Comparing the effects of 5-minute premature infant oral motor intervention with 15-minute Fucile treatment in term infants with feeding difficulties: A multi-arm randomised clinical trial

PURPOSE

The aim of the present study was to investigate whether term infants with feeding difficulties who received either a 5-minute premature infant oral motor intervention (PIOMI) or a 15-minute Fucile treatment had different outcomes, compared to term infants in a nontreatment group.

METHOD

Stable term infants (N = 51) born between 37-41 weeks of gestational age with feeding difficulties were randomly assigned into one of two intervention groups and a control group. One intervention group received PIOMI and the other group received Fucile treatment once a day for seven consecutive days; the control group received usual care only. The volume of milk intake, the amount of weight gain, and the length of hospital stay were compared across all groups.

RESULT

Findings indicated that the volume of milk intake and weight gain showed significant improvement in all three groups. However, pairwise comparison revealed that infants in the Fucile group had significantly higher volume of milk intake and weight gain compared to infants in both the control and PIOMI groups. Length of hospital stay was not significantly different amongst all groups.

CONCLUSION

The effects of Fucile treatment were more considerable than for usual care or PIOMI. This finding raises the possibility that prolonged exercise may facilitate improvement in feeding skills for term infants with feeding difficulties.

Pragmatic features in patients with schizophrenia

Schizophrenia is a heterogeneous disorder. Despite the fact that communication and language skills may be impaired in schizophrenia, only a few studies have examined specific aspects of pragmatic competence in these patients. Therefore, this study aimed to compare the pragmatic skills of schizophrenic patients and a control group. Forty-three schizophrenic patients with a Mean ± SD age of 40 ± 1.21 years old and a control group were assessed using the Adult Pragmatics Profile (APP), which is a validated tool consisting of three scales: verbal, nonverbal and paralinguistic. The participants in the schizophrenia group demonstrated significant impairments in pragmatic abilities compared to the participants in those the control group. The most remarkable difference was in the nonverbal scale (5.00 ± 1.09), while the lowest difference was seen in the verbal scale (18.30 ± 3.91). Within the nonverbal subscales, eye contact was the most impaired. Schizophrenic patients presented with impairments in their pragmatic skills (verbal, nonverbal and paralinguistic). As pragmatic skills play a paramount role in social communication, it is of great significance to address these impairments to enhance patients' quality of life.

The Association between Depression Severity, Prosody, and Voice Acoustic Features in Women with Depression

The aim was to define the association between the severity of depression, prosody, and voice acoustic features in women suffering from depression and its comparisons with nondepressed people. Prosody and acoustic features in 30 women with major depression hospitalized in a psychiatric ward and 30 healthy women were investigated in a cross-sectional study. To define the severity of depression, the Hamilton Rating Scale for Depression (HRS-D) was applied. Acoustic parameters such as jitter, shimmer, cepstral peak prominence (CPP), standard deviation of fundamental frequency (SD F0), harmonic-to-noise ratio, and F0 and also some speech prosodic features including the speed of speech, switching pause duration means, and durations of produced sentences with different modals were measured quantitatively. Also, six raters judged the patient's prosody qualitatively. SPSS V.28 was used for all statistical analyses (p < 0.05). There was a significant correlation between HRS-D with jitter, SD F0, speed of speech, and switching pause means (p ≤ 0.05). The means of CPP and duration of producing emotional sentences differed between the depression and control groups. The HRS-D scores were significantly correlated with switching pauses in patients (Pearson coefficient = 0.47, p=0.05). The results of the perceptual evaluation of prosody judged by six raters showed an 85% correlation between them (p ≤ 0.001). Some acoustic and prosodic parameters are different between healthy women and those with depression disorder (e.g., CPP and duration of emotional sentences) and may also have an association with the severity of depression (e.g., jitter, SD F0, speed of speech, and switching pause means) in women with depression disorder. It was indicated that the best sentence modal to assess prosody in patients with depression would be exclamatory ones compared to declarative and interrogative sentences.

Dysphagia following cerebellar stroke: analyzing the contribution of the cerebellum to swallowing function

Swallowing is essential for human health, and the cerebellum is crucial for motor movement regulation. Cerebellar strokes may cause dysphagia, but their exact effects remain unexplored in swallowing function. Therefore, the aim of this study was to analyze the precise clinical characteristics of the oral and pharyngeal phases of swallowing after cerebellar stroke and to critically discuss the cerebellum's contribution to swallowing. The study involved 34 participants with cerebellar strokes, gathered through convenience sampling. Neurologists diagnosed isolated strokes, and a speech and language pathologist examined swallowing ability using the Mann Assessment of Swallowing Ability. The study found that 52.9% of people experienced dysphagia after a cerebellar stroke. Dysphagia was significantly associated with a higher risk of aspiration. Age was also significantly correlated with dysphagia. No significant correlation was found between swallowing ability and sex. In conclusion, this study suggests isolated cerebellar stroke can adversely affect the motor and non-motor aspects of swallowing and cause severe dysphagia and aspiration risk. Thus, early diagnosis and timely management of dysphagia following a cerebellar stroke can help prevent serious consequences.

The impact of subcortical stroke-related aphasia on executive functions and working memory

Aphasia is a common post-stroke disorder characterized by impairments in speaking, listening, reading, and writing. Although cognitive impairments have been well studied in cortical aphasia, deficits associated with subcortical aphasia remain to be elucidated. The current study aimed to assess executive functions (EF) and working memory (WM) in patients with subcortical aphasia, and investigate the relationship between language abilities and cognition deficits. Participants of this research included patients with thalamus lesions (n = 9; mean age = 53.89 years) and healthy individuals (n = 9; mean age = 54.33 years). Assessment materials were the Mini-Mental State Examination (MMSE), Persian Western Aphasia Battery (P-WAB-1), digit span subtest of Adult Wechsler Test (WAIS-R), and Wisconsin Card Sorting Test (WCST). Obtained results revealed significant differences in all components of EF, as well as in WM forward and backward digit spans between patients and healthy individuals. However, investigating the relationship between MMSE and AQ scores and components of EF and WM revealed no significant difference. In conclusion, the findings of the present research indicated defects in cognitive functions, including WM and EF, in patients with subcortical stroke. Accordingly, it is crucial to provide optimal rehabilitation therapies for the improvement of language and cognitive problems upon subcortical aphasia.

Rehabilitation Registration Systems: Current Recommendations and Challenges

Introduction: In recent decades, following the upward trend of aging, one out of three people in the world need rehabilitation services during the period of illness or injury. Considering the long-term complications and high costs of treatment, the need to follow up and review the evidence to find the best care programs and extensive planning in this field seems mandatory. Registry systems (registration) in this area can provide the necessary evidence for strategic decisions in this field. Of course, launching and developing these systems comes with challenges. Therefore, the purpose of this comprehensive literature review is to examine the challenges and benefits of developing a rehabilitation registration system.Materials and Method: A systematic review, in studies published in English, without time limit and by searching for keywords in the keywords, title and abstract of reliable scientific databases Web of Science, Scopus, PubMed and Science Direct, as well as searching the title of studies in the database Cochrane data was accessed on March 31, 2021. Studies that were a possible answer to the researched question based on the title and content were examined. A total of 1924 related studies were identified; And finally, 32 qualified articles were included in this review.Results: One of the most important challenges investigated was the limitation of rehabilitation comprehensive registration systems. Other challenges include the lack of support for ensuring the quality of registration data, insufficient funds for investment, privacy and data security, the unclear purpose of registration system development, access to hardware infrastructure, lack of binding laws and regulations related to registration systems, lack of access to sufficient information. To implement information registration systems, continuous monitoring and holding training courses.Conclusion: The most important challenge investigated was that currently the health care and rehabilitation registration systems around the world are focused on single diseases (single discipline rehabilitation), which does not meet the needs of patients due to the multifactorial nature of rehabilitation services and chronic diseases. Therefore, it seems that the connection between the data registration systems with the help of a comprehensive guideline or model or the creation of a national integrated central database in the form of integration with other health information systems and based on electronic health records will be very efficient.

The acoustic voice quality index, version 2.06 and 3.01, for the Persian-speaking population

INTRODUCTION

Dysphonia assessment includes approaches like acoustic analysis, which is non-invasive and easy to use and provides an understandable numerical output. The Acoustic Voice Quality Index (AVQI) is an acoustic model that can detect dysphonia. The Persian language is spoken by around 70,000,000 native speakers. Since AVQI versions 2.06 and 3.01 have not been validated for the Persian yet, this study investigated their concurrent validity and diagnostic accuracy among the Persian-speaking population.

METHODS

This scale development study was conducted from 2020 to 2021 on 180 normophonic and dysphonic native Persian-speaking residents of Mashhad, Iran. Five raters rated the samples by auditory-perceptual-judgments, including Grade from the Grade-Rough-Breathy-Asthenic-Strained (an ordinal scale) and the overall dysphonia severity from the Persian version Consensus Auditory Perceptual Evaluation of Voice (a continuous scale) to investigate both versions' concurrent validity. The intra- and inter-rater reliability and concurrent validity were evaluated for both scales. Both versions' diagnostic accuracy was assessed by the receiver operating characteristic, and the optimal thresholds were determined.

RESULTS

AVQI-version-2-Persian thresholds of 3.47 and 4.04 provided sensitivity of 88.30% and 85.53% and specificity of 79.07% and 85.58% by the ordinal and continuous scales, respectively. AVQI-version-3-Persian thresholds of 3.07 and 3.03 also rendered sensitivity of 74.47% and 85.53%, and specificity of 97.67% and 91.35% by the ordinal and continuous scales sequentially.

CONCLUSION

The significant values of concurrent validities and diagnostic accuracies of both versions of AVQI-Persian confirmed that it can discriminate between normal and pathological voices among the Persian-speaking population. Hence, it can be used for screening or diagnosis purposes.

Dysgraphia and dysprosody in a patient with arteriovenous malformation: a case report

Arteriovenous malformation (AVM) results from development of abnormal connections between veins and arteries. This study reported anAVM case suffering from dysgraphia and dysprosody. According to the results after the trauma, the patient's handwriting was identified as macrographic and illegible, and written letters and verbs were neglected in free writing or dictation. Moreover, prosody of the patient's utterances was changed. Finally, an intervention was conducted to improve the writing impairments whereby they eventually enhanced. AVM can adversely affect communication opportunities and working life due to these impairments. Thus referring the patient to speech and language pathologists seems sensible and necessary.

A Comparison of Language Features Between Patients With Alzheimer Disease and Their Healthy Counterparts

Introduction: Alzheimer Disease (AD) is a neurological disorder associated with the progressive damage of memory and problems in communication and language skills. The examination of language in AD was less studied; therefore, this research aimed to compare linguistic characteristics between AD patients and their healthy counterparts.Materials and Methods: A total of 32 patients with AD (16 women and 16 men) with an Mean±SD age of 77±7.41 years, and their healthy peers (19 women and 13 men) with an Mean±SD age of 81.34±6.04 years participated in this study. Both groups were evaluated with the Persian bedside version of western aphasia battery. The results were assessed by the Independent t test. The significance level was set at less than 0.05.Results: The mean scores of each test and the general criterion for the adversity quotient index were significant between the two groups (P<0.001). The highest difference was in continuous and naming indices, and the least difference was seen in the repeat index.Conclusion: The AD considerably affects all oral language skills; therefore, patients are significantly weaker than healthy individuals.

Persian Translation, Validation and Reliability of the Voice Handicap Index-Throat (VHI-T)

OBJECTIVE

The aim of the present study is to validate, and assess the reliability of the Persian version of Voice Handicap Index-Throat (VHI-Tp) as a self-reported questionnaire for patients with throat problems that could make the patients' estimation of the throat discomforts possible. It is a subscale to be used independently.

STUDY DESIGN

This is a cross-sectional study.

MATERIALS AND METHOD

During this study, the VHI-Tp was administered to120 patients with throat problems related to laryngeal discomfort (51 male and 69 female, age range: 30-60 years).The diagnosis of Voice disorder was performed by an ENT physician based on video-laryngoscopy evidences and medical examination. To assess the content validity, the questions were first given to 15 experts to comment on content applicability and relevance through a Likert scale. Eighty patients rated its importance to detect face validity. To evaluate the concurrent validity, the same 80 patients completed both the VHI-Tp as well as the Persian version of Voice Symptom Scale. The VHI-Tp total scores of the patients with diagnosed throat problem related to laryngeal discomfort and of the 40 healthy participants were compared to test the clinical validity (discriminant validity). Also, internal consistency reliability was assessed using Cronbach α coefficient. The relative reliability was calculated by asking 40 of all patients out of the 80 participants, to complete the VHI-Tp twice, with a week of interval between the first and the second times. To detect the absolute reliability, Standard Error of Measurement and Smallest Detected Change were calculated.

RESULTS

Discriminative validity differed significantly between patients and healthy participants. There was a significant correlation between the VHI-Tp and Voice Symptom Scale total scores (r = 0.6, P < 0.05). The internal consistency was confirmed (Cronbach α = 0.78). The test-retest reliability was excellent (intraclass correlation coefficient = 0.95).The Standard Error of Measurement and Smallest Detected Changes were acceptable (0.39 and 1.08), respectively.

CONCLUSION

The Persian version of the VHI-T was demonstrated to be a valid and reliable self-rated questionnaire for use in Persian patients with throat problem related to laryngeal discomfort.

Contrast Sensitivity Abnormalities in Deaf Individuals

Purpose:

Hearing impaired children are heavily dependent on their sense of vision to develop efficient communication skills; any contrast sensitivity defect can negatively impact their lives because they are not able to use auditory stimuli to recognize probable dangers in the world around them. The purpose of this study was to determine the contrast sensitivity abnormalities in deaf individuals.

Methods:

In this cross-sectional study, contrast sensitivity of 15- to 20-year-old high-school boys with hearing disability from Tehran, Iran were evaluated. Sixty-four eyes were tested for contrast sensitivity and refractive error. All subjects had an intelligence quotient (IQ) >70. We investigated their contrast sensitivity with Vector vision CVS-1000 in 4 different spatial frequencies.

Results:

Profound hearing loss was noted in 50% of the subjects. The frequency of contrast sensitivity abnormalities in 4 different spatial frequencies varied between 51.6% and 65.6%. The largest abnormalities were recorded at 18 cycles per degree. Only 12.5% of deaf students had corrected distance visual acuity (CDVA) greater than zero (in LogMAR). The abnormalities in contrast sensitivity showed no correlation with the type or severity of hearing loss.

Conclusion:

Hearing impaired boys are at a greater risk for contrast sensitivity abnormalities than boys with normal hearing. The larger frequency of contrast sensitivity abnormalities in high spatial frequencies than in other frequencies may demonstrate greater defects in the central visual system compared with the periphery in individuals with hearing loss.

Pattern Visual Evoked Potentials in Dyslexic Children

PURPOSE

This study aimed to compare pattern visual evoked potential (PVEP) components in dyslexic and normal children.

METHODS

This cross-sectional analytic study recruited 72 children, including 36 dyslexic and 36 normal participants aged 8-12 years. Visual examinations included measurement of distance visual acuity, refraction, and PVEP components of amplitudes and latencies with two different check sizes of 15 and 60 minutes (min) of arc at two contrast levels of 25% and 100%.

RESULTS

Our results demonstrated significant differences between dyslexic and normal children in terms of P100 latency and amplitude of PVEP at 25% contrast, with check sizes of 15 and 60 min of arc. However, there were no significant differences between the two groups regarding P100 latency and amplitude at 100% contrast with check sizes of both 15 and 60 min of arc.

CONCLUSION

Dyslexic participants showed reduced amplitude and prolonged latency in most PVEP components at low-contrast levels. These findings may support the magnocellular deficit hypothesis in dyslexic participants, even though the parvocellular pathway remains intact.

Pattern Visual Evoked Potentials in Dyslexic versus Normal Children

Purpose:

Presence of neurophysiological abnormalities in dyslexia has been a conflicting issue. This study was performed to evaluate the role of sensory visual deficits in the pathogenesis of dyslexia.

Methods:

Pattern visual evoked potentials (PVEP) were recorded in 72 children including 36 children with dyslexia and 36 children without dyslexia (controls) who were matched for age, sex and intelligence. Two check sizes of 15 and 60 min of arc were used with temporal frequencies of 1.5 Hz for transient and 6 Hz for steady-state methods.

Results:

Mean latency and amplitude values for 15 min arc and 60 min arc check sizes using steady state and transient methods showed no significant difference between the two study groups (P values: 0.139/0.481/0.356/0.062). Furthermore, no significant difference was observed between two methods of PVEPs in dyslexic and normal children using 60 min arc with high contrast (P values: 0.116, 0.402, 0.343 and 0.106).

Conclusion:

The sensitivity of PVEP has high validity to detect visual deficits in children with dyslexic problem. However, no significant difference was found between dyslexia and normal children using high contrast stimuli.

The assessment of pragmatics in Iranian patients with right brain damage

BACKGROUND

Pragmatics is appropriate use of language across a variety of social contexts that provides accurate interpretation of intentions. The occurrence of the right hemisphere lesions can interfere with pragmatic abilities, and particularly with the processing of nonliteral speech acts.

METHODS

Since the objective of this study was to assess different aspects of pragmatic competence in the right hemisphere damage (RHD) patients, 20 Iranian patients with right hemisphere lesions were examined by adult pragmatic profile (APP) and a novel checklist was introduced for Persian language speaking individuals. Meanwhile, 40 healthy adult individuals, who were age and gender matched with RHD patients, were considered as the control group. After obtaining video records, all subjects were evaluated for 35 pragmatic skills, including 24 verbal, 5 paralinguistic, and 6 nonverbal aspects, by a two-point scale system.

RESULTS

Studying RHD patients and their healthy counterparts revealed that the performance by participants with right hemisphere lesions exhibited a high degree of inappropriate pragmatic abilities compared with controls in all domains. Furthermore, RHD patients showed a trend of increasing difficulty in understanding and producing different pragmatic phenomena, including standard communication acts.

CONCLUSION

Present results indicated that the right hemisphere lesions significantly affected pragmatic abilities in verbal, paralinguistic and nonverbal aspects. Such a pattern of performance, which is in line with deficits previously reported for RHD, proved the unquestioned role of the right hemisphere in processing nonliteral language.

Frequency and clinical patterns of stroke in Iran - Systematic and critical review

Background

Cerebrovascular disease is the second commonest cause of death, and over a third of stroke deaths occur in developing countries. To fulfil the current gap on data, this systematic review is focused on the frequency of stroke, risk factors, stroke types and mortality in Iran.

Methods

Thirteen relevant articles were identified by keyword searching of PubMed, Iranmedex, Iranian University index Libraries and the official national data on burden of diseases.

Results

The publication dates ranged from 1990 to 2008. The annual stroke incidence of various ages ranged from 23 to 103 per 100,000 population. This is comparable to the figures from Arab Countries, higher than sub-Saharan Africa, but lower than developed countries, India, the Caribbean, Latin America, and China. Similarly to other countries, ischaemic stroke was the commonest subtype. Likewise, the most common related risk factor is hypertension in adults, but cardiac causes in young stroke. The 28-day case fatality rate is reported at 19-31%.

Conclusions

Data on the epidemiology of stroke, its pattern and risk factors from Iran is scarce, but the available data highlights relatively low incidence of stroke. This may reflect a similarity towards the neighbouring nations, and a contrast with the West.