Determination of birth indices in healthy neonates

Determination of birth indices is essential for primary supportive care, evaluation of perinatal anomalies, determination amount of difference from standard values and for further follow up. In this study using a multicentre sampling, a number of 2832 healthy neonates selected. Mean and percentile values of four main birth indices; weight, height, head and chest circumference are presented. In this study, males outnumbered the females (50.8 vs. 49.2). Mean (± SD) weight, height, head and chest circumferences were 3231.70 gr (±3.92), 49.77 cm (±1.76), 35.03 cm (± 1.27) and 33.34 cm (±1.56), respectively. Weight, height and head circumference had significant statistical differences in male and female. Chest circumference had difference in gender groups, but it seemed to be clinically not significant (mean difference= 0.416). Birth weight in both genders plus height and chest circumference in girls were significantly lower than NCHS standard values. But, head circumference was more. Height and chest circumference of males had no statistically difference. © 2007 Tehran University of Medical Sciences. All rights reserved

Questionnaires measuring patients' spiritual needs: A narrative literature review

Context: The objective of the present review was to collect published spiritual needs questionnaires and to present a clear image of the research condition of this domain. Evidence Acquisition: First, an electronic search was conducted with no limits on time span (until June 2015) or language in the following databases: PubMed, Scopus, Ovid, ProQuest and Google Scholar. All derivations of the keywords religion and spiritual alongside need and its synonyms were included in the search. Researches that introduced new tools was then selected and included in the study. Due to the limited quantity of questionnaires in this domain and with no consideration given to the existence or lack of exact standardization information, all of the questionnaires were included in the final report. Results: Eight questionnaires were found: patients spiritual needs assessment scale (PSNAS), spiritual needs inventory (SNI), spiritual interests related to illness tool (SpIRIT), spiritual needs questionnaire (SpNQ), spiritual needs assessment for patients (SNAP), spiritual needs scale (SNS), spiritual care needs inventory (SCNI), and spiritual needs questionnaire for palliative care. Conclusions: These questionnaires have been designed from a limited medical perspective and often involve cultural concepts which complicate their cross-cultural applicability. © 2016, Mazandaran University of Medical Sciences

The diagnostic value of 99mTc-IgG scintigraphy in the diabetic foot and comparison with 99mTc-MDP scintigraphy

Diabetic foot infection is the most common etiology of nontraumatic amputation of the lower extremities, and early diagnosis is of great importance in its management. The aim of this prospective study was to evaluate the strength of 99mTc-IgG scintigraphy in diagnosis of osteomyelitis of the diabetic foot and to compare 99mTc-IgG scintigraphy with 99mTc-methylene diphosphonate (MDP) scintigraphy. Methods: A prospective university hospital-based study was performed over 24 mo. Eighteen patients with type II diabetes and foot ulcers (15 men and 3 women; age range, 45-80 y) were referred for imaging because of clinically suspected osteomyelitis. Early (5-h) and late (24-h) 99mTc-IgG scanning and 3-phase skeletal scintigraphy were completed for all patients at a 3- to 4-d interval. Regions of interest over the involved bony sites and the contralateral normal sites were drawn, and the abnormal-to-normal ratios were acquired for both 99mTc-IgG and 99mTc-MDP studies. Results: From a total of 23 lesions, we observed 10 sites of osteomyelitis, 10 sites of cellulitis, and 3 sites of aseptic inflammation confirmed by MRI, clinical presentation, histopathologic examination, and follow-up evaluation as a gold standard. Both 99mTc-IgG and 99mTc-MDP scanning showed excellent sensitivity for diagnosis of osteomyelitis, but the specificity was significantly lower (69.2% and 53.8%, respectively). Sensitivity, specificity, and accuracy in the diagnosis of osteomyelitis were, respectively, 100%, 53.8%, 73.9% for 99mTc-MDP scanning; 100%, 69.2%, 82.6% for 5-h 99mTc-IgG scanning; and 60%, 76.9%, 69.5% for 24-h 99mTc-IgG scanning. There was no significant difference between the semiquantitative indices of 5-h and 24-h 99mTc-IgG scanning for inflammation, cellulitis, and osteomyelitis. Conclusion: Although both 99mTc-IgG and 99mTc-MDP scintigraphy have high sensitivity for the diagnosis of osteomyelitis, the specificity of these studies is poor. For 99mTc-IgG scintigraphy, 5-h images appear to be adequate, and there is little benefit to performing additional imaging at 24 h. © 2011 by the Society of Nuclear Medicine, Inc

Anxiety disorders in multiple sclerosis: Significance of obsessive-compulsive disorder comorbidity

Background: Considering reports on the associations of symptoms of anxiety disorders with multiple sclerosis (MS), this study aimed to 1) further evaluate various anxiety disorders systematically presenting in patients with MS and 2) compare the results with a control group. Methods: To assess anxiety disorders in patients with MS in a case-control study, 85 registered patients in the Iranian Multiple Sclerosis Society (IMSS) were randomly selected according to the inclusion criteria. A group of healthy individuals whose age and gender were matched with the case group were also selected. Both groups underwent a clinical interview based on DSM-IV diagnostic criteria. Results: Frequency of diagnosis of all anxiety disorders in the two groups was 22.4 and 7.1, respectively, indicating a statistically significant difference. Frequency of obsessive-compulsive disorder (OCD) was significantly higher in the case group (P<0.05). Relation of university education with the diagnosis of generalized anxiety disorder was significant too (P<0.05). Conclusions: OCD in patients with MS was more frequently observed than in the control group

Participating in university entrance exam despite repeated failure: a qualitative study of participants' experiences

Objectives: To explore the experiences of general practitioners who continue to sit a highly-competitive residency entrance examination, despite repeated failure. Methods: This qualitative, exploratory study employed semi-structured, in-depth interviews with 35 candidates of a residency entrance exam who had failed the examination at least twice and were preparing to sit it again. Interview questions addressed the challenges they faced and how they managed these challenges. Interview data were audiotaped, transcribed, and analysed to identify themes. Results: The results demonstrated that more than 50 (n=19) of candidates struggled continuously and internally with different aspects of the exam. These include being under a great deal of pressure to succeed, failing to prioritize study materials, inefficient review during the final days  of preparation, and sitting the exam with an afflicted body. Furthermore, during the examination, they frequently used inefficient strategies to answer questions. Afterwards, they experienced feelings of freedom associated with having finished the exam. Conclusions: Participation in a highly-competitive examination exerts a considerable amount pressure on low-performing candidates. This climate not only results in burn out of participants, but it also influences their learning styles and identities as future physicians. It is therefore necessary to design a syllabus for both test candidates and policy makers, in order better to manage this environment. Candidates also should be aware of their individual weaknesses in order to improve their studying skills

Manipulating resource allocation in plants

The distribution of nutrients and assimilates in different organs and tissues is in a constant state of flux throughout the growth and development of a plant. At key stages during the life cycle profound changes occur, and perhaps one of the most critical of these is during seed filling. By restricting the competition for reserves in Arabidopsis plants, the ability to manipulate seed size, seed weight, or seed content has been explored. Removal of secondary inflorescences and lateral branches resulted in a stimulation of elongation of the primary inflorescence and an increase in the distance between siliques. The pruning treatment also led to the development of longer and larger siliques that contained fewer, bigger seeds. This seems to be a consequence of a reduction in the number of ovules that develop and an increase in the fatty acid content of the seeds that mature. The data show that shoot architecture could have a substantial impact on the partitioning of reserves between vegetative and reproductive tissues and could be an important trait for selection in rapid phenotyping screens to optimize crop performance

The person-centred approach to an ageing society

Modern care is often based on investigations such as laboratory markers and imaging - for example, X-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the point of departure from each person\ub4s subjective experience of illness and its impact on daily life. A patient is considered as a person with emotions and feelings. PCC is considered present within clinical care according to a definition articulated by the Centre for Person Centred Care at the University of Gothenburg (GPCC) when three core components are present: elicitation of a detailed patient narrative; formulated partnership between caregiver and patient and documentation of the partnership in the patient record. Accordingly, when there is an illness requiring care and the person is attended using these components, PCC is being applied. In most situations today, PCC is not applied in terms of the narrative and is not fully elicited or the partnership and/or the documentation are not included. It is proposed that the challenge to Society arising from changing demographics can be addressed by implementing PCC and creating an alternative to existing healthcare. The importance and benefits of such an approach on a wider scale is not yet clear as research has been limited to date. Studies in selected patient populations (heart failure and hip fractures), however, have shown promising results. As the population ages, there will be a dramatic increase in healthcare consumption. Even with technological developments, there will be a need for tremendous resources to be dedicated to care. A new organization and attitude from healthcare policymakers and providers above and beyond the present model appears required in order to respond to this demand. As part of such change, person-centred care, with the interaction between healthcare providers and the person of the patient, can facilitate, compensate and develop more effective healthcare services for the future