Balance measures of mini and brief balance evaluation system tests for Iranian population.

Introduction: Falling is a serious problem for all ages. There are several tests to assess balance. Mini-BESTest and brief-BESTest are balance tests for which there are no normative values for Iranian people. We aimed to provide the normative values of mini-BESTest and brief-BESTest among healthy Iranian adults. Methods: A cross-sectional study was designed. Three hundred healthy adults (150 males and 150 females) in six age groups (18-29, 30-39, 40-49, 50-59, 60-69, +70 years) completed the tests using Persian mini-BESTest and brief-BESTest. Normative values were calculated for age groups. Results: Normative values of mini-BESTest and brief- BESTest decreased significantly with age (from 27 to 21.9 for mini-BESTest and from 22.9 to 15.4 for brief BESTest). There were no significant differences between genders except for females in 30-39 and 40-49 years age groups which scored better on brief-BESTest and mini-BESTest, respectively. Males had significantly scored better in brief- BESTest in 60-69 and ≥ 70 age groups. Conclusions: The normative values of the mini-BESTest and brief-BESTest provided for healthy Iranian adults can help clinicians when assessing subjects with balance dysfunction.

Normative values of functional reach test, single-leg stance test, and timed "UP and GO" with and without dual-task in healthy Iranian adults: A cross-sectional study.

Background: Balance impairment is a common problem in all age groups. There are several tools to assess balance. Functional reach test (FRT), single-leg stance (SLS) test, timed up and go (TUG) test, and TUG with the cognitive dual-task (TUGcog) are commonly employed balance tests. The current study aimed to determine the normative values of FRT, SLST, TUG, and TUGcog across age groups and genders in healthy Iranian adults. Methods: We designed a cross-sectional study, and 240 healthy adults (120 males and 120 females) in six age groups (18-29, 30-39, 40-49, 50-59, 60-69, ≥70 years) completed FRT, SLST, TUG, and TUGcog based on the Persian version of BESTest instructions. Results: There were significant age-specific declines in balance performances. Gender had effects on 18-29 years and older adults (≥60 years), and males performed better than females. Male and females had similar performance on the TUG and TUGcog tests in 60-69 years (p > 0.05). Conclusions: The normative values of FRT, SLS, TUG, and TUGcog provided for healthy Iranian adults increase the clinical utility of tests, and serve as a reference to estimating the individuals' balance performance across age and gender groups.

The trend of fall-related mortality at national and provincial levels in Iran from 1990 to 2015.

Falls are one of the major causes of unintentional injuries. Understanding the epidemiology of fall-related mortality helps to identify the root causes of this event and planning preventive strategies to inhibit falls. The aim of this study was to assess the trend of fall-related mortality rate and its epidemiological patterns based on sex and age-groups at national and subnational levels in Iran during the years 1990 to 2015. All data were gathered from Death Registration Systems, cemetery databases of Tehran and Isfahan, the Demographic and Health Survey of 2000 and three rounds of national population and housing censuses. The age-standardized death rate (ASDR) due to falls per 100,000 people decreased from 2.61 (95% Uncertainty Interval (UI): 1.94-3.51) in 1990 to 2.13 (1.62-2.80) in 2015 at national level. Males were at higher risk of death due to falls than females. Our data showed that the elderly population was at higher risk of death due to falls and individuals less than 4-year old had the highest fall-related mortality rate among children and adolescents. Our data should be used to accelerate interventions to reduce fall-related mortality.

Management of a Penetrating Thoracic Injury with Thoracoscopy; A Case Study.

INTRODUCTION: Various strategies could be considered dealing with penetrating thoracic injuries. Thoracoscopy is much less invasive than routine thoracotomy approach for managing such cases in which the sharp object remains in the body. The case presented in this article was managed with thoracoscopy for a penetrating dorsolateral thoracic injury. CASE PRESENTATION: A 35-year-old man with a penetrating dorsolateral thoracic injury referred to the emergency department. Despite an elevated pulse rate, the patient has proper blood pressure and O2 saturation. Considering the patient's stability and the results of imaging which did not show any massive vascular injury, the patient was taken to the operation room for thoracoscopy. At thoracoscopy, we saw 4 cm of the blade in the thoracic cavity between the third and fourth intercostal space. There was a mild laceration of lung tissue without any active bleeding. Considering the position of the blade and the absence of active bleeding and vascular injury at the trauma site, we successfully removed the blade by the thoracoscope without any complications. CONCLUSION: Our experience of removing a retained knife by thoracoscopy showed that it can be an appropriate alternative for patients with penetrating thoracic injury who are hemodynamically stable and have appropriate conditions for thoracoscopy.

Acute Gastric Dilation Following Trauma: A Case Report.

INTRODUCTION: Acute gastric dilation following trauma is an unusual event that can occur in different settings, and can cause gastric necrosis as a rare though fatal condition. The present report involves a case of acute gastric dilation following multiple traumas, which caused gastric necrosis and total gastrectomy. CASE PRESENTATION: A 19-year-old morbid obese male presented to the emergency department (ED) following a motor vehicle accident.He had a left lower extremity crash injury. In his serial examinations, he was complaining of upper abdominal pain with epigastric tenderness. After nasogastric tube (NGT) reinsertion, due to detecting coffee ground secretions in the drained fluid, the patient was transferred to the operating room.A midline laparotomy was performed that revealed dilation and discoloration of the stomach. Gastric decompression was performed. All the discoloration then disappeared except for that of certain suspicious areas, which necessitated evaluations. On the following day, given the lack of improvement in the patient`s condition, he was transferred to the operating room for a second laparotomy. CONCLUSION: The present report emphasized on the importance of NGT insertion in multiple-trauma patients, which is, however, neglected in many cases. Moreover, acute gastric dilation is recommended to be considered in the differential diagnosis of patients with multiple or abdominal trauma and complaints of vomiting or abdominal pains.

Comparison of Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Sleeve Gastrectomy on Weight Loss, Weight Regain, and Remission of Comorbidities: A 5 Years of Follow-up Study.

BACKGROUND: This study was conducted to evaluate the amount of weight loss and weight regain and also remission rate of obesity-related comorbidities including diabetes mellitus (DM), hypertension (HTN), and dyslipidemia in patients who underwent LRYGB or LSG during 5 years of follow-up. METHODS: A total of 120 patients who underwent LRYGB or LSG from 2011 to 2013 were enrolled and followed-up for 5 years. Changes in weight, body mass index (BMI), percent weight loss (%WL), and percentage of excess weight loss (%EWL) were recorded. RESULT: %WL and %EWL were similar between two procedures at 1 year following operation. In patients who underwent LSG, %WL and %EWL were 24.6 ± 1.3% and 61.9 ± 3.5%, respectively, and in LRYGB were 30.4 ± 1.3% and 79.4 ± 3.6%, respectively, 5 years after surgery. Weight regain was 32.0% in LSG and 9.3% in LRYGB after 5 years. The remission rate of diabetes mellitus, hypertension, and dyslipidemia was 70%, 54%, and 100%, respectively, after 5 years of surgery. CONCLUSION: Comparing the 5-year success rate of these two techniques, LRYGB seems to be superior to LSG, with lower weight regain and higher weight loss. The short- and long-term effects of two procedures on remission of comorbidities were comparable.