Posterior Ulno-Humeral Dislocation with Radioulnar Shaft Fracture: Case Report and Literature Review

  Background: The occurrence of radioulnar shaft fracture and elbow dislocation simultaneously is not a usual event, and it has only been reported in a few studies. This study aimed to report a case with posterior ulno-humeral joint dislocation and concomitant radioulnar shaft fracture. Furthermore, in a literature review, we summarized other studies that reported this kind of fracture-dislocation and the treatment chosen in each study.   Case Report: A 12-year-old boy was admitted to the emergency department due to high-energy trauma following a car accident while cycling. Open fracture of the left radioulnar shaft and posterior dislocation of the left elbow were detected.   Conclusion: More studies are required to advance our knowledge about this kind of fracture-dislocation, especially its mechanism of injury. Subsequent examinations can help us design an efficient classification system and determine the best treatment option for radioulnar shaft fracture with elbow dislocation

Program to reduce empowerment barriers hindering mothers to contribute to speech skills of hearing-impaired children with cochlear implant

Background and aims: Given the importance of reducing barriers hindering the empowerment of mothers from contributing to the rehabilitation of hearing-impaired children with cochlear implants, the present study points to the direction of designing, adopting, and assessing a program that would lessen such barriers. Methods: In this randomized controlled trial (RCT), participants were consecutively selected from individuals referring to speech-therapy centers serving hearing-impaired children in the Town of Shiraz (Iran). Intervention and control groups were established using randomized block selection (35 individuals per group). The parent-based intervention was adopted in 6 training sessions, each session lasting 80 minutes. A researcher-made questionnaire was employed to investigate empowerment barriers, while children’s speech skill was assessed using the Newsha scale. Results: Data collected from 35 intervention and 33 control group members were examined. Evaluation of primary and interactional effects of "time" and "group" shows time to have a meaningful effect on "parental discord" and "empowerment barrier" variables (P<0.001). Time-group interaction also proved significant regarding effects on "difficulty working with hearing-impaired child" and "parents’ false beliefs". Compared to the control group, the intervention group shows significant improvement across all variables at studied different time periods. Not to forget the immediate effects of time and group on the "speech skill" variable, which also proved significant (P=0.001). Conclusion: The results denote the effectiveness of the parent-based intervention on mothers’ empowerment and speech improvement in children with impaired hearing

Comparing “Mean Length of Utterance” and “Mean Length of Five Phrasal Utterances” between 2-To-5 Year-Old Normal Farsi-Speaking Children

Background: Since most clinical treatments of Persian children’s language impairments are based on either the therapist, clinicians’ experiences (mostly), or English language norms (sometimes), comparing two minor indices of speech quality, namely “mean Length of Utterance” (MLU) and “mean length of five phrasal utterances” (MLFPU) between different age groups of children, would be unequivocally efficient to help diagnose and treat Farsi-Speaking Children with language impairments. Methods: To compare the two mentioned indices of 2 to 5-year-old normal Farsi-speaking children, the speech samples of 500 children were scrutinized by elicitation, transcription, and statistically analyzing their language samples. Results: The net results prove that as the children’s ages grow from 2 to 5, the two mentioned indices increase and extend as well. Conclusion: The influence of chronological age on the indices varies, regarding the type of language samples. Hence, the analysis of speech quality indices in assessment of children’s language ability has to be performed based on the language sampling methods

Evaluation of wrist arthroscopy outcomes in patients with chronic wrist pain

Background: Wrist arthroscopy is an evolving diagnostic and therapeutic modality which is progressively used by Iranian surgeons. Little data is published about the procedure’s indications, outcomes, complications and prognostic factors. In following study we evaluate the outcome and complications of diagnostic and therapeutic arthroscopy in our patients. Methods: In a prospective study from September 2009 to March 2013, 100 patients entered in the study. All the patients had chronic wrist pain without any sign of improvement despite at list three months non-operative treatment and underwent diagnostic and therapeutic wrist arthroscopy. All patients were evaluated by wrist range of motion, visual analogue scale (VAS), the quick-disabilities of the arm, shoulder and hand (Q-DASH), and Mayo wrist functional score before and after arthroscopy. Patients were visited at 3, 6, 12 weeks intervals after surgery and every six months thereafter. The most frequent diagnoses were triangular fibrocartilage complex (TFCC) injury, dorsal wrist ganglion cyst and Kienbock disease which were treated with accordant arthroscopic methods. Major and minor complications of arthroscopy and prognostic factors were evaluated. Results: Eighty nine patients participated in long term follow-up. The follow-up duration was 19±13 months. At final fallow-up there were 28.6±9.6 degrees improvement in wrist range of motion, 5.1±3.4 reduction in VAS score (P<0.04), 37.9±30 improvement in Mayo functional wrist score (P<0.02) and 47.5±33 reduction in Q-DASH score (P=0.009). 82% of patients were satisfied with postoperative results and 16% experienced recurrence. The preoperative diagnosis was not a prognostic factor for outcome of arthroscopic treatment. The rate of postoperative complications was 31.4%, which most of them were minor and transient complications. The most frequent complication of wrist arthroscopy in our patients was transient hypoesthesia in superficial ulnar nerve territory. Conclusion: According to our results, wrist arthroscopy have acceptable outcome in TFCC injuries and Kienbock disease. With the ever-expanding list of indications and procedures that can be performed with wrist arthroscopy, it can be considered as an essential diagnostic and therapeutic tool for the orthopedic surgeon

Phenomenological needs assessment of parents of children with cochlear implants

Background: The use of cochlear implants has been a remarkable success in reducing disabilities in those with impaired hearing, which have made a significant change in the patients’ quality of life. Only by relying on cochlear implants, disabilities cannot be eliminated in the hearing impaired, and, alongside this intervention, rehabilitation practices such as through family and community support are necessary. Aim: To explain the needs of parents of children with cochlear implants to increase the quality of rehabilitation services and family-based interventions. Methods: A descriptive phenomenology study was performed with the participation of 16 people, including eight mothers, three fathers, and five experts involved with the rehabilitation of children aged 2-7 years with cochlear implants. The research setting was centers with speech therapy service providers for hearing-impaired children in the city of Shiraz (Iran) in 2015. Information was gathered through in-depth interviews with participants and analyzed by using Colaizzi’s nine-step analysis method and MAXQDA (Ver10) applications. Results: The mean age of participants was 34 years, and the average age of diagnosis of hearing problems in children was 12 months. The obtained data from the analysis of interviews about the needs of parents of children with cochlear implants were categorized into 19 sub-contents and five contents, as follows: the need for access to health care services; psychological needs; mood-related needs of a child; educational needs and financial requirements. Conclusion: Parents of children with cochlear implants have numerous needs, and they encounter problems based on their situation and experiences. The results indicate the necessity of close cooperation among different professionals such as an audiologist, pediatrician, psychologist, and speech therapist for the program’s success

Subarachnoid Space Transplantation of Schwann and/or Olfactory Ensheathing Cells Following Severe Spinal Cord Injury Fails to Improve Locomotor Recovery in Rats

Treatment of spinal cord injury by exogenous cells has brought both successful and unsuccessful results. Olfactory ensheathing cells and Schwann cells have been widely used for transplantation purposes. In this study, we investigated the effects of these cells on contused spinal cord by introducing cells into subarachnoid space. Fifty thousand Schwann cells or olfactory ensheathing cells or a mixture of both cell types were transplanted one week after a 3-second clip compression injury at T-9 spinal cord level in rats. Starting from the day one of spinal cord injury, animals were assessed for six months by BBB test and then were sacrificed for immunohistochemistry labeling of the spinal cord injury site. There was no locomotor recovery in any of the treatment groups including controls. Immunohistochemistry assessment indicated positive labeling of P75 and S100 markers in the cell-transplanted groups compared with control. Our data suggest that transplantation of Schwann cells and/or olfactory ensheathing cells into the subarachnoid space does not improve motor recovery in severely injured spinal cord, at least with the number of cells transplanted here. This, however, should not be regarded as an essentially negative outcome, and further studies which consider higher densities of cells are required

Corrigendum to: “Subarachnoid Space Transplantation of Schwann and/or Olfactory Ensheathing Cells Following Severe Spinal Cord Injury Fails to Improve Locomotor Recovery in Rats” [Acta Med Iran 2016;54(9):562-569]

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Additional file 2 of Cell therapy efficacy and safety in treating tendon disorders: a systemic review of clinical studies

Additional file 2: Table S1. PubMed keywords and Mesh terms. Table S2. Databases search results. Table S3. PubMed databases search details. Table S4. PICOT table. Table S5. Inclusion and Exclusion criteria. Table S6. Excluded case reports. Table S7. Studies’ outcomes and results