فهرست مطالب hadis sabour

The National Traumatic Spinal Cord Injury Registry in Iran (NSCIR-IR), was implemented initially in three hospitals as a pilot phase from 11 Oct 2015 to 19 Jun 2016 and has been active in eight centers from 19 Jun 2016. Poursina Hospital, a trauma care referral center in Rasht, Guilan Province of Iran is one of the registry sites, and has been involved in registering eligible patients since 1 Jan 2016. This study aimed to identify the challenges and solutions for sustaining the NSCIR-IR in a regional center.

This was a mixed-methods study. For the quantitative analysis, a retrospective observational design was used to measure case capture or case identification rate, mapping cases in the registry against those eligible for registry inclusion amongst the register of hospital admissions. For the qualitative component, data was collected using focus group discussions and semi-structured interviews, followed by thematic analysis.

From 19 Jun 2016 to 24 Jan 2018, the proportion of case capture (case identification rate) was 17%. The median time between case identification and data entry to the system was 30.5 d (range: 2 to 193 d). Thematic analysis identified a lack of trained human resources as the most important cause of low case identification rate and delay in data completion.

Recruitment and education to increase trained human resources are needed to improve case capture, the timeliness of data input and registry sustainability in a regional participating site.

Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI).
Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP) and diastolic BP (DBP) were measured 3 times and the mean values entered analysis.
Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively). Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21) and DBP (P = 0.011, r = 0.22). The effect of eicosapentaenoic acid (EPA) on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively). However, intake of docosahexaenoic acid (DHA) was related to lower BP among people with SCI.
This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension.

Bone loss in spinal cord injured patients is common problem. Based on high prevalence of osteoporosis in these patients, this study was designed for the first time to evaluate bone mineral density and related markers in spinal cord injured patients.
Inpatients with chronic spinal cord injury who was referring to the clinic of spinal cord injury research center were recruited. Anthropometric, bone mineral density, serum levels of phosphorus, 25(OH)D, ALP, CTX, osteocalcin, PTH, calcitonin and food intake were evaluated.
There was a significant difference in bone density of lumbar and femoral site groups. Serum level of CTX in male group was significantly higher than femoral group (r=0.23). Time since injury was related positively to T. Score and Z. Score lumbar bone mineral density. Patients who was injured at lumbar level had the highest calcitonin level (p=0.04). Mean intake of calcium was 565.7±270mg/day in female group and 835.3±755mg/day in male group, in both it was lower than the recommended amount.
Our study showed that vitamin D and calcium deficiency are common problem and these patients had different grades of low mineral density.

Health-related quality-of-life (HR-QoL) may be affected by various factors including injury-related characteristics among individuals with spinal cord injury (SCI). However, the impact of the influence of these variables has not yet been fully described in Iranian population. Here, we assessed the relationships between injury-related characteristics and HR-QoL among Iranian people with SCI. HR-QoL was assessed using short-form health survey (SF-36). Referred patients to Brain and Spinal Injury Research Center between 2010 and 2012 were invited to participate in this investigation. Injury-related characteristics including injury level and completeness, time since injury, plegia type, and American Spinal Injury Association (ASIA) Impairment Scale were evaluated. Total of 104 patients (85 men and 19 women) entered the study. The majority of patients had a complete injury (77.9%). The most frequent ASIA score was A (75%), and the most common level of injury was at thoracic sections (61.5%). Lower injury levels were associated with higher scores in physical component summary (P = 0.040), mental component summary (P = 0.010) and subsequently total score (P = 0.006). Mean age and time since injury were 52.58 ± 12.69 and 10.88 ± 16.68 years, respectively, and were not related with HR-QoL (P = 0.950 and 0.220, respectively). There was no difference in HR-QoL between patients with tetraplegia vs. paraplegia and participants with complete vs. incomplete injury. lower injury level is a significant predictor of better QoL among individuals with SCI whereas other injury-related characteristics including completeness, time since injury and plegia type may not influence HR-QoL.

Clinical studies have reported that osteoporosis after spinal cord injury (SCI) can be the inflammation-induced base condition and n-3 polyunsaturated fatty acids (PUFAs) suppress the production of pro-inflammatory cytokines. This study documents the effects of n-3 PUFAs on cytokines in a group of patients after chronic SCI. This double-blind, placebo- controlled trial was designed in 82 (69 males and 13 females) osteoporotic patients with SCI for 4 months. All participants received 1 000 mg calcium and 400 IU vitamin D daily. The patients received two MorDHA capsules (435 g of DHA and 65 mg of EPA per day) or two placebo capsules (one with lunch, and the other with dinner) in the treatment and control groups, respectively. Serum interleukins and Dietary intakes were assessed in the beginning and end of the study. Mean difference for each group was compared by using Student''s t test. A total of 75 (13 females, 62 males) participants completed the study over 4 months. The supplemented and control groups did not show any difference in their baseline characteristics. There were significant difference neither between two groups at the end of the study nor in each group between beginning and end of the study. Conclusins: MorDHA supplementation for 4 months had no significant effect on inflammatory markers. Although mean difference in all pro-inflammatory cytokines were not significant in both treatment and control groups during the study (P>0.05), the decrease in treatment group was weakly higher that it may be important in point of clinical view.

Studies have shown that patients with Spinal Cord Injury (SCI) are susceptible to various diseases including dislipidemia and Cardiovascular Disease (CVD). In this study for the first time, we evaluated the relationship between dietary intake and metabolic variables of 162 patients. This cross sectional study was done in Tehran University of Medical Sciences. All of the consumed food items and the variables were measured. Independent-sample t-test was used for comparison of dietary intake and serum profile. Multiple regression analysis was used to estimate predicting variables of serum variables. Men as compared to women had higher triglycerides (TG) levels and lower HDL-C levels (p<0.05). Patients with paraplegia compared to those with tetraplegia had significantly higher total cholesterol and LDL-C levels (p<0.001). In regard to serum profile, there is a positive correlation between LDL-C levels and age (p<0.05). Dietary intake of saturated fat showed positive correlation with FBS (p<0.05). Moreover, there is a significant negative correlation between LDL-C levels and dietary intake of PUFA (p<0.05). Body Mass Intake (BMI), cholesterol intake and level of trauma were positive predictors for serum cholesterol. Waist circumference, level of injury and cholesterol intake were positive predictors for serum LDL. Moreover, PUFA intake and education level were negative predictor for serum LDL. Despite low intake of saturated fat and cholesterol in older participants, serum LDL level was high. Male group had higher levels of TG. So, attention to dietary intake of patients with SCI and encouraging healthy dietary habits may have important effects on their health.

Despite an elevated obesity risk in people with spinal cord injury (SCI), investigation on the effects of age, obesity predictors and injury related factors is yet to be unknown within the SCI population. Obesity predictors were measured in 162 patients. 27.5% of the participants were overweight and 5.6% of them were obese. Mean BMI was different between patients with tetraplegia and paraplegia (p < 0.01). More than 20% of participants had central obesity, significantly patients with higher age and time since injury. Significant positive relationship was found between level of injury and BMI. Participants with higher age and time since injury had higher waist circumference.

Metabolisms of vitamin D, calcium and parathormone change during normal preg-nancies. Evaluating these changes and factors affecting them, especially consumption of vitamin D containing foods by mothers and its bioavailability to the fetus, are essential. The primary aim of this study was to determine the relationship between bone turnover and maternal nutritional status of vitamin D during normal pregnancies.

This cross-sectional study was done on 449 healthy pregnant women and their newborns who had attended educational hospitals of Tehran University of Medical Sciences in 2003. Average intakes of vitamin D and calcium were studied by a food frequency question-naire and measurements of serum calcium, vitamin D, PTH, cross-laps and osteocalcin of the mothers and their infants through cord vein. Statistical analysis was done by SPSS software, version 11.5 and p<0.05 was considered significant.

Serum concentrations of vitamin D in cord blood samples from newborns, whose mothers had adequate vitamin D intake (200IU/Day of vitamin D for pregnant women), were higher. There was a positive correlation between maternal serum calcium and calcium in the cord blood of the newborns (r=0.35). There were significant differences in concentration between PTH, osteocalcin and cross-laps of the mothers and their newborns (p<0.001). The serum concentrations of vitamin D and calcium in the cases and their infants had a correlation with adequate intake of the two (p<0.05). There was a reverse association between bone turnover markers and calcium with vitamin D intake in mothers.

The nutritional status of vitamin D in human fetus and neonates is completely dependent on vitamin D stores of their mothers and adequate intakes of these elements can influ-ence bone metabolism in mothers and newborns. Therefore, programs aimed at improving vitamin D and calcium intake through educational materials and classes, which focus on the consumption of rich sources of vitamin D, should be considered. Fortification and supplementation of these elements to those at risk has to be nationally regarded.