmidt-grade, grading of magnetic resonance imaging, self-paced walking test, and stenosis ratio (SR) were employed. For the SR, quartile analysis was applied for classifying LSCS and the Hufschmidt-grade was modified into a 4-grade score. An initial score was assigned to each metric based on the severity of LSCS. Using the inverse-variance weighting method, the relative weights of these domains and their categories were determined. The score for all of the cases was obtained based on their weight by summing up the points of the four variables. Quartile analysis was used and a CLSCS score was proposed. Finally, intra- and interobserver reliability, and validity were assessed.ResultsA total of 357 patients were studied. The final CLSCS score for each case ranged from 4 to 16.5. Based on the quartile analysis, using the new criteria set, the CLSCS score was divided into four categories: CLSCS<7 (grade 0); 7≤CLSCS<10 (grade 1); 10≤CLSCS<13 (grade 2); and 13≤CLSCS≤16.5 (grade 3). The kappa values of for the CLSCS score indicated a perfect agreement. The CLSCS was correlated with the ODI and NCOS. All patients with grade 3 CLSCS were observed in the surgical group.ConclusionsThe CLSCS score can be helpful for classifying LSCS patients and in the decision-making process

Outcome Measure of Pain in Patients with Lumbar Disc Herniation: Validation Study of the Iranian version of Pain Sensitivity Questionnaire

Study DesignCross-sectional.PurposeTo translate and culturally adapt an Iranian version of the Pain Sensitivity Questionnaire (PSQ) in Iran.Overview of LiteratureInstruments measuring patient reported outcomes should satisfy certain psychometric properties.MethodsThe PSQ was translated following cross-cultural adaptation guidelines. A total of 101 patients with lumbar disc herniation (LDH), and 39 healthy cases were included in the study. All participants completed the PSQ and the Pain Catastrophizing Scale (PCS). The internal consistency, test-retest reliability, known group comparison, criterion validity and item-scale correlations were assessed.ResultsThe mean age of participants was 51.7 years. Reliability, validity and correlation of PSQ and PCS showed satisfactory results. Cronbach's alpha coefficients were 0.81 for PSQ-total, 0.82 for PSQ-minor, and 0.82 for PSQ-moderate. The intraclass correlation coefficients value was 0.84 (0.616–0.932) indicating an excellent test-retest reliability. The instrument discriminated well between sub-groups of patients who differed in a standard predictive measure of LDH surgery (the Finneson–Cooper score). Total PSQ were also significantly correlated with the total scores of the PCS, lending support to its good convergent validity. Additionally, the correlation of each item with its hypothesized domain on the PSQ indicated acceptable results, suggesting that the items had a substantial relationship with their own domains.ConclusionsThe adapted Iranian PSQ is a valid and reliable questionnaire for the assessment of pain in patients with LDH

Knowledge, Attitude, and Practice Toward SARS COV-2 in Qazvin Province: A Population-Based Study

Background and Objectives: The spread of COVID-19 in the world has had adverse effects on all aspects of people´ life and social and economic development of the communities. The current study was conducted to determine the knowledge, attitudes, and practices toward COVID-19 in the general population of Qazvin province. Methods: This cross-sectional study conducted on 1223 people above 15 years in Qazvin province between December and January 2020. We used multistage stratified random sampling to select the participants from urban and rural health centers. The questionnaires were completed by the patients as well as through phone interviews. The questions included demographic information and knowledge, attitude, and practice toward COVID-19. Results: In total, 1223 subjects with a mean (standard deviation) age of 35.6 ± 12.2 years participated in this study. The scores of knowledge, attitudes, and practice were 68%, 72% and 91%, respectively. The lowest score of knowledge was related to awareness of common symptoms of the disease (6%). Forty-two subjects believed they observed the principles of disease prevention. A distance of 2 meters was observed by 50.3%. The scores of knowledge (P=0.007) and practice (P=0.028) increased with age, and the scores of knowledge (P<0.001) and attitude (P=0.001) increased and decreased with an increase in the education level, respectively. Males had significantly lower knowledge (P=0.002) and practice (P<0.001) scores. Moreover, rural residents had higher attitude scores compared to urban residents (P=0.002). Conclusion: The results suggest that the general population of Qazvin province had desirable knowledge, attitude and practice towards COVID-19 at the time of the epidemic. Keywords: Knowledge, Attitudes, Practices, COVID-19, Ira

Flange Wrinkling in Flexible Roll Forming Process

AbstractFlexible roll forming is an advanced sheet metal forming process for producing variable cross section profiles. Flange wrinkling at the transition zone where the cross section changes is a major defect in the flexible roll forming process. In this paper, the flange wrinkling at the transition zone is studied using finite element analysis. The results showed that the strip deformation at the transition zone can be considered as a combination of two strip deformations observed in the conventional roll forming process and the flanging process. According to finite element analysis results, when the flange wrinkling occurs, compressive longitudinal strain is smaller than the necessary compressive longitudinal strain calculated by mathematical modeling to obtain the intended profile geometry in the compression zone. Therefore, comparison of compressive longitudinal strain obtained from the finite element analysis and the necessary compressive longitudinal strain is a good criterion to predict the flange wrinkling occurrence. A flexible roll forming setup was developed. Longitudinal strain history is obtained from the finite element simulation and is compared with the experimental data from the flexible roll forming setup. Results show a good agreement and confirm the finite element analysis

Outcome Measures of Functionality, Social Interaction, and Pain in Patients with Cervical Spondylotic Myelopathy: A Validation Study for the Iranian Version of the Copenhagen Neck Functional Disability Scale

Study DesignCross-sectional.PurposeTo translate and validate the Iranian version of the Copenhagen Neck Functional Disability Scale (CNFDS).Overview of LiteratureInstruments measuring patient-reported outcomes should satisfy certain psychometric properties.MethodsNinety-three cases of cervical spondylotic myelopathy were entered into the study and completed the CNFDS pre and postoperatively at the 6 month follow-up. The modified Japanese Orthopedic Association Score was also completed. The internal consistency, test-retest, convergent validity, construct validity (item scale correlation), and responsiveness to change were assessed.ResultsMean age of the patients was 54.3 years (standard deviation, 8.9). The Cronbach α coefficient was satisfactory (α=0.84). Test-retest reliability as assessed by the intraclass correlation coefficient analysis was 0.95 (95% confidence interval, 0.92-0.98). The modified Japanese Orthopedic Association score correlated strongly with the CNFDS score, lending support to its good convergent validity (r=-0.80; p<0.001). Additionally, the correlation of each item with its hypothesized domain on the CNFDS was acceptable, suggesting that the items had a substantial relationship with their own domains. These results also indicate that the instrument was responsive to change (p<0.0001).ConclusionsThe findings suggest that the Iranian version of the CNFDS is a valid measure to assess functionality, social interaction, and pain among patients with cervical spondylotic myelopathy