Reduction of current migraine headache pain following neck massage and spinal manipulation.

BACKGROUND: Migraine headache significantly impacts the health of individuals and of society. The application of simple physical nonpharmacological techniques could greatly reduce the therapeutic costs and side effects in acute onset of such headaches. METHODS: Ten male patients (mean age was 32.0 ± 10.59 years) with acute onset of a migraine headache according to IHS-2004 diagnostic criteria were enrolled in the study. Neck and upper thoracic spine massage and manipulation technique was performed. Headache pain intensity was assessed before and after the intervention by means of a verbal analog scale. RESULTS: Following treatment, headache pain intensity was significantly reduced compared to the pretreatment values (1.85 ± 1.11 vs. 5.80 ± 2.25, p = .005). As a percentage, this represents a mean pain reduction of 68.77% ± 18.56. No side effects were observed, and all of the patients reported satisfaction with the intervention. CONCLUSION: Our results show that the applied cervical and upper thoracic massage and manipulation technique could reduce the headache attack pain intensity in patients with migraine headaches, though further testing, including study designs that make use of control groups, is needed.

Screening people with type 2 diabetes at risk for foot ulceration in Iran.

BACKGROUND: Foot screening is one of the most effective means of preventing foot complications in diabetes. Therefore the aim of this study was to perform a screening program for people with type 2 diabetes at risk of foot complications. METHODS: Physical examinations consisting of vascular, neurological, musculoskeletal, and dermatologic examinations were performed. We used a Semmes-Weinstein monofilament and a 128-Hz tuning fork to test peripheral neuropathy. The study population was categorized based on Scottish Intercollegiate Guidelines into three groups of low, medium, and high risk for diabetes foot disease. RESULTS: Of a total of 148 people with type 2 diabetes, 4.7% had an active foot ulcer, and 41.9% were classed as low risk, 40.6% as medium risk, and 12.8% as high risk. CONCLUSIONS: Considering the potential of developing risk of foot disease in people with diabetes, it is recommended that foot screening should be performed by primary care practitioners and specialists to detect foot disease in an early stage. Foot screening program for people with diabetes should also be taken into account by health policy makers in national guidelines.

The effectiveness of foot care education on people with type 2 diabetes in Tehran, Iran.

AIM: The aim of this study was to evaluate the impact of a simple educational program on the knowledge and practice of people with type 2 diabetes in relation to the foot at risk in Tehran, Iran. METHODS: One hundred and forty-eight people with type 2 diabetes underwent a structured interview using a 32-item designed questionnaire (DiFoKaPS-32) about their knowledge of foot care standards in diabetes and their personal foot care behaviours. Each participant in the study received a single 20 min education session individually. The mode of the intervention was face-to-face. RESULTS: The applied educational intervention aimed at patients with type 2 diabetes has improved their knowledge and practice about diabetic foot care (P<0.0001 and P=0.011; Wilcoxon Signed Ranks test, respectively). Knowledge and practice scores were increased significantly after the education in the lean group (BMI < or =25) rather than the obese ones. CONCLUSIONS: In conclusion the findings of our study have shown that a simple face-to-face education is an effective and applied method to improve the knowledge about foot care. It has also shown that it could increase the motivation and change the behaviour of people with type 2 diabetes regarding their feet. In addition, the obese patients referring to a diabetic clinic need much more attentions and tighter care programs.

Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran.

INTRODUCTION: Appendicitis is the most common acute surgical condition of the abdomen. Age, sex and seasonal variations have been observed in many studies. To describe and find the possible differences in the epidemiology of acute appendicitis in Shahr-e-Rey, we carried out a retrospective study of all patients with acute appendicitis admitted to Shohadaay-e Haftom-e Tir hospital as it is the only hospital in this restricted part of Tehran. METHODS: Using hospital discharge abstract of patients who were admitted with the diagnosis of acute appendicitis from summer 1996 to spring 2004, we studied the demographic features, particularly age and sex, date of admission and final diagnosis of these patients. RESULTS: During the observation period, 1093 cases were admitted with the diagnosis of acute appendicitis. Of these, 74.4% were males and 6.1% were not actually an acute appendicitis. The age-specific incidence of acute appendicitis has different patterns in male and female. The incidence was highest in males aged 20-29 years whereas in females the highest incidence was observed in 10-19 years age group. A significant seasonal effect was also observed, with the rate of acute appendicitis higher in the summer months (p<0.006). The rate of false positive diagnosis was highest in the patients aged 0-9 years (p<0.0001). Of those correctly diagnosed, 85.5% had uncomplicated acute appendicitis; 8.3% had perforation; and others (6.2%) had acute appendicitis complicated with other situations. CONCLUSION: Appendicitis is more common in males, in those aged 20-29 years, and during the summer months. The age-specific incidence and sex ratio of acute appendicitis give the impression that epidemiologic features of acute appendicitis are different with worldwide data. However, the seasonal variation and false positive rate of acute appendicitis are in a good agreement with other studies.