Search

Background and Aim: Multiple sclerosis (MS) is a neurological disorder that involves central nervous system. Studies have showed that multiple sclerosis affects behavioral central auditory tests, such as masking release or masking level difference (MLD). The purpose of this study is to compare the masking level difference between multiple sclerosis patients and normal subjects. Methods: This cross sectional and non-interventional study was conducted on 32 multiple sclerosis patients aged between 20-50 years and 32 controls matched for age and gender in Faculty of Rehabilitation, Tehran University of Medical Sciences. masking level difference test was performed on each subject. Results: The mean masking level difference in the two groups was significantly different (p

The purpose of this study is to investigate the effect of PRECEDE-PROCEED Model Combined with the Health Belief Model and the theory of Self-Efficacy to Increase Normal delivery among nulliparous women. Pregnant women in their second trimester with child birth fear scores of 28 or more were randomly selected and assigned into experimental (50) and control group (50). The intervention consisted of nine educational sessions based on the integrated theory. The control group only received routine antennal care. The findings showed that the educational intervention based on the integrated theory was effective in reducing the rate of primary caesarean section.

The autologistic model, first introduced by Besag, is a popular tool for analyzing binary data in spatial lattices. However, no investigation was found to consider modeling of binary data clustered in uncorrelated lattices. Owing to spatial dependency of responses, the exact likelihood estimation of parameters is not possible. For circumventing this difficulty, many studies have been designed to approximate the likelihood and the related partition function of the model. So, the traditional and Bayesian estimation methods based on the likelihood function are often time-consuming and require heavy computations and recursive techniques. Some investigators have introduced and implemented data augmentation and latent variable model to reduce computational complications in parameter estimation. In this work, the spatially correlated binary data distributed in uncorrelated lattices were modeled using autologistic regression, a Bayesian inference was developed with contribution of data augmentation and the propos...

Background and Aim: Main feature of auditory processing abilities is temporal processing including temporal resolution, temporal ordering, temporal integration and temporal masking. Many studies have shown the superiority of musicians in temporal discrimination over non-musicians. In this study we compared temporal processing in musicians and non-musician controls via Gap in Noise (GIN) test.Methods: This cohort study was conducted on 24 musicians with mean age of 25.3 years and 24 normal hearing non-musician controls with mean age of 24.5 years, in Faculty of Rehabilitation of Tehran University of Medical Sciences. GIN test results (approximate threshold and percent of corrected answers) obtained and analyzed by Mann-Whitney non-parametric statistical test.Results: There was significant difference between approximate threshold and percent of corrected answers between musicians and non-musician group (p0.05).Conclusion: the lower approximate threshold and the more corrected answers in GIN test by musician group indicate rapid auditory temporal processing ability of this group rather than non-musicians group. This might be related to effects of musical training on central auditory processing.

Background and Aims: Main feature of auditory processing abilities is temporal processing including temporal resolution, temporal ordering, temporal integration and temporal masking. Many studies have shown the superiority of blinds in temporal discrimination over sighted subjects. In this study, temporal processing was compared in congenital blind subjects with sighted controls via gap in noise test (GIN).Methods: This analytic-prescriptive non-invasive cohort study was conducted on 22 congenital blinds (11 males and 11 females) with a mean age of 26.22 years and 22 sighted control subjects (11 males and 11 females) with a mean age of 24.04 years with normal hearing in faculty of Rehabilitation Tehran University of Medical Sciences. Gap in noise test results, approximate threshold and percent of corrected answers, were obtained and then, were analyzed by Mann-Whitney non-parametric statistical test.Results: There was a significant difference in the approximate threshold and the percent of corrected answers between congenital blinds and sighted control subjects (p0.05).Conclusion: Auditory temporal resolution ability, the lower approximate threshold and the more corrected answers in gap in noise, in blind subjects is better than the sighted control group and it might be related to the compensative neuroplasticity after visual deprivation.

The aim of this study is to evaluate familial thrombophilia factors in infertile patients with polycystic ovarian syndrome (PCOS).This analytic study was performed on 123 infertile women with PCOS as the case group, and 73 infertile women with male factor as the control group, who were under treatment. Blood samples were taken on the third day of the menstrual cycle for evaluation of protein S, protein C, antithrombin III, APC-resistance, homocysteine levels and additional metabolic and endocrine parameters for both groups. Comparisons between groups were performed by the t-test, and Fisher exact test. p0.05 was accepted as statistically significant.Although the mean value of protein S and protein C in the case group was lower than the control group, there was no significance difference (p=0.752 and p=0.602, respectively). The mean of antithrombin III, activated protein C resistance (APC-R) and homocysteine levels in the two groups were not significant (p=0.756, p=0.603 and p=0.157, respectively).We were unable to determine a positive relationship between PCOS and thrombophilia. The existence of a possible trend towards high prevalence of thrombophilia in women with PCOS needs further research.

Aim: To determine whether a nurse telephone follow-up service could improve the level of adherence to a diabetes therapeutic regimen for patients with type 2 diabetes. Methods: A total of 61 patients attended a 3 day diabetes self-care program at the Iranian Diabetes Society. They were randomly assigned to one of the experimental or control groups. A telephone follow-up program was applied to the experimental group for 3 months, twice per week for the first month and weekly for the second and third months. The data-collection instruments included a data sheet to record the glycosylated hemoglobin (HbA1c) level and a questionnaire. The data were collected at baseline and after 12 weeks. Results: There were significant differences between the control and the experimental groups in their adherence to a diabetic diet, exercise, foot care, blood glucose monitoring, and medication-taking. Also, the HbA1c levels differed significantly between the two groups after 3 months. Conclusion: A nurse-led telephone follow-up was effective in enhancing the level of adherence to a diabetes therapeutic regimen, such that the HbA1c level decreased.

Background and Aim: Vestibular evoked myogenic potentials (VEMP) originate from the saccule and the inferior vestibular nerve. In this study, the prevalence of VEMP and latency of the p13 and n23 were compared between three groups of individuals, including symptomatic and asymptomatic Meniere's disease cases and normal participants.Methods: This study was conducted on 42 cases with the mean age of 40.48 years; thirty were Meniere's disease patients, of which 19 were symptomatic and 11 were asymptomatic; twelve were normal participants. The VEMP were recorded with 500 Hz tone bursts at 120 dBpeSPL. Then the prevalence and latency of the waves were analyzed and compared in the three above mentioned groups.Results: The prevalence of VEMP in symptomatic Meniere's disease patients (52.6%) was significantly less than asymptomatic individuals (90.9%) and also normal subjects (100%)(p0.05). The latency of p13 for symptomatic, asymptomatic and normal participants was 16.41, 15.20 and 14.14 ms, respectively and the latency of n23 for these groups was 20.25, 18.77 and 18.50 ms, respectively.Conclusion: In Meniere's disease, after medical management, the succule probably regains normal function resulting in re-existence of VEMP. It seems that there is no change in the latency of the waves, most likely due to involvement of the inner ear and intactness of the nerve. VEMP may be a useful test for diagnosis of Meniere's disease and additionally for monitoring the trend of medical management.

Objectives The main objective of this study was modelling experienced caries of deciduous teeth in 3–5 years old children treated in Children's Department of Tehran University of Medical Sciences, Iran, using the spatial autologistic regression. The other objective was identifying a risk pattern of decayed dents of these children. Materials and methods The study group consisted of 400 children (3–5 years old). Two groups of postgraduate and under graduate dentistry students under consideration and approval of the professors of dentistry from the Tehran University of Medical Sciences diagnosed and categorised the caries statuses of deciduous dents of the children. The caries statuses were considered as spatially correlated binary data. The appropriate model was autologistic regression. Results The fitted autologistic model showed that caries in the three nearest neighbours of a tooth, which includes the two adjacent and the one vertically opponent teeth, had significant effect on its caries. The computed risks based on the fitted model revealed a definite-spatial pattern of caries events. Conclusions Every decayed deciduous tooth in the mouth of a preschool child threatens the three nearest teeth. The risk pattern of caries in each quarter of the teeth lattice of children from incisors to molars has an ascending rate. The dents in maxilla and posterior locations have higher risks of caries than in mandible and anterior locations. These findings are valuable in preventive health care and therapeutic approaches in dentistry of children.

Background: After cardiovascular disease, cancer is the most common cause of death. HESA-A is a natural product of herbal and marine origin. The aim of this study was to investigate the beneficial effects of HESA-A in patients with end-stage metastatic cancers. Methods: In this clinical trial, 30 consecutive patients (18 men, 12 women) with end-stage cancers and liver metastasis at the Cancer Research Center of Tehran University of Medical Sciences were studied. Patients received HESA-A 50 mg/kg/d orally in 2 to 3 divided doses for 3 months. At the start and end of the 1st, 4th, 8th, and 12th weeks of the study, the patients were assessed and hematological and hepatic biochemical indices were measured. Also, the Karnofsky Performance Scale questionnaire was completed for each patient. Results: The mean age of patients was 56.23 ± 12.10 years. Mean Karnofsky Performance Scale scores of the patients increased from 48 ± 14.36 to 78.42 ± 15.37 after 12 weeks of treatment. A total of 90.4% of the patients who remained in the study were alive for 12 weeks. No significant hepatic or hematologic adverse effect was seen during the study. Conclusion: HESA-A appears to be an effective and safe anticancer compound that may increase survival of end-stage patients and can be used in selected cases. Further prospective controlled clinical trials with large sample size and longer follow-up period are warranted to understand the mechanisms of action of HESA-A and evaluate its long-term effects on the survival and quality of life of patients with cancer and as well as its unfavorable side effects.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Preterm delivery is a relevant public health problem since it is an important factor determinant of morbidity and the main reason for neonatal mortality. Many publications have pointed at clinical methods, biological, biochemical and ultrasonographic markers, which applied in combination or on their own, aim at predicting spontaneous preterm delivery. Transvaginal sonography is an effective method for the study of uterine cervix during pregnancy since it permits to assess the cervical morphology and biometry in detail with a high degree of reliability. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of the cervix length and cervical funneling."n"nMethods: A prospective cohort of 200 women carrying high risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation."n"nResults: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence of cervical funneling presented a satistically significant association with spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p

To compare the effects of tibolone with those of conventional hormone replacement therapy on climacteric symptoms and sexual function in postmenopausal women.In a randomized, controlled trial, 140 postmenopausal women were allocated into three groups. Of the subjects included, 47 women received 2.5 mg tibolone + one Cal+D tablet (500 mg calcium and 200 IU vitamin D) daily; 46 women received 0.625 mg conjugated equine estrogen + 2.5 mg medroxyprogesterone (CEE/MPA) + one Cal+D tablet daily; and 47 women received only one Cal+D tablet as the control group. The Greene Climacteric Scale (GCS) questionnaire was used to detect the efficacy of treatment on climacteric symptoms. Rosen's Female Sexual Function Index (FSFI) was used for sexual function evaluation. Sex hormone binding globulin (SHBG), free estradiol index (FEI) and free testosterone index (FTI) were measured before and after treatment. The women were followed up for 6 monthsAfter treatment, all subscores in the GCS improved in the tibolone and CEE/MPA groups (p0.01), except the sexual subscore in the CEE/MPA group, compared with baseline. There were significant differences in the FSFI in the tibolone and CEE/MPA groups in comparison to the control group after treatment. Tibolone, in comparison to CEE/MPA, significantly lowered SHBG levels and increased the FTI and FEI and improved the desire, arousal and orgasm sexual domains of the FSFI (p0.001).Tibolone may be an alternative to conventional hormone replacement therapy in the treatment of climacteric symptoms and sexual dysfunction in postmenopausal women.

Introduction Osteoarthritis is the most prevalent chronic non-infective joint arthritis. Because of its chronic disease nature, local drugs are preferred due to lower complications. In the present study, the new herbal pomade Marhame-Mafasel for knee osteoarthritis was used in a double-blind crossover trial. The aim of the study was to assess the efficacy and safety of Marhame-Mafasel pomade, which consists of several medical herbs including Arnebia euchroma and Matricaria chamomilla, in osteoarthritis of the knee. Material and methods This study was a placebo-controlled double-blind crossover trial. Forty-two patients with pain associated with osteoarthritis of the knee (diagnosed by criteria of the European League against Rheumatism and physical examination) were drawn from patients attending the Clinic of Mostafa-Khomeini Hospital. In this study we assessed efficacy (analgesic effect and improved function) of herbal pomade Marhame-Mafasel, which was used locally in patients with primary osteoarthritis of the knee over three weeks. The instrument of the study was the Western Ontario and McMaster Universities (WOMAC) LK3.1 standard questionnaires. Results The participants in each group were 21 patients; 30 (71.4%) were women and 12 (28.6%) of them were men. The participants were between 40 and 76 years old. Six patients had mild arthritis, 15 had moderate arthritis and 21 had severe arthritis. The positive analgesic effect of the herbal pomade Marhame-Mafasel in primary knee osteoarthritis was proven. The herbal joint pomade Marhame-Mafasel had a significantly greater mean change in score compared to the placebo group for osteoarthritis severity (p < 0.05). Conclusions Herbal pomade Marhame-Mafasel in comparison to placebo has more effect on reduction of pain of primary knee osteoarthritis.

Background and Aim: Tinnitus is an unpleasant sound which can cause some behavioral disorders. According to evidence the origin of tinnitus is not only in peripheral but also in central auditory system. So evaluation of central auditory system function is necessary. In this study Auditory brainstem responses (ABR) were compared in noise induced tinnitus and non-tinnitus control subjects.Materials and Methods: This cross-sectional, descriptive and analytic study is conducted in 60 cases in two groups including of 30 noise induced tinnitus and 30 non-tinnitus control subjects. ABRs were recorded ipsilateraly and contralateraly and their latencies and amplitudes were analyzed.Results: Mean interpeak latencies of III-V (p= 0.022), I-V (p=0.033) in ipsilatral electrode array and mean absolute latencies of IV (p=0.015) and V (p=0.048) in contralatral electrode array were significantly increased in noise induced tinnitus group relative to control group. Conclusion: It can be concluded from that there are some decrease in neural transmission time in brainstem and there are some sign of involvement of medial nuclei in olivery complex in addition to lateral lemniscus.

Background and Aim: Tinnitus is a common symptom among lots of people but little is known about its origins. This study was aimed at comparing the Auditory Steady-State Response (ASSR) thresholds in normal cases and patients with subjective idiopathic tinnitus (SIT) in order to diagnose its real origins.Materials and Methods: This case-control study was conducted on 19 patients with tinnitus and 24 normal cases aged 18-40 yr.The patients underwent broad medical tests to roll out any background reason for their tinnitus. ASSR thresholds were estimated in both groups at 20 and 40 amplitude modulation. The patients were selected from tinnitus patients in Research Center in Hazrat Rasoul Hospital, Tehran, Iran.Results: The mean ASSR thresholds at 40HZ modulation were worse in tinnitus patients compared to normal ones (p

IL-10 is an anti-inflammatory cytokine that is important in the regulation of inflammatory processes in different conditions. Sulfur mustard (SM) intoxicated patients are suffering from different inflammatory diseases in their lung, skin and eyes. Physical activity (PA) is reported to control inflammation by reducing pro-inflammatory and inducing anti-inflammatory cytokines. Our previous study revealed lower PA and more sedentary lifestyle among SM exposed population. This study aimed to determine the relationship of PA with IL-10 production in SM exposed subjects. Baseline, mitogen-induced and the serum levels of IL-10 were evaluated. In a historical cohort study, Sardasht-Iran Cohort Study (SICS), 372 SM exposed participants were studied 20 years after exposure and were compared with 128 unexposed control participants. The Global Physical Activity Questionnaire (GPAQ; developed by WHO) was used to obtain a self-reported measure of physical activity. Whole blood culture supernatants and serum samples were used for IL-10 measurement by ELISA technique. In both the control and exposed groups mitogen-induced IL-10 production was significantly elevated with severity of PA intensity (p

Sulfur mustard (SM) is a blistering chemical agent which has short and long term toxicity against many organs. The respiratory tract is one of the main targets, and is the most disabling long term complication of SM. Inflammatory mediators especially IL-8 and IL-6 play the primary role in the various chronic pulmonary diseases. Sardasht-Iran Cohort Study (SICS) was designed to evaluate immunological and molecular parameters in SM exposed people 20 years after exposure. In the present study, the association of the serum levels of IL-8, IL-6, C reactive protein (CRP) and rheumatoid factor (RF) with long term pulmonary involvement was evaluated. There were 348 exposed and 120 control participants. The clinical evaluations were done for all subjects and Spirometry was performed according to American Thoracic Society Criteria. Severity of pulmonary involvement was assessed by Global Initiative for chronic Obstructive Lung Disease (GOLD) classification. The serum levels of IL-8, IL-6 and RF were assessed by ELISA assay. CRP was assessed by photometric method. The serum levels of IL-8 and IL-6 significantly decreased in the SM exposed participants compared to the control group. There were no significant associations between the serum levels of IL-8 and pulmonary symptoms (chronic cough, sputum, hemoptysis, and dyspnea), pulmonary findings (crackles, rales, and wheezing) as well as spirometry parameters. IL-6 was associated with wheezing and CRP was associated with wheezing and rales in SM exposed group. We concluded the serum levels of these inflammatory mediators probably do not have any major role in pathogenesis and persistence of pulmonary complications and do not reflect the degree of severity of pulmonary involvement following SM exposure.

Mustard gas, even in low doses, has the ability to inflict damage in multiple organs especially the skin, eyes, as well as the respiratory tract. This damage may cause many complications which persist during the lifespan of exposed subjects. Pro-inflammatory cytokines including TNF, IL-1alpha, IL-1beta and IL-1Ra cause systemic inflammatory reactions and numerous changes including altered cell signaling and migration, changes in cytokine production and fever. The aim of this study was to determine the serum levels of these cytokines in subjects who were exposed to mustard gas 20 years ago in comparison with an unexposed control group. In this historical cohort study 368 sulfur mustard (SM) exposed participants from Sardasht and 126 age-matched unexposed volunteers from Rabat (a nearby town) as controls were chosen by a random systematic sampling. The serum concentrations of IL-1alpha, IL-1beta, IL-1Ra and TNF were measured by a sandwich ELISA technique. Median of the serum levels of cytokines TNF, IL-1alpha, IL-1beta and IL-1Ra in the control group was 23.79, 1.89, 1.91 and 32.9 pg/ml respectively, while in the SM-exposed participants these values were 11.11, 0.81, 1.73 and 26.7 pg/ml respectively. The serum pro-inflammatory cytokine levels were significantly lower in the exposed group than in controls (p

Sulfur mustard (SM) is highly toxic for various organs. The eyes, skin, respiratory tract, as well hematopoietic and immune systems are the main organs affected by SM. Granulocyte-macrophage colony stimulating factor (GM-CSF) is a potent cytokine that plays an important role in the hematopoietic and immune system. The aim of this study was to determine the serum levels of GM-CSF and its relation to blood cell count and other inflammatory cytokines 20 years after SM exposure. The association of GM-CSF with the clinical severity of pulmonary, ophthalmic and dermatologic complications has also been studied. In this historical cohort study named as Sardasht-Iran Cohort Study (SICS), 369 SM exposed male participants and 125 unexposed volunteers were studied. The serum concentrations of cytokines were measured by ELISA technique. The severity of clinical complications was graded according to the criteria verified by the Medical Committee of the Foundation of Martyr and Veterans Affairs. The serum levels of GM-CSF in the SM exposed group did not display any significant differences with the control group. Median of GM-CSF was 7.33 and 9.39 pg/ml in the SM exposed group and the controls respectively. There was a positive correlation between the serum levels of GM-CSF and the percent of eosinophils only in the exposed group. Moreover, positive correlations were found between circulating levels of GM-CSF with IL-1α, IL-1β, TNF-α and IL-6. This correlation was not observed between GM-CSF and IL-8 in both study groups. The serum levels of GM-CSF did not show any significant association with clinical complications.

Article history:Received 26 May 2009Received in revised form 27 August 2009Accepted 27 August 2009Keywords:Fas ligandNitric oxideInflammationPulmonaryMustard gasIran Sulfur mustard (SM) has short- and long-term toxicity against various organs including the respiratorysystem. However, the basic and molecular mechanisms of SM long-term toxicity have not clearly beendefined. Thus, the aim of this study was to evaluate the association of soluble Fas ligand (sFasL) as well asnitric oxide (NO) serum levels with long-term pulmonary complications in a SM exposed population20 years after SM exposure. In this historical cohort study 372 male SM exposed subjects and 128 age-matched unexposed controls were studied. Clinical evaluation and pulmonary function tests were carried outfor all participants and serum concentrations of sFasL and NO measured. According to our results, the serumlevels of sFasL and NO were not significantly different between the exposed and control groups. However,the serum levels of sFasL in the exposed group with pulmonary problems were significantly higher than theircorresponding in the control group (116.711±81.166 vs 86.027±30.199 and p=0.028). Furthermore asignificant elevation in sFasL levels was found in the exposed subjects with pulmonary problems comparedto those exposed participants without pulmonary problems (116.711±81.166 vs 90.692±57.853 andp=0.004). Based on Global Initiative for chronic Obstructive Lung Disease (GOLD) classification analysis apositive correlation was observed between sFasL levels and pulmonary problems. There was also asignificant negative correlation between sFasL and the white blood cell (WBC) count in the SM exposedcohort, but not in the control group. No significant association was shown between NO and pulmonaryimpairment in the SM exposed subjects. Thus, our results indicate that elevated serum levels of sFasL may beassociated with progression of pulmonary diseases in the SM exposed subjects.© 2009 Elsevier B.V. All rights reserved.

Ocular damages induced by sulfur mustard (SM) are the important problems in exposed patients. The damaging mechanisms are not clearly understood. In the present study the relationship between the serum levels of inflammatory mediators and ocular injuries induced by SM was evaluated. Bulbar conjunctiva and limbal tissue abnormalities were significantly more frequent in the expose versus control group ( P = 0.004 and 0.048 respectively). The serum levels of IL-1α and TNF-α in the exposed group with and without Slit lamp findings were significantly lower than their counterpart in the control group. The serum levels of IL-1β in the exposed group with Slit lamp findings were significantly lower than their counterpart in the control group. The serum levels of IL-1β in the controls with Slit lamp findings were significantly higher than the controls without Slit lamp findings. The serum levels of IL-1Ra and MMP-9 in the exposed group with and without Slit lamp findings do not display any significant differences as compared to the similar controls. The serum levels of IL-6 in the exposed group with or without Slit lamp findings were significantly lower than their counterpart in the control group ( P = 0.048 and 0.008 respectively). The serum titers of the CRP and RF in the exposed group without Slit lamp findings were significantly elevated versus their counterpart in the control group ( P = 0.004 and 0.011 respectively). The serum levels of these inflammatory cytokines except for IL-1Ra and MMP-9, decreased in SM exposed subject independent of ocular problems. More local studies on the eyes are needed to clarify the exact role of this cytokines in ocular problems of chemical.

The concept of burnout describes a number of destructive aspects in the health-care system, especially in nursing. A descriptive study was carried out in order to investigate the relationship between burnout and productivity among 200 baccalaureate nurses working in educational hospitals in Tehran, Iran. Burnout and productivity questionnaires were employed and the data were analyzed by using descriptive and inferential statistics. The results showed that emotional exhaustion and depersonalization had significant negative correlations with productivity. Also, a significant positive correlation was found between personal accomplishment and productivity. Efforts to alleviate burnout among nurses should lead to an increased quality of patient care and improved quality of work life; if not, health-care systems will pay the price for nurses' burnout through the quality of services that they offer.

Sulfur mustard (SM) has been used as a dangerous chemical warfare agent since the early 20th century. Although many descriptive studies about SM-induced ocular injuries are present in the medical literature, few of them have been conducted over a large group with serious ocular involvement.This descriptive study was conducted on 149 severe SM-intoxicated war veterans. Ocular history, anterior and posterior segment findings using a slit lamp, and direct and indirect ophthalmoscopic findings were recorded. Severity of the disease was also recorded based on a chart of the Foundation of Martyrs and Veterans Affairs.Ocular complains included photophobia (73.2%), sense of decreased vision (72.5%), dry eye sensation (66.4%), foreign body sensation (61.1%), tearing (46.3%), and pain (43.0%). Slit lamp findings were meibomian gland dysfunction (MGD; 96%), blepharitis, punctal closure, trichiasis, tear break-up time, and tear meniscus layer abnormality (80% to 90%). Conjunctival disturbances included vascular abnormality, ischemia, hyperemia, subconjunctival fibrosis, and pterygium. Limbal changes were abnormal vessels, limbal tissue loss and pigment loss, and pannus formation. Corneal problems included epithelial and stromal disturbances, calcium deposition, and melting. The most frequent previous surgeries were punctal closure, lamellar keratoplasty (LK), and stem cell allograft. Severity of intoxication included mild (17%), moderate (25%), and severe (57%).Chronic blepharitis and decreased tear secretion are the 2 most important and influencing factors in progression of ocular problems in SM injuries. The more severe the initial exposure, percentage of disability, and duration of ocular involvement, the higher the likelihood of mustard gas keratopathy.

Sulfur mustard (SM) is a vesicant or blistering chemical agent that possesses mutagenic and carcinogenic properties and alkylates DNA. Little is known about the long-term effects of sulfur mustard on blood cells. The aim of this study is to examine the long-term effects of SM on peripheral blood cells in SM victims of the Iraq-Iran war (1980–1988). This study, which is a part of Sardasht Iran Cohort Study (SICS) was designed in two groups: exposed (372 participants from Sardasht) and control (128 unexposed people from Rabat). The exposed group was divided into hospitalized and not hospitalized subgroups based on the severity of lesions at exposure time. A comparison was made between the study groups’ overall blood exams. The hospitalized group had significantly higher numbers of red blood cells (p = 0.003) than not hospitalized and the control groups. The exposed group had significantly higher HCT and MCV (P = 0.007) than the control group. Exposure group had significantly lower numbers of PLT (P = 0.001)...

Sulfur mustard has various toxic effects. Some of the complications due to sulfur mustard toxicity are well known and some are unclear. In this study, serum total bilirubin and some hematologic parameters were evaluated in populations exposed to different doses of sulfur mustard. The sulfur mustard–exposed victims from Sardasht-Iran were divided into two groups 20 years after exposure, based on hospitalization at the time of the exposure. Studied groups were hospitalized and not hospitalized (n = 169 and n = 203, respectively). Liver function tests including total serum bilirubin, direct bilirubin, SGOT, SGPT, ALP, and hematologic parameters composed of RBC count, hemoglobin, hematocrit, and RBC indexes were evaluated. Total counts for RBC, MCV and total serum bilirubin were significantly different between the two groups, but there was no statistically significant difference in direct bilirubin, SGOT, SGPT, ALP, hemoglobin, hematocrit, MCH, MCHC between the two groups.

This review describes the evaluation of acute and chronic systemic and ocular toxic effects of sulfur mustard (SM) on exposed humans. It is intended to increase the awareness of extensive and dangerous environmental hazards of this agent and describe different treatment modalities for systemic and ocular involvement. Historical information and current events were accessed through the internal and external military field manuals and Internet searches. We reviewed the history, mechanism of action, and clinical and treatment modalities relating to ocular involvement of SM poisoning, by accident, terrorism, or war exposure. SM is the most dangerous organochlorine vesicant agent, which alkylates DNA. In liquid or gas form, its main targets are the eyes, skin, and lungs. Clinical effects are like burns accompanied by loss of immunity, respiratory failure, and ophthalmic, gastrointestinal, and hematological signs. Ocular effects of SM differ in acute and chronic toxicity. There are no specific antidotes for SM poisoning; hence, preventive medicine and modalities are paramount. So the first and most efficient treatment is to remove and decontaminate the victims. Most of the acute ocular problems heal during a few weeks after exposure, but rare regression of the signs and symptoms can occur up to more than 20 years after exposure, the so-called delayed keratitis that may lead to an uncontrolled penetrating keratoplasty and blindness.

Sulfur mustard (SM) was the most common chemical warfare agent used by Iraqi military forces against Iranian soldiers and civilians in border towns. Studies about late skin complications in SM-expo...

Mustard gas was the most extensively used chemical agent in the Iraq-Iran war (1980–1988). It affects many important organs and systems; however, its cardiovascular effects are still unclear. In a historical cohort study, we evaluated the symptoms and signs of mustard gas exposed victims (397 cases) and compared the findings with the control group (132 persons). Typical chest pain was more frequent in the exposed group (11% versus 0%, P = 0.450). In addition, exertional dyspnea was found in 50% of the exposed group versus 30% in the control group (P = 0.162). Chest pain and dyspnea were more frequent in the exposed group and cardiac signs were the same in the two groups. Further studies must be planned for evaluating ischemic and valvular heart diseases, myopathy and other cardiovascular problems in these victims.

Sulfur mustard (SM) is an alkylating agent used several times by Iraqi forces as a chemical warfare agent in the Iraq-Iran war (1980–1988). Eyes, skin and respiratory system are the most sensitive organs to SM exposure. This agent has a suppressor effect on the immune system. As we did not find any study on the late rheumatologic complications of SM in the exposed victims in literature, in this study we investigated these complications in Sardasht (Iran) civilians 20 years after exposure. In a cohort study, 370 victims of Sardasht (that divided into two groups: hospitalized, n = 167, and non hospitalized, 203) in comparison to 128 control subjects from Rabat (Iran). The chief rheumatologic complaints, the physical examinations, the most probable clinical diagnosis and the rheumatic laboratory tests were compared between the study groups. The chief complaint was lower extremity pain; the most frequent physical finding was widespread tenderness and the most frequent clinical diagnosis was psychogenic pain. ...

Sulfur mustard was employed as a chemical warfare agent by the Iraqi forces in the borderline regions of Iran during the Iraq-Iran war (1980–1988). The short- and long-term biological effects of sulfur mustard agent have been studied in both basic and clinical aspects. One organ that was primarily affected was the respiratory system. Among the adults, regular physical activity positively affects the respiratory system as well as the individual’s ability to perform important daily tasks. We investigated the self reported physical activity in chemical victims 20 years after sulfur mustard exposure, compared the data with those of the matched counterparts, and explored any potential association with BMI. The exposed group was 357 and the control group was 125 individuals. Physical activity was measured using the global physical activity questionnaire (GPAQ) that evaluates work, recreational, transport and sitting activities. A significant difference was found between the control and exposed groups in terms o...

Mustard gas (MG) is one of the well-known chemical substances that have been used as chemical warfare agents. In the present study, the stage of change of physical activity and the total physical activity min/ week of victims exposed to MG in Sardasht, Iran (1988) 20 years after exposure were measured. The aim of this study was to investigate the proportion of victims in each stage of change and the causative factors associated with reduced physical activity such as MG-related pulmonary complications in a sample of the victims. In a historical cohort study, 357 victims with a history of mustard gas exposure were studied. An algorithm was applied to evaluate the stage of change in physical activity, which was defined as being engaged in moderate to vigorous physical activity for at least 30 minutes on most days per week. Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). The distribution of the stage of change for physical activity was as follows: 60.5% in precontemplation, 20.7% in contemplation, 3.9% in preparation, 0.8% in action and 14.1% in maintenance. There was a significant difference between the control and exposed groups in pre-adoption stages (precontemplation stage, contemplation stage and preparation stage) and post-adoption stages (action stage and maintenance stage) of physical activity (P < 0.001). The findings of the present study can contribute to improving health behaviors and to the administration of health promotion programs in the victim populations.

Sulfur mustard (SM) has widely been used against the military and civilians during the Iraq-Iran war (1980–1988). It mostly affects the respiratory system. A large historical cohort study was designed to evaluate the pulmonary status of non-military victims in Sardasht, Iran, in comparison with a matched control group 20 years after a single massive exposure. The exposed group was divided into two subgroups of hospitalized and non-hospitalized based on the severity of the injuries indicated by hospitalization a few days following exposure. All participants’ respiratory symptoms and signs were evaluated by internists. Dyspnea (n = 261; P = 93.2%) was the most common symptom. Chronic cough, cough severity, sputum, hemoptysis, dyspnea, pattern of dyspnea, severity of dyspnea (P

To describe the long-term health status of Sardasht civilians 20 years after sulfur mustard exposure, a historical cohort study was carried out in Sardasht (Iran) that included 372 exposed and 128 unexposed civilians. Their symptoms, diagnoses, drug use, and general health were compared. The most common complaints were about the respiratory system (93.5%), eyes (52%), skin (94.7%), and anxiety and depression (69.2%). Respiratory (42.5%), skin (75.5%), ophthalmic (19.6%), and mental (62.7%) diseases were diagnosed by specialists and they were more common in the exposed group than the control group (P < 0.001). Most of the exposed group had used drugs (70.6%), which was more than control group (42.8%). It seems that exposure to sulfur mustard caused a lot of health problems in Sardasht. Identifying the pathophysiology of these problems can help them more, but more investigation is needed.

Background and Aim: One of the most important problems of children who suffer from autism is abnormality in receiving and integrating sensory inputs, especially hearing input. It has been shown that brainstem has a key role in receiving, encoding and integrating hearing input. Auditory brainstem response (ABR) is a tool by which we can evaluate this function. The purpose of this study was to assess and to compare autistic and normal children brainstem hearing function. Materials and Methods: This case-control study was conducted on thirty (58 ears) autistic and thirty (57 ears) normal 6-12 years old children. The children with autism were divided into slight and severe subgroups according to Autism Diagnostic Interview-Revised questionnaire. Click-evoked ABR was recorded and compared between groups. Results: There was significant difference between two groups V and III wave latencies and I-III and I-V interpeak latencies (p

Frailty is usually modeled as an unobserved random variable acting multiplicatively on the baseline hazard function, where a shared unobserved quantity in the intensity induces a positive correlation among the observed failure times. Using the asymptotic properties of the nonparametric maximum likelihood estimator for the gamma frailty model, we derive a power function for testing the shared frailty parameter and evaluate the effect of number of groups and number of individuals per groups on the power of the test by simulation studies. The results show that choosing between 8 and 25 groups with sample sizes between 200 and 500 individuals will be enough to get a high power.

Background: Some human error in health care is inevitable. Research into the predisposing factors for these errors is an important step in their management. Aim: To survey nurse perceptions of the contributing factors to nursing practice errors. Methods: A descriptive survey was carried out in three selected educational hospitals in Tehran city. Data were collected by questionnaire and analysed using descriptive statistics. The study sample consisted of 96 nurses and nursing managers. A multistage sampling strategy was used. Results: Results showed that from nurses' and nursing managers' perspectives, various factors could contribute to the occurrence of nursing errors in the ‘management’, ‘environment’ and ‘nursing care’ sections. In addition, there were differences between nurses working on various wards about the causes of nursing errors in each section. Conclusion: A culture of safety recognizes that safety is ‘no accident’. Rather, it requires a change in management practices, providing a suitable environment with the requisite supply of resources and infrastructure, and increasing nurses' knowledge. Outcomes that are identified from the process of practice error management should promote interventions designed to prevent future practice errors based on the above contributing factors. Limitations: The study relied on self-report by a sample of nurses. These responses should now be tested by empirical research into actual nursing practice errors in order to test whether the nurses' perceived ideas of causation are substantiated.

Multiple sclerosis is an inflammatory and demyelinating disease of the central nervous system which mainly affects young adults. To overcome wide spectrum troublesome symptoms of multiple sclerosis which affects the quality of life both in patients and their families, new drugs and remedies have been examined and offered. The preclinical beneficial effects of different medicines have mostly been examined in an animal model of multiple sclerosis called experimental allergic encephalomyelitis (EAE). In this study we have tested a traditionally used natural (herbal-marine) product called MS14 in EAE mice. EAE mice were fed with MS14 containing diet (30%) on the immunization day and monitored for 20 days. The results show that while clinical scores and therefore severity of the disease was progressive in normal-fed EAE mice, the disease was slowed down in MS14-fed EAE mice. Moreover, while there were moderate to severe neuropathological changes in normal fed mice, milder changes were seen in MS14 fed mice. Copyright © 2008 John Wiley & Sons, Ltd.

Background and Aim: Blocking of the adenosine receptor in central nervous system by caffeine can lead to increasing the level of neurotransmitters like glutamate. As the adenosine receptors are present in almost all brain areas like central auditory pathway, it seems caffeine can change conduction in this way. The purpose of this study was to evaluate the effects of caffeine on latency and amplitude of auditory brainstem response(ABR).Materials and Methods: In this clinical trial study 43 normal 18-25 years old male students were participated. The subjects consumed 0, 2 and 3 mg/kg BW caffeine in three different sessions. Auditory brainstem responses were recorded before and 30 minute after caffeine consumption. The results were analyzed by Friedman and Wilcoxone test to assess the effects of caffeine on auditory brainstem response.Results: Compared to control group the latencies of waves III,V and I-V interpeak interval of the cases decreased significantly after 2 and 3mg/kg BW caffeine consumption. Wave I latency significantly decreased after 3mg/kg BW caffeine consumption(p

Objective: To compare the effect of a whole body vibration training (WBVT) programme with a conventional training (CT) programme on knee proprioception and postural stability after anterior cruciate ligament (ACL) reconstruction. Methods: Twenty athletes with unilateral ACL reconstruction were randomly assigned to the WBVT or CT group; all participants received 12 sessions of WBVT or conventional training. Absolute error in joint repositioning for two target angles (30° and 60°) was measured with the Biodex dynamometer; bilateral dynamic postural stability (anteroposterior, mediolateral and overall stability indices) was measured with the Biodex Stability System pre-intervention and post-intervention. Results: The improvement in postural stability in the WBVT group was significantly greater than that in the CT group (p⩽0.05). The p values of the changing scores of open overall, open anteroposterior, open mediolateral, closed overall, closed anteroposterior and closed mediolateral stability indices were 0.002, 0.010, 0.0001, 0.001, 0.0001 and 0.046, respectively. In addition, there were significant differences in all averages of absolute angular error at 60° and 30° between the WBVT and CT groups in both knees (p = 0.001 in healthy knees and p = 0.001 and p = 0.0001 in reconstructed knees), apart from the healthy knees at the 30° target position, which was not significant (p = 0.131). Conclusions: Whole body vibration training improved proprioception and balance in athletes with reconstructed ACL.

Eyes are very sensitive to sulfur mustard (SM) gas because they have wet surfaces. The severity of ocular damage is related to the dose and duration of exposure to SM, and recovery may take up to several years after the exposure. We conducted a large cohort study to evaluate the ocular signs and symptoms of 367 chemical war victims in Sardasht City, Iran, 20 years after their exposure to mustard gas. The results of these chemical war victims (i.e., the cases) were compared with the results for 128 unaffected civilians (i.e., the controls). Photophobia was the most significant symptom in the cases (36.8%) (compared with 20.3% in the controls) (por = .001). Ocular surface discomfort (burning, itching, and redness) was the second most significant symptom in the cases (29.2%) (compared with 19.5% in the controls) (p = .034). Other symptoms such as foreign-body sensation, tearing, pain, blurring of vision, and dry eye sensation were not significantly different between the 2 groups. In the slit-lamp findings, bulbar conjunctival abnormality was the most significant sign in the cases (9.3%) (compared with 1.6% in the controls) (p = .004). Limbal tissue changes were the second most significant sign in the cases (3.0%) (compared with 0.0% in the controls) (p = .048). Other slit-lamp findings related to tearing and abnormalities in the lids and cornea were not significantly different between the 2 groups. Our findings in the present study showed that photophobia and ocular surface discomfort (burning, itching, and redness) were the most significant symptoms. In addition, bulbar conjunctival abnormalities and limbal tissue changes were the most significant signs among the sulfur mustard chemical war victims.

Background and Aim: The purpose of this research is to study the standardization of speaking and reading rates in a group of normal speaker of female students, and to compare them. As the rate of speech is an important variable in the evaluation and treatment of stuttering, cluttering, dysarthria and apraxia. Materials and Method: One hundred of second grade students of primary school and an equal number of fifth grade students participated in this study. All subjects were native speakers of Farsi, who passed an informal, screening test of articulation and speech. None of the subjects had a history of speech, hearing, or neurological disorders. The subjects were asked to read from the 180 words portion of their Farsi book and tell story. Their speech was recorded by using a tape recorder. Then the data were analyzed for word and syllable rate. In transcribing the samples, single morpheme was counted as single word and compound words were counted as two words if they had two free morphemes. Non-word interjections were excluded from word and syllable counts while word interjections and repeated words were included in the count. Independent t-test and paired t-test were used for analyzing. Results: In the second grade students the reading rate is, on the average, 189.4 syllable per minute (SPM)(94.9 word per minute(WPM), 3.1 syllable per second(SPS)) and the talking rate is 189.8 SPM (99.1 WPM, 3.1 SPS) and in the fifth grade student the reading rate is 223.9 SPM (119.0 WPM, 3.7SPS) and the talking rate is 210.26 SPM (109.5 WPM , 3.4 SPS). Conclusion: The result highlight that in the fifth grade students, reading rates are higher than talking rates while in the second grade they are not, because they do not have enough skills for whole word reading. A remarkable finding in this research is that, reading and talking rates in the fifth grade students are higher than the second grade students.

Background and Aim: The short-term memory (STM) has been studied to a great extent so far. Using some strategies and techniques to help the subject to access to his/her memory is important for Speech pathologist. Priming is a process that increases the chance of accessing to some information of memory by means of some simulations. So, primings are some words which facilitate the retrieval of the target words. The purpose of this study is comparing phonological and semantic priming on the short verbal memory span.Materials and Methods: The research was conducted on sixty-four 18-25 year-old male students in Tehran University of Medical sciences. Due to some distortion factors, including bilingualism, stutter-ing, and articulation problem, that can effect the reaction time, were determined as exclusion critenia. In additiion, subjects with difficulty in Wepman auditory discrimination were ruled out. The test was performed via the second version of programmed DMDX software and reaction time was recorded.Results: Semantic tasks and rhyming tasks were retrieved faster than the other tasks in lexical access respectively. There was a significant difference between the semantic and rime tasks but there is no significant difference between alliteration and unrelated tasks.Conclusion: The result of this research indicates that the semantic level is activated faster than the other levels and the phonological level is activated right after that. The alliteration level is the last level that activated. It has some similarities with some other investigations on the reaction time in phono-logical tasks.

To study the effect of iron supplementation on pregnancy outcome in pregnant women with haemoglobin (Hb)or = 13.2 g/dl.A randomised, double-blind, placebo-controlled trial.Routine health services.Seven hundred and twenty-seven pregnant women with Hbor = 13.2 g/dl in the early stage of the second trimester.Each woman took one ferrous sulphate [DOSAGE ERROR CORRECTED] tablet (150 g tablet, containing 50 mg of elemental iron) [DOSAGE ERROR CORRECTED] daily in the case group (n = 370) or placebo in the control group (n = 357) throughout pregnancy.Pregnancy outcome.While there were no significant differences in demographic and obstetric characteristics between the two groups before any intervention, small-for-gestational-age birth rate and the number of women with hypertension disorder increased significantly in the case group in comparison with the control group (57 [15.7%] versus 36 [10.3%], P = 0.035, 10 [2.7%] versus 3 [8%], P = 0.05, respectively).Our finding proves that routine iron supplementation in nonanaemic women is not rational and may be harmful.

The assessment of the various impairments in brain damage including spasticity is important. The purpose of this study was to develop a new biomechanical method based on quantification of velocity reduction (VR) suitable for clinical use. A highly reliable system was developed to apply a constant torque perturbation at the elbow. This system was used to measure the VR in 30 healthy adults and 10 hemiplegic patients. In healthy subjects, the mean VR was 3.02% (SE (standard error) = 0.29). In hemiplegic patients, the mean VR in the impaired arm (81.47%, SE= 2.87) was significantly higher than the VR (%) either in the nonimpaired arm (9.86%, SE= 0.92) (WSRT (Wilcoxon Signed Ranks Test) : Z = -12.74; p It is concluded that the quantification of velocity reduction may be used as an objective method of measuring spasticity in neurological conditions.

Background: Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Methods: Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ2 tests. Results: Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002. Conclusion: Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.

Background and Aim: Auditory temporal resolution skill is calculated according to the minimum required time to analyze or integrate acoustic events. This skill, which is essential for speech perception, was evaluated by gap detection tests. The aim of this study was to determine the presence or absence of any differences between the right and left ear in the gap detection test. Methods: After performing auditory tests to rule out any hearing loss or auditory processing disorders, the gap detection test was administered to 40 adults. Results: Gap detection thresholds were 5.35 ms and 5.30 ms in the right and left ear, respectively, and the average correct answers percentages were 69.03% and 68.03% in the right and left ear, respectively. According to these data, results were similar for both ears. Conclusion: There is no laterality in temporal resolution tasks. However, we cannot generalize the results of the present study as being applicable to the whole society.

Background: Chronic pain has been estimated to affect between 2% - 40% of the adult population and its prevalence is increasing. Objectives: This study aimed to provide epidemiological data of chronic pain and associated factors in Tehran, capital of Iran. Patients and Method: We analyzed the data of 23457 people, from the Urban HEART-2 (health equity assessment and response tool) study in Tehran, collected in October 2011, and determined the association between any type of chronic pain and other variables using multiple logistic regressions. Results: The prevalence of chronic pain among adults in Tehran City was 24%. Chronic low back pain and chronic knee pain were the most common complaints (12.4% and 11.2%, respectively). A significant difference was found in the prevalence of chronic pain between districts of Tehran (P < 0.001). Associated factors were different for different types of chronic pain, and anxiety and increasing age were identified as common risk factors associated with all types of chronic pain (P < 0.001). Conclusions: The results of this study show a considerable prevalence of chronic pain among adults in Tehran. Therefore, it is necessary to pay more attention to different types of chronic pain by planners and policy makers.

Background and Aim: Hearing sensitivity is so vital for musicians as loud music can cause hearing loss. The aim of this study was to assess hearing sensitivity of musicians in order to determine the effects of music exposure on hearing organ. Materials and Methods: This case-control study was conducted on 15 string musicians with musicianship history of more than 10 years and 15 normal hearing subjects. They all were male and 20-30 years old. TEOAE and DPOAE performed and after otoscopy, immittance and pure tone audiometry in octave frequencies between 250 to 16000 Hz. Results: There is not significant difference between pure tone thresholds of two groups for all frequencies. A significant difference of TEOAE is found between two groups for total response and amplitudes of TEOAE .DPOAE amplitudes are not significantly different between two groups. Conclusion: Musicianship may affect TEOAE amplitudes , but cannot affect results of PTA and DPOAE. Therefore this can be useful to detect cochlear lesions secondary to music exposure and also as a tool in hearing protection program.