The Effect of Teaching Practical Physical Modalities on the Ordering Skills of Physical Medicine and Rehabilitation Residents

Introduction: Physical modalities are performed by physiotherapists based on physiatrists’ orders, so the residents pay less attention to the need and importance of learning the practical modalities. The aim of this study was to determine the effect of teaching the practical aspects of modalities to residents of Physical Medicine and Rehabilitation in order to improve their skills and attitudes toward ordering and doing physical modalities. Methods: In an interventional, before after study, all residents of physical medicine and rehabilitation, took the medical history of the patients willingly participatedand performed physical examinationand ordered physical modalities. They were also assessed by performing the modalities on the patient. Following the primary assessment, an experienced physiotherapist taught the residents how to do physical modalities. After the practical education, residents were assessed by ordering the modalities and performing them on simulated patients. Their satisfaction of the educational program was evaluated after the intervention. Results: The mean scores of using modalities before and after the education were 23.08± 5.50 and 52±10.18 respectively (p=0.0001). The mean scores of ordering the modalities before and after the education were 1 and 1.66 (p=0.038). The mean score of satisfaction was 91.66±8.74 out of 100. Conclusion: Since physical medicine and rehabilitation residents and specialists who order physical modalities for patients do not perform it on their own patients, teaching the practical physical modalities can improve their skills. The satisfaction rate of residents with the course was very high

Consumption of fruit and vegetables among elderly people: a cross sectional study from Iran

<p>Abstract</p> <p>Background</p> <p>There is substantial evidence that low consumption of fruit and vegetables (FV) is a major risk factor for many chronic diseases. The aim of this study was to assess FV consumption and the variables that influence it among elderly individuals in Iran aged 60 and over.</p> <p>Methods</p> <p>This was a cross-sectional study to investigate FV intake by a randomly-selected sample of members of elderly centers in Tehran, Iran. A multidimensional questionnaire was used to collect data on demographic characteristics, daily consumption of FV, knowledge, self-efficacy, social support, perceived benefits, and barriers against FV. Data were analyzed using t-tests, one way analysis of variance, Pearson correlation, and logistic regression.</p> <p>Results</p> <p>In total, 400 elderly individuals took part in the study. The mean age of the participants was 64.07 (SD = 4.49) years, and most were female (74.5%). The mean number of FV servings per day was 1.76 (SD = 1.15). Ninety-seven percent of participants (n = 388) did not know the recommended intake was at least five servings of FV per day. Similarly, 88.3% (n = 353) did not know the size of a single serving. The most frequent perceived benefits of and barriers against FV consumption were availability and expense, respectively. Knowledge (OR = 0.59, 95% CI = 0.39-0.88), perceived benefits (OR = 0.92, 95% CI = 0.88-0.96) and barriers (OR = 1.08, 95% CI = 1.04-1.14), self-efficacy (OR = 0.89, 95% CI = 0.83-0.95) and family support (OR = 0.91, 95% CI = 0.83-0.99) were significantly associated with fruit and vegetable consumption.</p> <p>Conclusion</p> <p>The findings of this study indicate that FV intake among elderly individuals in Iran was lower than the recommended minimum of five daily servings and varied greatly with age, marital status, educational attainment, and income level. The results also indicated that low perceived benefits, low self-efficacy, and perceived barriers could lead to lower consumption of FV. It seems that in order to improve FV consumption among elderly individuals in Iran, raising awareness, improving perception of benefits and enhancing self-efficacy regarding FV consumption should receive more attention. Indeed, it is essential to plan health education programs and nutritional interventions for this group of the population.</p

Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study

Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care. Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy

Impact of RAS/RAF mutations on clinical and prognostic outcomes in metastatic colorectal cancer

Introduction: Early-activated RAS/RAF mutation status is a key molecular finding in colorectal cancer (CRC), while these mutations have been proposed as predictive and prognostic biomarkers. The present study has been designed as a longitudinal study to evaluate and summarize the different genotypes of metastatic CRC (mCRC), and assessing any association with the disease prognosis and clinicopathological characteristics. This study was performed in two main referral hospitals of Tabriz University of Medical Sciences, over three years (2016-2018). Methods: Mutations were detected by Idylla tests of KRAS/NRAS/BRAF among a total of 173 mCRCs, using surgically-resected specimens or biopsied samples. To evaluate the factors associated with overall survival (OS) and prognosis, the Cox proportional hazards model was used in two steps to estimate the outcome measures (hazard ratio, or HR) with a 95% confidence interval (CI). Results: The nominal 1 to 5-year OS rates were 78%, 65%, 55%, 46%, and 42%, respectively. KRAS mutations in codon 12 was an independent significant prognostic factor, as the patients with codon 12 mutations had a significantly lower OS (P Log-rank=0.049) and a higher hazard of mortality (HR=2.30; 95% CI: 0.95-5.58; P=0.066). Also, the mCRC patients with liver metastasis (HR=2.49; 95% CI: 1.49-12.52; P=0.002) and tumors of the distal colon (HR=3.36; 95% CI: 1.07-10.49; P=0.037) had a significantly worse prognosis. Conclusion: KRAS mutation in codon 12 was an independent significant poor prognostic factor, and patients with liver metastasis had a significantly worse prognosis. Routinely performing specific oncogenic tests may help improve the patients’ prognosis and life expectancy

Effects of Sesame Seed Supplementation on Lipid Profile and Oxidative Stress Biomarkers in Patients with Knee Osteoarthritis

Background: This study was designed to assess the effect of sesame seed on lipid profile and oxidative stress biomarkers in knee osteoarthritis (OA) patients. Methods: Fifty patients with knee OA were allocated into two groups receiving 40 g of sesame seed daily along with standard medical therapy (n=25) or standard treatment (n=25) for two months. Serum total antioxidant capacity, malondialdehyde (MDA) and lipid profile (total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, triglycerides) were measured. Results: After the intervention period two months of study, serum TC, LDL-cholesterol and MDA decreased significantly in the sesame group (P0.05). There was no significant difference in pre and post-treatment values of lipid profile and oxidative parameters between the two groups (P>0.05). Conclusion: Current study showed a positive effect of sesame seed in improving lipid profile and oxidative stress in patients with knee OA and indicated the fact that sesame seed might be of help to reduce oxidative stress in OA patients

Factors associated with pharmacological and psychotherapy treatments adherence in patients with borderline personality disorder

BackgroundBorderline personality disorder is a major mental illness characterized by sustained relationship instability, impulsive behavior, and intense affects. Adherence is a complex behavior, from minor refusals to abandonment of treatment, which can be affected by various factors. Therefore, the present study aimed to investigate the factors affecting pharmacological and psychotherapy adherence, patients' attitude toward medication, and assessing medication and treatment adherence in patients with borderline personality disorder referred to an outpatient referral clinic in Tehran, Iran.MethodsThe study was a cross-sectional study. The files of patients with borderline personality disorder referred to the outpatient clinic of the Tehran Psychiatric Institute were reviewed as the first step. Data were collected using the Drug Attitude Inventory-10 (DAI-10) questionnaire and a questionnaire to determine the attitude of patients toward pharmacological and psychotherapy treatment as well as therapeutic adherence. After collecting data, patients' therapeutic adherence was divided into poor, partial, and good compliance.ResultsNinety-four patients were involved in the study, and fifty-four were women. Findings of DAI showed that 54 (57.4%) participants had negative attitudes toward medication, while 38 (40.4%) participants showed a negative attitude toward psychotherapy treatment. Additionally, the percentage of patients with good psychotherapy adherence (44.7%) was higher than that of patients with good medication adherence (31.9%). The most common reasons for discontinuation of treatment were medication side effects (53.1%), dissatisfaction with the therapist (40.3%), and then fear of medication dependence (40%). Patients with higher education levels and a positive history of hospitalization in a psychiatric ward had better adherence to psychotherapy (P &lt; 0.05).ConclusionResults of the current study show that attitude toward psychotherapy is more favorable than pharmacotherapy among patients with BPD. The rationale may be that medications are mainly prescribed for comorbid conditions and do not have substantial effects on the BPD symptoms, resulting in low medication adherence

Assessment of Factors Affecting Quality of Life of Elderly Clients Coveraged Bye Health Centers of Southern of Tehran

Objectives: The world population is aging rapidly because of rising life expectancy and deacrising fertility rate.with increasing longevity and special aging problems attention and evaluation the quality of life of elderly for health promotion would be significant importance Methods & Materials: this study is a descriptive and analytical study carried out to investigate the quality of life of elderly clients coveraged bye health centers of southern of tehran, in 2010-2011.132 elderly clients were selected by using the cluster randomised sampling from 5health centers. in this study a short form standard questionnaire (sf36)was used for evaluation diverse domains of life quality scores. we also measured some other personal characteristics through demographic questionnaire. data were analyzed with descriptive and analytic statistics by spss software. Results: the mean score of physical domains of quality of life which was 54.42&plusmn;24.42 and emotional domain of quality of life was 55.19&plusmn;24.04. mean age was 67.97&plusmn;6.86. research showed age had meaninful reverse relationship to quality of life (P=0.000, r=-0.4), men had higher quality of life scores than women.education level was directly related to all domains of life quality (P=0/000). married persons and who they lived with childerns or others had the higher quality of life scores than singles (divorced, widow) (P<0.001). and physical activity was directly related to quality of life (P=0.000). but statistically significant differences were not found between the mean score of quality of life and BMI. (physical domain: P=0.59-emotional domain: P=0.127). notsmokers had higher quality of life scores than smokers. (P<0.05). Conclusion: total score of quality of life of elderly was moderate (54.81). therrefore attention and try to improving the quality of life of elderly clients is essential

The Effectiveness of Acceptance and Commitment Therapy on Achievement Motivation and Quality of Life among Female High School Students in Sari

Background and Objective: Acceptance and commitment therapy is among the ways to increase student's achievement motivation and quality of life. Therefore, the aim of the present study is to determine the effectiveness of acceptance and commitment therapy on the achievement motivation and quality of life among female high school students in Sari in northern Iran. Materials and Methods: The design of this study was semi-experimental with a pre-test, followed by a test with a control group. Participants included female high school students in Sari who were randomly assigned to two experimental and control groups. Data were collected via the Achievement Motivation and Quality of Life Scale at school. The analysis of covariance was used for data analysis by using SPSS-21 software. Results: Responses of 30 female high school in the experimental group and 30 in the control group were analyzed. The mean (SD) age of the experimental group was 16.1 (2.4) and 16.6 (3.1) respectively. Acceptance and commitment therapy increased the achievement motivation among the experimental group from 50.6 (7.6) to 73.6 (6.8), P<0.001. In addition, the quality of life of participants among the experimental group was improved from 62.2 (7.6) to 89.1(7.6), P<0.001. On the other hand, the achievement motivation and quality of life of the control group did not show a significant difference in pre-test and post-test. Conclusion: Acceptance and commitment therapy increased achievement motivation and quality of life at school among high school student

Simultaneous bilateral biceps tendon rupture: A case report with practical sonographic diagnosis

Simultaneous bilateral complete tear of the biceps tendons is a rare clinical entity with challenging treatment approaches. Current diagnostic imaging of rupture of the biceps tendon has reverted to magnetic resonance imaging; however, in the recent years, sonography has been widely used in musculoskeletal practice. The authors present a case of simultaneous bilateral biceps tendon rupture diagnosed on the basis of fundamental sonographic findings of the torn biceps tendons