A Qualitative Exploration of Voice Oriented Quality of Life in Iranian Patients: A Cultural Explanation

<p><strong>PURPOSE: </strong>The phrase<strong> </strong>“health-related quality of life” (HRQOL) refers to patients’ perceptions of the influence of disease and treatment on their physical, psychological, and social function. Also, cultural aspects should be taken into account when evaluating quality of life and should be considered in related surveys.  In the current study, the most prominent voice-related QOL dimensions, including culture-based items in Iranian individuals was examined.</p><p><strong>METHODS:</strong> A convenience sample (n= 23) of adults was interviewed addressing voice related quality of life areas. Participants consisted of 15 people (13 men and 2 women) over 18 years with voice disorders lasting at least 6 months with mean age 41.46±16.06, 3 people (2 men and 1 woman) with mean age 47.66±6.65 who worked as radio broadcasters with over 20 years of experience in the field, and 5 experienced specialists in voice disorders (3 speech therapists and 2 otolaryngologists). A semi-structured interview method was used. The components of voice quality of life based on the interviews were extracted by a fourteen stage process content analysis.</p><p><strong>RESULTS:</strong> Many of the extracted components were common to both the interviews and those found in the relevant literature and some of them are new. Some of the new components appear to fit best under the category of “cultural”. Eleven cultural elements are “religious beliefs in disease tolerance and promotion of quality of life”, “More support expectation from family”, “Fear about pain and thinking about serious problems (such as Cancer)”,  “Throat strain results in more disappointment  ” “Fatalism in coping with problem and promotion of Quality of life”, “Traditional home remediation”, “Hope for spontaneous recovery”, “Discrimination because of sound problems”, “Pain and globus sensation as a factor in finding remediation more quickly”, “Negative judgments”, “Negative thoughts about people with voice disorders”. These elements appear to have a potentially strong effect on health quality of life especially in the voice domain.<strong></strong></p><p><strong>CONCLUSIONS: </strong>Relative to the development of a Quality of Life questionnaire for voice, important cultural components of Iranian patients were identified in the current study. Identifying these components may help Iranian voice clinicians obtain a more accurate understanding of health-related quality of life aspects within the Iranian culture. This may lead to more effective remediation for voice patients. </p>

Brain regions involved in swallowing: Evidence from stroke patients in a cross-sectional study

Background:

Limited data available about the mechanisms of dysphagia and areas involving swallow after brain damage; accordingly it is hard to predict which cases are more likely to develop swallowing dysfunction based on the neuroimaging. The aim of this study was to investigate the relationship between brain lesions and dysphagia in a sample of acute conscious stroke patients.

Materials and Methods:

In a cross-sectional study, 113 acute conscious stroke patients (69 male mean [standard deviation (SD)] age 64.37 [15.1]), participated in this study. Two neurologists and one radiologist localized brain lesions according to neuroimaging of the patients. Swallowing functions were assessed clinically by an expert speech pathologist with the Mann Assessment of Swallowing Ability (MASA). The association of brain region and swallowing problem was statistically evaluated using Chi-square test.

Results:

Mean (SD) MASA score for the dysphagic patients was 139.61 (29.77). Swallowing problem was significantly more prevalent in the right primary sensory (P = 0.03), right insula (P = 0.005), and right internal capsule (P = 0.05).

Conclusion:

It may be concluded from these findings that the right hemisphere lesions associated with occurring dysphagia. Further studies using more advanced diagnostic tools on big samples particularly in a perspective structure are needed.

Leisure time activities of Iranian patients with multiple sclerosis: a qualitative study

BACKGROUND

Leisure time is one of the most important aspects of life, especially for people with chronic diseases. The concept and types of leisure have frequently been evaluated in different socio-cultural populations. The aim of this study was to identify the nature of leisure activities among a sample of Iranian patients with multiple sclerosis (MS) and classify the identified types of activities in the context of Iranian culture.

METHODS

In this qualitative study, semi-structured interview was applied to gather data from 34 MS patients that were selected through purposive sampling. The interviews were continued up to the point of saturation. Content analysis was used to explore experiences of the interviewees regarding their leisure activities.

RESULTS

Six categories of leisure activities were extracted for the studied patients with MS i.e.physical, social, individual, art/cultural, educational and spiritual/religious.

CONCLUSION

The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease.

Tuberculous ventriculitis: A rare complication of central nervous system tuberculosis

Tuberculous ventriculitis is an inflammatory infection of the ventricular system of the brain, and is caused by Mycobacterium tuberculosis. We herein present the case of an immunocompromised patient with brain tuberculomas who developed ventriculitis during treatment. The patient was successfully treated with a high dose of steroid, long-term antituberculosis drugs, and aggressive supportive care.

Modeling of carrier dynamics in InGaAs/GaAs self-assembled quantum dot lasers

In this study, a theoretical model is used to simulate the lasing characteristics of InGaAs/GaAs self-assembled quantum dot lasers. The rate equation for InGaAs/GaAs is numerically solved using the fourth-order Runge-Kutta method. We consider the homogeneous and inhomogeneous broadening of the optical gain, both with and without considering the nonlinear gain. The results indicate that for a certain injected current, there is a specific homogeneous broadening (HB) with the best lasing performance when HB is near, comparable, or equal to inhomogeneous broadening for every laser-injected current. We show that if the linear optical gain is replaced by the total gain, the output power will reduce a little and the peaks will be more broadened and the maximum of the gain spectrum decreases. The time evolution of the photon number for different currents and different HBs is shown. The results indicate that by increasing the HB, the number of photons in the steady state and the delay in the starting oscillation will increase. In addition, we show that there is threshold coverage for quantum dots to begin lasing and an optimum quantum dot coverage in which the self-assembled quantum dot lasers operate with the lowest possible threshold current and maximum output power.

Exploring the Relation Between Impairment Rating by AMA Guide and Activity and Participation Based on ICF in the Patients with Hand Injuries

The aim of this paper is to analyze the relation between components of disability with distinguished score of impairment, activity and participation questionnaire based on clinical data of persons with hand injuries. Impairment was evaluated by use of AMA guide 6th edition and disability by DASH questionnaire on Convenience sample of patients (N = 117), with chronic hand injuries. Linking and allocating items of the DASH were done based on the ICF Core Set for Hand Conditions and the opinions of a group of experts from different related fields. Data was analyses by using Kappa index, Chi square test and a set of Pearson, Part and Partial correlations coefficient. Most of the DASH items were allocated to the activity; one to four of the items could not be classified and 0 to 22 were classified as having overlap. Participation and activity scores correlated positively with each other (r > 0.80). Impairment had high correlation with activity and participation scores (>73). With controlling the effect of each or both construct, this relation between them with impairment diminished but still significant between activity and impairment. There is a huge overlap in definition of activity and participation. The most effecting item in relation of disability and impairment is activity restriction. Participation had no relation with impairment.

Gender as a Moderator of the Relation Between Age Cohort and Three-Dimensional Wisdom in Iranian Culture

This study examined whether gender moderated the association between age cohort and the cognitive, reflective, and compassionate dimensions of wisdom, using an Iranian sample of 439 adults from three age cohorts: young (18-34), middle-aged (35-54), and older (55 and above). Results indicated that the interaction effect between gender and age cohort was significant for three-dimensional wisdom and all three wisdom dimensions. Compared with younger women and older men, older women tended to have less education and to score lower on the cognitive wisdom dimension, but they had similar average scores as older men on the compassionate wisdom dimension. Overall, the association between age and wisdom was only positive for men, due mainly to the positive relation between age and the reflective and compassionate wisdom dimensions for men after adjusting for education. The results are interpreted with reference to generation gaps, socialization of men versus women, and life experiences and opportunities.

Resistant Strains of Enterotoxigenic Staphylococcus aureus; Unknown Risk for Multiple Sclerosis Exacerbation

Background:

Despite all advances in neurological sciences, there are unknown aspects in the epidemiology of multiple sclerosis (MS). Based on this hypothesis, the enterotoxigenic strains of Staphylococcus aureus (S. aureus) are possible risk factors for exacerbations of MS.

Objectives:

The present study was carried out to investigate the role of resistant strains of enterotoxigenic S. aureus in MS exacerbation.

Materials and Methods:

Two-hundred nasal swab samples were collected from non-MS (n = 80), MS stable (n = 60) and MS exacerbation (n = 60) groups. Samples were cultured and those that were S. aureus-positive were analyzed for the presence of enterotoxins, using polymerase chain reaction (PCR). Antimicrobial susceptibility was performed using disk diffusion method.

Results:

Ninety out of 200 nasal samples (45%) were positive for S. aureus. The highest levels of nasal colonization were seen in MS exacerbation group (68.33%). The most commonly detected enterotoxins were sea (30%), sec (15.55%) and seb (11.11%). There were significant differences between S. aureus colonization and type of samples (P = 0.026) and, also, between type of samples and prevalence of enterotoxins (P = 0.022). The highest levels of enterotoxigenic genes were seen in MS exacerbation group. The S. aureus strains had the highest levels of resistance against tetracycline (80%), ampicillin (72.22%), methicillin (66.66%), erythromycin (66.66%), oxacillin (63.33%), trimethoprim-sulfamethoxazole (61.11%) and cotrimoxazole (55.55%).

Conclusions:

Our findings should raise awareness about the role of sea and sec enterotoxins, in resistant strains of S. aureus, as a risk factor for MS exacerbation. It is better to keep MS patients away from polluted environments of hospitals and health centers.

High doses of garlic extract significantly attenuated the ratio of serum LDL to HDL level in rat-fed with hypercholesterolemia diet

Background

Hypercholesterolemia is associated with an increased risk of heart disease. In this study, we investigated the antihyperlipidemic effects of garlic (Allium sativum L.) in rat models of hypercholesterolemic.

Methods

Wistar male rats were randomly divided into 4 diet groups with garlic supplementation. Male Wistar rats were fed by standard pellet diet (group I), standard diet supplemented with 4 % garlic (group II), lipogenic diet (containing sunflower oil, cholesterol and ethanol) equivalent to 200 mg raw garlic/kg body weight (raw) (group III) and lipogenic diet equivalent to 400 mg raw garlic/kg body weight (raw) (group IV).

Results

Rats fed 400 g/kg garlic extract(GE), had a significantly lower concentration of serum low-density lipoprotein cholesterol (LDL-C) cholesterol and elevated HDL –C cholesterol at day 28 (P < 0.05).In addition,serum levels of LDL-C was lower in the III and IV group than those in the IV group (P < 0.001 for each). However, cholesterol efflux capacity was positively correlated with HDL cholesterol concentration (P < 0 · 0001). It was also directly correlated with garlic supplementation (P < 0 · 0001).

Conclusion

Together Taken, the results are clearly indicative of the beneficial effects of garlic in reducing lateral side effects of hyperlipidemia. Our data demonstrate that GE has protective effects on HDL in rats with high LDL intake. Therefore, it could be used to remedy hypercholesterolemia with help reduce risk of coronary heart disease

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1834155749171141

Association between Hepatitis G and Unknown Chronic Hepatitis

Background:

Hepatitis G virus (HGV) is a hepatotrope virus with unknown importance. The genome of the virus has been detected in patients with acute or chronic non-A-E hepatitis, cirrhosis, and hepatocellular carcinoma. The aim of this study was to determine the association between hepatitis G and unknown chronic hepatitis.

Methods:

This case-control study was performed in Ebne-Sina military hospital in Hamadan, Iran. The cases were 35 military staff with unknown chronic hepatitis. The control group consisted of 59 healthy subjects who had normal levels of serum alanine aminoteransferase (ALT). The data were analyzed by SPSS, version18, using Fisher’s exact test, the Student’s t-test, and multivariate logistic regression analysis.

Results:

Only one patient in the case group (2.9%) tested positive for HGV antibodies, and no one was infected in the control group. There was no association between HGV infection and unknown chronic hepatitis in our study (P=0.37). A significant association was found between the male gender and unknown chronic hepatitis (OR=14.9, P=0.01).

Conclusion:

No association between HGV infection and unknown chronic hepatitis was found in our study, so it was not necessary to evaluate these patients for HGV infection.

A prospective randomized controlled trial of controlled passive mobilization vs. place and active hold exercises after zone 2 flexor tendon repair

PURPOSE

The rehabilitation program after flexor tendon repair of zone II laceration varies. We designed a Prospective Randomized Controlled Trial of controlled passive mobilization (modified Kleinert) vs. Place and active hold exercises after zone 2-flexor tendon repair by two-strand suture (Modified kessler).

METHODS

Sixty-four fingers in 54 patients with zone 2 flexor tendon modified Kessler repairs were enrolled in a prospective randomized controlled trial comparing place and active hold exercises to controlled passive mobilization (modified Kleinert). The primary outcome measure was total active motion eight weeks after repair as measured by an independent and blinded therapist.

RESULTS

Patients treated with place and active hold exercises had significantly greater total active motion (146) eight weeks after surgery than patients treated with controlled passive mobilization (114) (modified Klinert). There were no ruptures in either group.

CONCLUSIONS

Place and hold achieves greater motion than controlled passive mobilization after a two-strand repair for zone 2 flexor tendon repairs.

Investigation of subwavelength grating structure for enhanced surface plasmon resonance detection

A metallic subwavelength grating structure built on a thin gold film is studied for surface plasmon resonance (SPR) detection of refractive index variations of biological buffer solutions. By employing finite element analysis as a numerical method, characteristics of the angle interrogated SPR sensor were calculated and discussed in a broad operating wavelength varying from visible to near-infrared (NIR). The effects of grating structural parameters such as grating depth, grating period, and grating fill factor in different operating wavelengths have been evaluated on the sensor performance parameters of sensitivity, full width at half-minimum, minimum reflectance at resonance, and resonance angle. Numerical results indicate that adjusting grating geometrical parameters can enhance the performance parameters of the sensor especially in the NIR wavelengths. The enhanced sensor performance parameters for optimizing grating geometry have been explored in detail for visible and NIR wavelengths of 633 and 984 nm, respectively. These findings are important for developing localized surface plasmon sensors with enhanced performance.

Design study of nanograting-based surface plasmon resonance biosensor in the near-infrared wavelength

A key issue with surface plasmon resonance (SPR) biosensors, which are the focus of many researchers, is improving their sensitivity to detect lower amounts of analyte in a solution. Most SPR developments have focused on the grating-based sensitivity-enhancement approach. In addition to sensitivity, a substantial enhancement of other sensor characteristics such as resolution and signal-to-noise ratio (SNR) is desired for designing a practical sensor. So, in this paper, the characteristics of surface plasmon polaritons sustained by 1D subwavelength metallic gratings on a thin metal slab (under the Krestchmann configuration) have been investigated numerically for the analyte-ligand interactions detection. Effects of different structural parameters, such as grating period, grating depth, metal film thickness, and fill factor have been evaluated on the sensor sensitivity as well as resolution and SNR. Numerical results indicate that the sensor working in the near-infrared wavelength has a better performance than that in the visible one. The result of numerical investigation has been used to design an optimized sensor with the best figure of merit.

Evaluation of Non Diseased Specified Outcome Measures in Hand Injuries to Assess Activity and Participation Based on ICF Content

The objective of the study is to provide information about non disease specified outcome measures which evaluate disability in patients who have impairments in hand and upper extremity and to find the extent to which they are evaluating "disability" based on ICF hand Core Set (activity limitation and participation restriction). MEDLINE, CINAHL, GOOGLE SCHOLAR , OVID and SCIENCE DIRECT databases were systematically searched for studies on non disease specified outcome measures used to evaluate upper extremity function; only studies written in English were considered. We reviewed titles and abstracts of the identified studies to determine whether the studies met predefined eligibility criteria (eg, non disease specified out come measures used in hand injured patients). All the outcome measures which had eligibility included. After full text review ,7 non disease specified outcome measures in hand were identified. Studies were extracted, and the information retrieved from them. All the outcome measures which had incuded, were linked with ICF hand core set disability part (activity and participation). All of them only linked to 16 (42 %) components of ICF hand Core Set, which were most activity and less participation from ICF. None of the non disease specified out come measures in hand injuries cover all domains of disability from the ICF Hand Core Set.

Construct Validity and Factor Structure of the Persian Occupational Self-Assessment (OSA) With Iranian Students

This study aimed to investigate construct validity and factor structure of the Persian Occupational Self-Assessment (OSA; Baron, Kielhofner, Iyenger, Goldhammer, & Wolenski, 2003 ) based on the model of human occupation (MOHO). Three hundred and thirty-six (179 male and 157 female) Iranian junior high students were measured using the OSA. The data were analyzed using a Confirmatory Factor Analysis (CFA) and the Rasch Rating Scale Model (RSM). In combination, the CFA and RSM results provided strong evidence for the construct validity of the Persian version. The CFA indicated that the hypothesized second-order model could explain the relationship of the OSA items to the latent variables of occupational competence and value for occupations. However, RSM item hierarchies did not replicate those found in previous international studies.

High performances III-Nitride Quantum Dot infrared photodetector operating at room temperature

In this paper we present a novel long wave length infrared quantum dot photodetector. A cubic shaped 6nm GaN quantum dot (QD) within a large 18 nm Al(0.2)Ga(0.8)N QD (capping layer) embedded in Al(0.8)Ga(0.2)N has been considered as the unit cell of the active layer of the device. Single band effective mass approximation has been applied in order to calculate the QD electronic structure. The temperature dependent behavior of the responsivity and dark current were presented and discussed for different applied electric fields. The capping layer has been proposed to improve upon the dark current of the detector. The proposed device has demonstrated exceptionally low dark current, therefore low noise, and high detectivity. Excellent specific detectivity (D*) up to approximately 3 x 10(8)CmHz(1/ 2)/W is achieved at room temperature.

Apexification of non-vital pre-molar stemming from possible dens evaginatus

Dens evaginatus is a dental anomaly that occurs more commonly in pre-molar teeth. Although not a cause for alarm in most instances, it can lead to serious consequences if it is damaged. This paper explores the treatment of a necrotic pre-molar with an open apex that caused serious facial swelling in an adolescent patient. It is believed that this swelling was the result of an enamel tubercle, or dens evaginatus, which was knocked off or traumatized.

Type of cell death and the role of acetylcholinesterase activity in neurotoxicity induced by paraoxon in cultured rat hippocampal neurons

Organophosphate (Ops) neurotoxicity is attributed both to its well-known cholinergic and non-cholinergic effects. In the present study we compared enzymatic and morphologic changes in neurons exposed to paraoxon during one day and one week. The effect of exposure time is important in neurotoxicity of Ops. The longer the exposure time is the more damage is observed in neurons, although there are few investigations about the effect in the post-exposure period. Hippocampal cells were obtained from rat neonates and cultured in Neurobasal/B27. Paraoxon at 50 and 100 microM were added. Inverted microscope and electron microscope were used to study cell morphology and Neutral Red staining was used to measure viability. We also assayed caspase-3 and (acetylcholinesterase) AChE activity. Hoechst staining was utilized to determine the type of cell death. Culture medium was replaced after 24 h in one-day group, however, tests were all carried out at the end of the first week in both group. The results indicate that paraoxon reduced the viability in a dose-dependent manner. Our results do not confirm apoptosis in either group; it seems that the cell death in one-day exposure group was not AChE dependent. In conclusion, present data imply that the toxicity of paraoxon is both dose and duration dependent, which may even remain after the cessation of exposure.

Modeling and simulation of ammonia removal from purge gases of ammonia plants using a catalytic Pd-Ag membrane reactor

In this work, the removal of ammonia from synthesis purge gas of an ammonia plant has been investigated. Since the ammonia decomposition is thermodynamically limited, a membrane reactor is used for complete decomposition. A double pipe catalytic membrane reactor is used to remove ammonia from purge gas. The purge gas is flowing in the reaction side and is converted to hydrogen and nitrogen over nickel-alumina catalyst. The hydrogen is transferred through the Pd-Ag membrane of tube side to the shell side. A mathematical model including conservation of mass in the tube and shell side of reactor is proposed. The proposed model was solved numerically and the effects of different parameters on the rector performance were investigated. The effects of pressure, temperature, flow rate (sweep ratio), membrane thickness and reactor diameter have been investigated in the present study. Increasing ammonia conversion was observed by raising the temperature, sweep ratio and reducing membrane thickness. When the pressure increases, the decomposition is gone toward completion but, at low pressure the ammonia conversion in the outset of reactor is higher than other pressures, but complete destruction of the ammonia cannot be achieved. The proposed model can be used for design of an industrial catalytic membrane reactor for removal of ammonia from ammonia plant and reducing NO(x) emissions.