Burden of care in primary caregivers of individuals with spinal cord injury in Iran: its association with sociodemographic factors.

STUDY DESIGN: A descriptive cross-sectional study. OBJECTIVES: The burden of care among primary caregivers of individuals with spinal cord injury (SCI) is affected by different factors. We aimed to evaluate the level of burden among caregivers and the association between the caregiver burden and sociodemographic factors of SCI individuals and their caregivers. SETTING: Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: The Zarit caregiver burden interview was used to evaluate the level of burden in caregivers through structured face-to-face interviews with 163 individuals with SCI, who were referred to receive outpatient rehabilitation, and their caregivers. RESULTS: The mean of caregivers' burden score was 38.9±15.2 and 11.7% reported no or little burden, 43.6% reported 'mild-to-moderate' burden, 33.1% reported 'moderate-to-severe' burden and 11.7% reported 'severe' burden of care. There was relationship between the level of injury (P=0.010) and occupational status (P=0.041) in SCI individuals and caregiver burden score. There was also a positive relationship between the caregiver burden score and duration of injury (r=0.176, P=0.025), the caregivers' age (r=0.350, P<0.001), and length of time that the current caregiver providing care (r=0.253, P=0.001). There was a negative relationship between the burden and caregiver's educational level (r=-0.235, P=0.002). CONCLUSIONS: The burden of care among the caregivers of SCI individuals is a multidimensional issue. The sociodemographic characteristics of individuals with SCI and their caregivers can affect the caregiver's burden. Many of these factors can be modified to reduce the burden of care.

Prostatic tumors in Iran.

1. Among all tissue examinations, 8.6% were on male urogenital organs, of which 2.9% were for carcinoma of the prostate. Biopsies of the prostate comprised a large percentage of all male urogenital biopsies. Since the specimens examined by various pathological laboratories in Tehran were received from all over the country, comparison of these statistics is significant. 2. Male urogenital tumors comprised 6.7% of male biopsies, of which 2.7% were for tumors of the prostate. 3. Male urogenital cancers comprised 2.3% of biopsies examined, of which only four were prostatic carconomas. Carcinoma of the prostate was the rarest cancer of the male urogenital organs in Iran. 4. We found 933 cases of cancer of male urogenital organs in 31 years. This comprised 6% of all male cancers, of which only 0.33% were carcinoma of the prostate. 5. Bladder carcinomas were the commonest and prostate carcinomas the rarest among males. 6. We found that 97% of prostate tumors were benign and 3% were malignant. Prostatic carcinoma was four times more prevalent among high income patients than among low income patients. 7. Benign tumors were most common in the 40 to 70 age groups, whereas the peak incidence for carcinoma of this organ was 50 to 70 years of age. 8. No particular clinical symptoms were found. Most patients reported pollakiuria, dysuria or urinary retention. 9. The initial growth site of tumors in the few cases that we were able to study was in the cortex region, especially from the posterior lobe. 10. Histological types of tumor found did not differ from other figures reported. We found no sarcomas. 11. No systematic study of asymptomatic nodules of carcinoma of the prostate has been made and we have never found any signs of such solitary nodules. This may be due to the low average age and the rarity of malignancy of the prostate in Iran. 12. The frequency of death in Iran due to carcinoma of the prostate is impossible to state since death certificates, in the majority of cases, specify secondary symptoms of the disease and not the original disease. 13. The incidence of prostatic carcinoma in the provice of Fars was five times greater and in Isfahan four times greater than in the province of Tehran. However, the figures for Tehran were compiled over the last 31 years, whereas the figures for Isfahan and Shiraz are only for the last ten years, and comparison of these three sets of figures may not be accurate. 14. Carcinoma of the prostate is not as common in Iran as it is in Europe and America. It is rather rare in Iran and compares favorably with figures for the Near Eastern and Far Eastern countries. The Middle Eastern countries of Lebanon, Israel and Afghanistan are very similar in incidence to Iran. In other countries in our region, the incidence is 1.8%.

Reinforcement of unsupported enamel by restorative materials and dentin bonding agents: an in vitro study.

OBJECTIVE: Preservation of unsupported occlusal enamel after removal of underlying carious dentin may result in maintenance of aesthetics as well as wear resistance against the opposing enamel. This study investigates the influence of different restorative materials and bonding agents on reinforcement of unsupported enamel in molars and compares it with sound dentin. MATERIALS AND METHODS: In this in vitro study, forty- five extracted human molars were selected and randomly divided into five groups of nine. All lingual cusps were cut off. The dentin underlying the buccal cusps was removed in all groups except the positive control. The negative control group received no restorations. After application of varnish and Panavia F, spherical amalgam (Sina) and after application of Single-Bond (3M), composite resin (Tetric Ceram) was used to replace missing dentin. All specimens were thermocycled, then mounted in acrylic resin using a surveyor. Lingual inclination of facial cusps was positioned horizontally. Load was applied by an Instron machine at a crosshead speed of 10 mm/min until fracture. Data were subjected to ANOVA (one way) and Post hoc Test (Duncan). RESULTS: Statistically significant differences were found between the five groups (P<0.001); however, no significant difference was revealed between bonded amalgam and the positive control groups (P=0.762). Composite and amalgam had the same effect (P=0.642), while the composite and negative group had no significant difference (P=0.056). CONCLUSION: Bonded amalgam systems (Panavia F) could reinforce the undermined occlusal enamel effectively.