Guillain-Barré Syndrome in North Eastern Iran; 1999-2005

ObjectiveTo study the clinical presentation, hospital course and outcomes of patients admitted with Guillain-Barre Syndrome (GBS) to three tertiary care hospitals in Mashhad, Iran.Materials and MethodsThe records of all patients admitted with flaccid paralysis between April 1999 and January 2005 were reviewed and those with the diagnosis of GBS were included in the study. Standard questionnaires were used to record clinical data on was recorded on a standardized questionnaire, which included patients' age, sex, antecedent infectious history, neurological signs and symptoms and ventilation requirements. The hospital course, including therapy given and the functional status of patients, was analyzed, including therapy given and the functional status of patients.ResultsNinety-one cases of acute flaccid paralysis were admitted to the hospitals during the study period. Eighty-three cases, age range 10 months to 11 years, were later diagnosed as GBS afterwards, with an age range of 10 months to 11 years. The mean age for disease onset was 4.2 years; there were 47 boys and 34 girls, male to female ratio 1:0.7. Upper respiratory tract infection (62.6%) was the most common antecedent event, followed by gastrointestinal infections (19%), urinary tract infection (1.2%) and chicken pox (2.4%), while the remaining cases (14.8%) had no other cases (14.8%) did not have any reliable history of any preceding antecedent infections. Most patients developed GBS within one month of the preceding infection. Cranial nerve abnormalities (19.3%), autonomic dysfunction (7.2%) and respiratory failure requiring intubation (10.8%) were also common. The in-patient mortality was 2.4% (2 of 83).ConclusionGBS was found to occur slightly more often in male patients, majority of whom had histories of previous infection. Despite persistent disability, in-hospital mortality was low.

Patients’ expectations and satisfaction with their health providers

The growing amount of research into patients’ expectations of medical consultations reflects the view of the patient as an active consumer rather than a passive recipient of care. Patients’ care often diverges from their expectations in important respects. Patients tend to receive more prescription and less information. The fulfillment of certain expectations has been related to satisfaction with the consultation that in turn would improve compliance. Patient satisfaction is also correlated with the patient’s reported intention to change physician. The higher the perceived fulfillment of the expectation is, the higher the satisfaction is. When fulfillment is lower than the expectation, the greater the gap and the lower the satisfaction. Today patient satisfaction is considered a key measure of quality of care and patients reporting higher satisfaction were more likely to have a higher quality of life

Patients’ expectations and satisfaction with their health providers

The growing amount of research into patients’ expectations of medical consultations reflects the view of the patient as an active consumer rather than a passive recipient of care. Patients’ care often diverges from their expectations in important respects. Patients tend to receive more prescription and less information. The fulfillment of certain expectations has been related to satisfaction with the consultation that in turn would improve compliance. Patient satisfaction is also correlated with the patient’s reported intention to change physician. The higher the perceived fulfillment of the expectation is, the higher the satisfaction is. When fulfillment is lower than the expectation, the greater the gap and the lower the satisfaction. Today patient satisfaction is considered a key measure of quality of care and patients reporting higher satisfaction were more likely to have a higher quality of life

Diode calibration for dose determination in total body irradiation

Background: Total Body Irradiation (TBI) is different from standard radiotherapy in many aspects, so it is not easy to predict the delivered dose to the patient under TBI treatment. Diode dosimetry procedures for surface dose reading can help to define variations of the actually delivered dose from the prescribed one. The aim of this study was to describe the measurements made to calibrate diodes in order to implement as a dosimeter for TBI tratment. An algorithm was also proposed based on diode dosimetry in order to determine the midplane dose. Materials and Methods: In this study, four p-type diodes connected to a MULTIDOSE electrometer were implemented as dosimeter. For diode calibration a water phantom with dimension of 30�30�32cm3 along with a 0.6 cc Farmer ion chamber were used. Directional dependence of diodes, the effects of thickness correction factor and complete backscatter factor were studied. Three algorithms, arithmetic, geometric mean and proposed algorithm were used to investigate midplane dose determination in TBI condition. Results: It was found by measurements that the effect of angle incident on diode response was significant and should have been taken into account. Variation in thickness correction factor was found about 0.7. The accuracy in midplane dose determination in the arithmetic, geometric mean and proposed algorithm was about 3.8, 12.5 and 3.3, respectively. Conclusion: Diode dosimetry is very useful as a check of midplane dose delivered to patients under TBI treatment. When the calibration and correction factors are carefully determined, high precision can be obtained. The proposed algorithm by this study seems to be useful in order to midplane dose determination in TBI condition

Comparison of the pharyngeal airway in snoring and non-snoring patients based on the lateral cephalometric study: a case-control study

BACKGROUND: Normal airways are a key factor during the craniofacial growth of the young. Therefore, sleep-disordered breathing (SDB) without treatment can have harmful consequences for development and health. OBJECTIVES: This study aimed to evaluate the cephalometric characteristics in non-snoring individuals and snoring subjects, and investigate differences in the pharyngeal airway space between the 2 groups. MATERIAL AND METHODS: This case-control study included 70 patients aged over 18 years, selected from a radiology center. The patients were divided into 2 groups: case (35 patients with a history of habitual snoring); and control (35 healthy patients). The Berlin sleep questionnaire was administered to the parents of the patients. The nasopharyngeal airway was measured according to the analysis of Linder-Aronson (1970), and 4 indices were measured and analyzed in each of the lateral cephalometric radiographs. RESULTS: No statistically significant differences were observed in the pharyngeal measurements between the 2 groups, although all means in the control group were higher than in the experimental group. However, there was a significant relationship between gender and the Ba-S-PNS and PNS-AD2 indices. CONCLUSIONS: Although the patients with nocturnal snoring had smaller airway dimensions, their pharyngeal measurements were not significantly different from the control group

Forensic gender determination by using mandibular morphometric indices an Iranian population: a panoramic radiographic cross-sectional study

Gender determination is the first step in forensic identification, followed by age and height determination, which are both affected by gender. This study assessed the accuracy of gender estimation using mandibular morphometric indices on panoramic radiographs of an Iranian population. This retrospective study evaluated 290 panoramic radiographs (145 males and 145 females). The maximum and minimum ramus width, coronoid height, condylar height, antegonial angle, antegonial depth, gonial angle, and the superior border of mental foramen were bilaterally measured as well as bicondylar and bigonial breadths using Scanora Lite. Correlation of parameters with gender was analyzed by univariate, multiple, and best models. All indices except for gonial angle were significantly different between males and females and can be used for gender determination according to univariate model. Condylar height, coronoid height, and superior border of mental foramen and ramus were still significantly greater in males than in females after controlling for the effect of confounders (p < 0.05). Based on the best model, a formula including five indices of bicondylar breadth, condylar height, coronoid height, minimum ramus width, and superior border of mental foramen was used for gender determination. Values higher than 56% indicate male gender, while lower values indicate female gender, with 81.38% specificity for correct detection of females and 88.97% sensitivity for correct detection of males. Despite the satisfactory results, future research should focus on larger populations to verify the accuracy of the present findings

Relationship between posterior permanent dentition pattern and radiographic changes of the mandibular condyle

This study assessed the relationship between posterior permanent dentition and radiographic changes of the mandibular condyle. This descriptive, cross-sectional study was conducted on 300 panoramic radiographs of patients over 40 years of age (188 females and 112 males). Panoramic radiographs were evaluated for condylar changes such as flattening, subcortical sclerosis, subcortical cyst, erosion, osteophytes, and generalized sclerosis. Presence of muscle pain and temporomandibular joint (TMJ) pain and sounds, and history of TMJ trauma were also assessed. The occlusal scheme of posterior teeth was analyzed according to the Eichner’s index. The frequency of condylar changes was calculated in the right and left sides, and their association with posterior permanent dentition was analyzed by the Chi-square test (alpha = 0.05). The frequency of flattening, muscle pain, TMJ sounds, and erosion was 11.7%, 9.7%, 5.7%, and 3.7% in the right side, respectively. The frequency of flattening, muscle pain, erosion, and subcortical cyst was 12%, 9.3%, 5%, and 5% in the left side, respectively. The frequency of bilateral muscle pain, flattening, TMJ sounds, and TMJ pain was 18%, 16.7%, 11.7%, and 9.3%, respectively. Cases with TMJ trauma, generalized sclerosis, and osteophytes were few. According to the Eichner’s index, most patients with condylar changes had classes A and B, and a smaller percentage had class C. No significant difference was noted between healthy individuals and those with condylar changes regarding dentition patterns. No relationship existed between condylar changes and posterior permanent dentition pattern

Salivary nitric oxide levels in adults with different DMFT scores in a selected iranian population: a cross-sectional study

Objectives: Due to the emphasis on the protective and antimicrobial role of Nitric Oxide against gas-trointestinal diseases, investigating its relationship with dental caries is a right topic. Therefore, this research has investigated the amount of saliva Nitric Oxide in different volumes of DMFT indicator in adults. Material and Methods: In this descriptive-analytical cross-sectional study, 80 participants (20-35 years old), without a history of systemic disease and drug use participated as research sam-ples, (53.8% of the participants in the study were women). Participants were selected from patients who had visited dental Department. The participants were divided in four groups based on DMFT (DMFT=0, 1≤DMFT≤3, 3<10, DMFT≥10). Non-stimulating saliva was collected from all participants between 9-11 am in a calibrated tube. Saliva Nitric Oxide was measured using a Nitrous Oxide test, based on the Griess reaction. We used a correlation test to analyze quantitative variables, and t-test or ANOVA for qualitative and quantitative variables. Results: A significant relationship between DMFT and age was identified. At different levels of DMFT, significant relationship between DMFT and sex was not found. In different groups of DMFT, no significant relationship between Nitric Oxide and DMFT exist. Conclusion: The level of Nitric Oxide saliva was not affected by the amount of DMFT