Journal of Research in Medical Sciences
Volume:15 Issue: 2, Mar & Apr 2010

Health related quality of life is considered to be an important outcome measure in studies involving patients with chronic neurological conditions such as Parkinson’s disease. Disease specific patient reported outcome measures(PROMs) are increasingly used as primary end points in clinical trials of new treatments for such conditions. The most widely used disease specific PROM in PD is the 39 item Parkinson''s Disease Questionnaire (PDQ-39). The aim of this study was to determine validity and reliability of Persian PDQ-39. Two hundred and forty Parkinson’s disease patients attending neurologic clinics of teaching hospitals were recruited. PD patients completed a translated version of the PDQ-39 after giving informed consent. Internal consistency reliability of the questionnaire was assessed by Cronbach''s alpha coefficient. Reproducibility (test/retest reliability) was assessed across the 3-week interval using the intraclass correlation coefficient (ICC). To assess convergent validity, results on the PDQ-39 were correlated with those gained on the SF-36, a widely used generic outcome measure. Discriminate validity of questionnaire were assessed by comparing PDQ-39 scores and the severity and the duration of disease. A value of 0.93 (Cronbach’s α) was gained for the summary score (PDQ-SI), indicating high levels of internal reliability. Alpha value of seven of the eight 8 domains was greater than 0.70. The intraclass correlation coefficient (ICC) ranged 0.47 to 0.90. The range of correlation coefficients between domains of SF-36 and PDQ-SI was -0.40 to -0.61. There was a statistically significant difference between severity of disease and mean scores of PDSI. This study provides evidence that the Persian version of PDQ-39 is valid and reliable measure of quality of life in PD.

The high prevalence of hypertension along with its serious complications on the body, have made this disorder to an important health problem. Hypertension monitoring in the house may be an effective method. Therefore, the aim of this study is to explore the effectiveness of education on blood pressure self-monitoring in patients with hypertension based on BASNEF model. In this clinical trial, 150 outpatients with hypertension referring to a private clinic in Yazd, Iran were recruited in the study. The data were collected by a validated and reliable questionnaire. The implementing educational program was continued for 2 months. BASNEF model applied to distinguish the behavior. The respondents acquired 17.72% of total hypertension self-monitoring behavior score, 47.03% of attitude, 12.37% of subjective norms, 33.46% of intention and 50.95% of enabling factors. After intervention there were significant increases in self-monitoring behavior (173.31%), attitude (62.60%), subjective norms (54.70%), intention (129.93%) and enabling factors (46.62%) in intervention group. The results of this study showed that the level of self-monitoring behavior in the patients was low. Educational programs, like what we implied in our study, in order to improve self-monitoring behavior in patients with hypertension may be helpful and necessary

ABSTRACT. The aim of this study was to investigate the effects of exercise training on maximum aerobic capacity, rest heart beat, blood pressure and anthropometric variables of postmenopausal women with breast cancer. Twenty nine women with breast cancer who received surgery, chemotherapy and radiotherapy with current hormone therapy divided into two groups; intervention and control. Subjects of intervention group performed 15 weeks combination exercise training including walking (2 sessions per week) and resistance training (2 sessions per week that different from walking days). Before and after 15 weeks, Vo2max, rest heart beat, blood pressure, body weight, body mass index (BMI) and waist to hip ratio (WHR) were measured in two groups. Data analyzed by using t- test. Significant differences were observed for Vo2max, rest heart beat, body weight, BMI and WHR between intervention and control groups (P< 0.05), after 15 weeks. In fact, exercise training had positive effects on the Vo2max, rest heart beat, body weight, BMI and WHR in postmenopausal women with breast cancer. No significant different was founded for blood pressure between two groups (P=0.193). In conclusion, exercise training can improve maximum aerobic capacity, rest heart beat and anthropometric variables in postmenopausal women with breast cancer.

Back ground: Alzheimer''s disease is the most common form of dementia which is still difficult to be differentiated from other types of brain disorders. Moreover, Mild Cognitive Impairment refers to the presence of cognitive impairments that is not severe enough to meet the criteria of dementia, and its diagnosis in early stages is so critical. There is currently no distinct method available for diagnosing Alzheimer''s or Mild Cognitive Impairment, and their diagnosis needs a combination of different methods and assessments. Our goal in this study was to evaluate the effectiveness of fMRI imaging in differentiating between Alzheimer''s, Mild Cognitive Impairment (MCI) and Healthy Aging. To prove fMRI''s ability, we compared resting-state brain activation patterns between these three groups of subjects using Independent Component Algorithm (ICA). We examined 40 age- and sex-matched subjects, 15 elderly, 11 MCI and 14 Alzheimer''s subjects. The results show that during a certain resting-state session, healthy aging brain benefits from larger area and greater intensity of activation (compared with MCI and Alzheimer''s group) in Posterior Cingulate Cortex (PCC) region of the brain, as part of Default Mode Network. This difference in activation pattern can be used as a diagnostic criterion in using fMRI for differentiating between Alzheimer''s disease (AD), MCI and Healthy Aging.

Few studies have attempted to delineate the clinical profile of multiple Sclerosis (MS) among people of Asia; therefore we sought to identify the characteristics of early-onset Multiple Sclerosis (EOMS) comparison to adult-onset form (AOMS) in Isfahan, IRAN.Patients and this prospective study consisted of 104 youths with multiple sclerosis beginning before the age of 16 years and 123 patients with adult-onset multiple sclerosis.Patients were followed for a mean period observation of 5 years. The common presenting symptoms, MRI finding, course of disease and disability score were compared between two groups. The mean onset age of disease in youths and adults were 14.05±1.9 and 27.7±8.06 respectively.Female /Male ratio was 4.47:1 in EOMS and 3.92:1 in AOMS, this ratio was 7:1 in really childhood MS (≤10 year).The most common presenting symptom was Optic Neuritis in the EOMS group and paresthesia in AOMS. Optic neuritis was common in AOMS too,but ataxia was more common in EOMS than AOMS. Seizure occurred more frequently in EOMS than in the AOMS group (12.6% vs 1.6% respectively p

Background. The reproductive and sexual health issues concerning persons affected by thalassemia major are complex. The study was planned to investigate the psychological attitudes and expectations in a group of thalassemic pregnant women attending hospital for regular blood transfusion. Methods. The study included 20 consecutive thalassemic patients and a control group of 42 healthy pregnant volunteers. We evaluated the personality structure by Rorschach''s test and the presence of psychic symptoms by SCL-90-R and STAI. Results. Narcissism and sexual traumas are significantly higher in thalassemic women with respects to the control group. Also the percent of anxiety and depression observed with the SCL-90-R was significantly higher than in control group. The score observed with the STAI shows that the state of anxiety changed significantly between thalassemic pregnant women and the control group, even though the scores values aren’t pathologic in neither group. Conclusions. This study addresses the need for developing, implementing and evaluating proper psychological support for thalassemic pregnant patients. The limit of this study is to analyze just thalassemic women because it doesn’t consider other pathologies; so the results can’t be extended to other pathologies different from thalassemic. Moreover, psychological screening and support prior to, during and following pregnancy would be indicated. Since not there are psychological studies in literature on the pregnancy in the thalassemic patients, the evaluation of the effects of pregnancy on the thalassemic disease will be the aim of future psychological investigations.

Publication bias is an important factor that may result in selection bias and lead to overestimation of the intervention effect. Capture recapture method is considered as a potentially useful procedure for investigating and estimating publication bias. We conducted a systematic review to estimate the duration of protection provided by hepatitis B vaccine by measuring the anamnestic immune response to booster doses of vaccine and retrieved studies from three separate sources, including a) electronic databases, b) reference lists of the studies, and c) conference databases as well as contact with experts and manufacturers. Capture recapture and some conventional methods such as funnel plot, Begg test, Egger test, and trim and fill method were employed for assessing publication bias. Based on capture recapture method, completeness of the overall search results was 87.2% [95% CI: 84.6% to 89.0%] and log-linear model suggested 5 [95% CI: 4.2 to 6.2] missing studies. The funnel plot was asymmetric but Begg and Egger tests results were not statistically significant and trill and fill approach made no change in pooled effect. Capture recapture method may be a useful practical approach for estimating the number of missing studies which are not usually detected by search strategy, although assumptions of this method may limit its general application in systematic reviews. In addition, capture recapture method may be considered as an alternative approach for estimating the extent of publication bias based on overlapping information rather than mirror image of extreme values on funnel plot.

Myocardial Infraction (MI) is one of the most causes of morbidity and mortality in industrial and developing countries. Recent studies have suggested that chronic infections with Chlamydia pneumoniae (Cpn) and Helicobacter pylori (Hp) may be associated with the risk of coronary heart disease (CHD). Determining risk factor of the CHD is of huge significance, so we executed the comparative study of antibody level to Chlamydia pneumoniae and Helicobacter pylori in patients with MI and healthy control in North of Iran. A cross sectional study was conducted on 140 citizens includes 70 cases and 70 controls that matched in age and sex. Seroprevalence was assessed by commercial ELISA tests measuring IgA and IgG antibodies to Cpn and Hp in sera. In this study, our results indicated that among patients, %11.4 was seropositive for Anti-Cpn IgA, %90.0 was seropositive for Anti-Cpn IgG, %51.4 was seropositive for Anti-Hp IgA and %58.6 was seropositive for Anti-Hp IgG. The present study shows that %68.57 of patients and %69.86 of controls are seropositive for anti-Hp specific IgA and IgG antibodies. Our findings show that previous infection to Cpn in patients with MI is important. But there are no significant association between infection with Hp as evidenced by elevated antibodies to Hp and MI.

Pulmonary Alveolar Proteinosis(PAP) is a rare disease of unknown etiology, characterized by the accumulation of proteinoceous material in the alveoli that is rich in lipid and is positive on periodic acid-Schiff(PAS) stain. PAP is rare in children. Two forms are encountered in pediatric practice: congenital alveolar proteinosis (CAP) and a later–onset form that is generally less severe. Broncho-alveolar lavage is the key to diagnosis. Therapeutic lung lavages are the only effective treatment for severe cases. Other therapeutic trials have been proposed such as: lung transplantation, adminstration of GM- CSF and gene-therapy. This case series presents six cases of PAP which were diagnosed by open lung biopsy in Mofid children hospital in Tehran capital city over a three-year period (2003–2006) and one in 1998. The aim of the present study was to provide detailed data on the characteristics of these patients and the methods of diagnosis and treatment.

In this case report we present a case of wide, deep, atrophic cutaneous leishmaniasis scar that was improved significantly using injection of autologus fibroblasts, dermabrasion and dressing with autologus keratinocytes and fibroblasts. To our best knowledge, it is the first time that separate cultured fibroblasts and keratinocytes are used in conjunction with dermabrasion for treatment of cutaneous leishmaniasis scar. We have started this procedure as an extensive research on patients with leishmaniasis scar that will be reported in the future.