Association of History Taking and Accuracy of the Interpretation of Cervical and Lumbar Magnetic Resonance Imaging

BACKGROUND: Disk herniation leading to radiculopathy is one of the most important causes of neck and back pain, requiring specific diagnostic tests. Magnetic resonance imaging (MRI) is one of these diagnostic methods. Interpreting the findings of this imaging method by an experienced skilled person is very important. AIM: The purpose of this study was to investigate the role of history on the accuracy of the lumbar or cervical MRI reports in patients with back and neck pain referring to the radiology department. METHODS: This study was performed on patients with complaints of lumbar or neck pain that MRI had been performed for them. At first, the MRI was studied by the residents of the 2nd and 3rd years and then a radiologist as a routine, respectively. From 4 to 6 months later, patients’ clinical history was presented to the same students and professors and MRI was re-reported. Statistical differences were evaluated and analyzed using SPSS software version 20. RESULTS: Out of 150 patients with mean age of 42.56 ± 10.65, 87 patients (58%) were female and 63 (42%) were male. Most of the patients were between the ages of 40 and 50 years (34.66%). The most common clinical symptom of patients was waist and neck pain followed by sensory disturbances of the extremities. The most pathologic changes found was disk bulging in 28.8% of patients (68 cases). In terms of lumbar canal stenosis, the most cases were in the L4-L5 levels of the moderate type. The most reported cases of cervical stenosis have been mild. Disk herniation and DOCP were two main factors causing canal stenosis in the study patients. Statistical difference in the MRI reports performed by the residents on most of the variables was statistically significant before and after knowing the clinical history of the patient (p < 0.05). However, this difference was less noted in the reports of the radiologists. CONCLUSION: The results of this study showed that knowing the history of patients in interpreting the results of MRI in patients with vertebral disk hernia is misleading and will lead to many false positive and negative results, especially for radiology residents. It is recommended that the residents and radiologists consider the MRI films before focusing on the biographies and clinical features of the patient, to prevent the occurrence of bias and to increase the accuracy of the reports

Recess Activity and General Health Status among Iranian Elementary Schools’ Pupils

Background: Regular and daily physical activity during childhood and at school is one of the important part of requirements of normal growth, development and well-being. To achieve physical activity promotion among school child aged population recess as outside of class time efforts is scheduled and allows students to engage in physical and social activities. The purpose of the present study was to assess recess activities as well as status of physical activities among a sample of Iranian students at the pri¬mary schools.Methods: This cross-sectional study was performed in four randomly se¬lected schools from a list of 26 elementary schools in March, 2012 in the city of Shahindej, located in North-west of Iran. Participants were 439 (10–12 years) elementary schools’. Physical activity level by self-reporting, mental health using the parent-completed Child Health Questionnaire, and happiness was assessed using a Persian translated version of the Subjective Happiness Scale. Hierarchical logistic regression analysis was applied in two steps using the enter method to analyze data in the SPSS version 17.Results: Backward logistic regression analysis showed that gender of the parent who answered the study questions, father’s education, educational grade of children, BMI, physical function, physical health, health status of the children and family function were significantly related to the children’s physical activity level.Conclusion: Promoting parents’ awareness and schools’ staff about im¬portance of physical activities especially in recess times must be an impor¬tant part of school and community mental health promotion programs

Completely simple and regular semi hypergroups

In this paper the notion of simple and completely simple semi hypergroups are introduced. Basic properties of these algebraic structures are considered. Some methods for constructing new kinds of these hyperstructures are presented. The regularity of semi hypergroups is considered and three structural results are proved

The Effect of Root Canal Preparation on the Development of Dentin Cracks

Introduction: Root fracture is not an instant phenomenon but a result of gradual development of tiny craze lines in tooth structure. Recent studies have shown that canal instrumentation has the potential to cause dentinal cracks. The purpose of this study was to evaluate and compare the formation of dentinal cracks caused by ProTaper rotary system to hand instrumentation.Materials and Methods: This in vitro study was carried out using 57 mandible incisor teeth. The teeth were decoronated. The roots were then examined to exclude cracked samples. A standard model for PDL simulation was used. The teeth were randomly divided into two experimental and one control group (n=19). The teeth in the experimental groups were prepared using hand or ProTaper Universal rotary instrumentation. The teeth in the control group were left unprepared. The teeth were then sectioned horizontally 3 and 6 mm from the apex, and the number of various dentinal defects was recorded using a dental operating microscope. The differences between groups were analyzed with Fisher’s exact test.Results: The hand group demonstrated significantly more defects than the control group (P=0.001). However, there was no significant difference between the rotary compared to the control and hand groups (P>0.05). There was no significant difference between groups with regards to fracture (P>0.05). Other defects including internal, external and surface cracks were more frequent in the hand than in the control or rotary groups (P=0.02), but the difference was not significant between the rotary and control groups (P>0.05).Conclusion: Canal preparation, whether hand or rotary, produces structural defects in dentin. The ProTaper rotary system when used according to the manufacturer’s instructions, tends to produce fewer cracks and can be considered a safe preparation technique

Recognition of the factors affecting survival in colon and rectal cancer patients referred to RCGLD center of Shahid Beheshti University of Medical Sciences: accelerated failure time parametric survival analysis with frailty

زمینه و هدف: عوامل تشخیصی سرطان کولورکتال بر بقای بیماران و تجویز درمان مناسب موثر است. با توجه به افزایش نرخ‌ این سرطان در ایران مخصوصاً در سنین جوانی و اینکه عوامل تشخیصی سرطان کولورکتال به عنوان یک سرطان واحد درک دقیقی از دو سرطان کولون و رکتوم و عوامل موثر بر آن فراهم نمی‌کند، بنابراین مطالعه حاضر به منظور تعیین عوامل خطر اختصاصی سرطان‌های کولون و رکتوم انجام گردید. روش بررسی: در این مطالعه توصیفی-تحلیلی تعداد 1219 بیمار مبتلا به سرطان‌های کولون و رکتوم طی دی ‌ماه 1383 تا مهرماه 1387 مورد بررسی قرار گرفتند. متغیر‌های دموگرافیک و بالینی در قالب تحلیل‌های یک متغیره و چند متغیره با رویکرد الگوی زمان شکست شتابنده تحلیل بقا و با انجام تصحیح توسط پارامتر شکنندگی توسط نرم‌افزار STATA 10 تجزیه و تحلیل شدند. یافته‌ها: بر اساس نتایج حاصل از این مطالعه برای سرطان کولون در زنان، بیماران بدون سابقه‌ی بیماری التهاب روده، بیماران با درجه‌ی تومور ضعیف متمایز شده و بیماران با مرحله‌ی پاتولوژیک I تومور احتمال بقای بالاتری به دست آمد و برای دو عامل سابقه‌ی مصرف الکل و اندازه‌ی تومور رابطه آماری معنی‌داری مشاهده نشد. همچنین برای سرطان رکتوم، بیماران با نوع اولین درمان عمل جراحی احتمال بقای بالاتری داشتند و برای دو عامل سابقه‌ی شخصی ابتلا به سرطان و مرحله‌ی پاتولوژیک تومور رابطه آماری معنی‌داری مشاهده نشد. همچنین برای هر دو نوع سرطان، رده‌‌های با شاخص توده بدنی 9/29–25 و بیشتر از 30 شاخص توده‌ی بدنی به ترتیب احتمال بقای بالاتر و رده‌ی کمتر از 5/18 احتمال بقای پایین‌تری را نشان دادند. در مجموع احتمال بقای بیماران مبتلا به سرطان رکتوم در مقایسه با بیماران مبتلا به سرطان کولون بالاتر بود. نتیجه‌گیری: ارزیابی جداگانه ی کولون و رکتوم، به درک بیشتری از عوامل موثر بر این سرطان‌ها می‌انجامد و می‌تواند در طراحی کارآزمایی‌های بالینی، تشخیص بهتر بیماری و یا تجویز درمان بهینه و اختصاصی کمک نماید

Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population

Background: Childbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. Methods: The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. Results: The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. Conclusion: The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes

Iranian women’s perception on the determinants of birth experience : A qualitative study

Background The prevalence of cesarean birth in Iran is very high. Having a negative childbirth experience is one of the reasons that primiparous women provide to prefer caesarean birth over a vaginal birth. This study is aimed to understand women’s perspective on what determines a positive or negative birth experience for them. Methods This qualitative study is a part a mixed method study that was conducted among primiparous women with a previous vaginal birth experience. The purpose of the main study was to develop a guideline based on Iranian primiparous women’s birth experiences. The quantitative phase of the study was a cross-sectional study where women’s childbirth experiences was measured in a survey via the Childbirth Experience Questionnaire-2. In the qualitative part of the study, women were invited for an in-depth interview via a random stratified sampling method based on their childbirth mean score (women with 10% of the upper bound score which indicated a positive birth experience and 10% of the lower bound indicating negative birth experience, n = 17). Conventional content analysis was used for data analysis. Results We extracted three main themes: (a) “Internal control”, (b) “External control”, and (c) “Support”. Possessing internal control, having a balanced external control to feel cared and feeling supported were the main reasons for women to feel positive about their birth experiences. Whereas, loss of internal control, imbalanced external control and unsupportive environment were related to their negative childbirth experiences. Conclusion Considering that women’s sense of control, the care and support that they receive can influence their childbirth experiences, there is a need for changing maternity policies and practices to highlight the importance of a woman-centred care to create a pleasant, respectful and positive memory for primirparous women who experience normal vaginal births

Risk Factors and Prevention of Pulmonary Embolism in Young Adults

Objective: Pulmonary thromboembolism (PTE) importance is due to some reasons, first, it is one of the most common cardiovascular diseases, second it has high mortality and morbidity especially in some situations and third, prevention of this event is applicable and effective in most cases. The aim of this study was evaluation of predisposing factors of pulmonary emboli in young patients and defining preventive strategies in this age group. Materials and Methods: In this retrospective study, recorded data including age, sex, presentation month, chief complaint, vital signs at admission, positive findings of physical examination, venous thromboembolism (VTE) risk factors, laboratory and imaging findings of patients with pulmonary embolism diagnosis who had 45 years old or less from March 2008 to March 2014 in Shahid Madani Heart hospital, Tabriz, Iran were evaluated. Statistical analysis was done via SPSS version 21. Results: Eight hundred seventy patients had pulmonary emboli diagnosis during study period, 101 of them were ≤ 45 years old. Fifty-three patients were men and 48 of them were women. Mean age of patients was 33.6 years. Abnormal lower limb was the most frequent positive finding at physical examination. The important risk factor in women was hormonal change due to pregnancy or oral contraceptive pill use which was present in 50% of females. Smoking and immobilization due to surgery or trauma were the most common risk factor in men. Women had higher pulse rate (113.53± 21.84 vs 101.33 ± 20.27, P = 0.005) and lower hemoglobin (11.76 ± 2.00 vs 13.52 ± 2.21, P = 0.000) than men. The overall mortality rate was 10.8%. Conclusion: Although all the risk factors of pulmonary emboli were not evaluated in our patients but the determined ones seem to be modifiable in majority of cases

The effect of protocol for disinfection of extracted teeth recommended by center for disease control (CDC) on microhardness of enamel and dentin

Background: According to the guideline of the United States center for disease control (CDC), the extracted teeth should be sterilized by autoclaving or storage in 10% formalin before using for educational or research purposes. The objective of this study was to evaluate the effect of this protocol on microhardness of dentin and enamel. Material and Methods: Thirty extracted single-root teeth were used in this study. The crowns were resected, and the roots were longitudinally sectioned into two halves. The Vickers microhardness (VHN) of specimens was measured on polished canal dentin and buccal enamel surfaces. The crowns were randomly divided into three groups (n=10). Group 1 and 2 were sterilized using autoclave and formalin, respectively while group 3 (control) was stored in synthetic tissue fluid. The root halves were also randomly divided into 3 groups (n=20) which were treated as mentioned above for crown samples. Following sterilization, VHN of samples was measured again. ANOVA and paired samples t-tests were used to analyze the data. Results: Autoclaving caused a significant reduction in microhardness of dentin ( P <0.001, 12.04% decreases in VHN). However, there were no significant differences for before and after sterilization within other groups. Conclusions: Based on the results of this study, the CDC protocol is recommended in studies related to enamel microhardness. However, Autoclaving is not an appropriate sterilization method in studies related to dentin microhardness. In these studies, two-week immersion in 10% formalin is recommended

Differentiating between girls and boys in transition through smoking stages: A sex-specific growth mixture modeling

Background: Smoking is a complex process, and adolescents pass through a number of different stages on the way to become smokers and it is sex-dependent. Methods: In this cohort study, the illustrative samples of 10th-grade students (2241 girls and 2956 boys) were assessed using a multistage sampling in Tabriz, Iran. The main variables of the study were smoking status, intention to start smoking, and smoking during the past week/ month, which were collected using a valid and reliable instrument. Sex-specific GMMs were fitted to assess the transition through smoking stages. Results: GMMs lead in a 2-class optimal model: "Occasional/Intending smokers" and "Non-smokers". GMMs indicated that girls had lower levels of smoking status, intention to start smoking, smoking during the past week/month in both classes (significant and negative intercepts: -8.5 to -0.6). In addition, transitions toward higher levels of smoking status, intention to start smoking, smoking during the past week/month were observed in both classes for boys, but in the second class for girls (significant and positive slopes: 0.2 to 2.7). Conclusion: This study highlighted the importance of stopping the initiation and avoiding transition through smoking stages with special sex-specific planning in the future