Oral health-related quality of life in patients with temporomandibular disorders: A case-control study considering psychological aspects.

OBJECTIVES: This case-control study aimed to compare patients with temporomandibular disorders (TMD) and healthy controls in terms of oral health-related quality of life (OHRQoL) considering Graded Chronic Pain Scale (GCPS) scores, pain duration, psychological impairment and demographic characteristics. METHODS: A total of 75 patients with TMD and 75 healthy controls were recruited. The short version of Oral Health Impact Profile (OHIP-14) was administered for evaluating the OHRQoL. Psychosocial impairments were assessed using the General Health Questionnaire-28 (GHQ-28). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I and II were also used for patient diagnosis and collecting GCPS scores, pain duration, age and gender. Independent-sample t tests, Pearson's chi-square tests and multiple logistic and linear regression models were applied for statistical analysis. RESULTS: The mean age of the patients was 34.3±12.4 years. A female-to-male ratio of 6:1 was seen in the TMD group. The prevalence and severity of the OHIP were significantly different between the TMD and control groups (66.7% vs 12.0% and 18.0 vs 9.2, respectively). According to multiple logistic regression for OHIP prevalence and multiple linear regression for OHIP severity in the TMD group, GCPS scores and pain duration, followed by psychological impairment, were the most important predictors of the OHRQoL. CONCLUSION: TMD negatively affected the OHRQoL, particularly in patients with psychological impairments. Meanwhile, age and gender did not seem to have a serious effect. Hence, promoting the quality of life of patients with TMD requires emphasis on chronic pain management and maintaining good mental health.

Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran.

STUDY DESIGN: A cross-sectional study. OBJECTIVES: This study was performed for epidemiological assessment of Iranian Traumatic Spinal Cord Injuries (TSCI), referred to a specialized spine center. SETTING: Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center, Tehran, Iran. METHODS: This study was performed from September 2011 to March 2015 on 1137 consecutive TSCIs. History, clinicoradiological findings as well as chronic complications and social integration were recorded. The capture-recapture method was used to calculate a rough estimation of TSCI prevalence in Tehran Province. RESULTS: Our report includes 1137 cases with a mean age of 29.1 years (s.d.=11.2 year)-79.2% of them being male (M/F=3.8/1). Rough estimation of TSCI prevalence in Tehran province was 2.36 per 10 000 population. Regarding etiology, 61.8% were due to motor vehicle accident (MVA), followed by falling 24.5%, heavy drop 5.2%, violence 3.8%, sport 2.8% and others causes 1.9%. Regarding injury level, 31.5% were cervical, 57.9% thoracic and 10.6% lumbar. Complete lesions were 53.5% of patients and 46.5% were incomplete. Most common neurological type was T1-S5 (American Spinal Injury Association Impairment Scale: A, B, C, 61.7%). Most common complications included urinary tract infection followed by pressure sore (grade III and IV, 37.5%), autonomic dysreflexia (37%) and neuropathic pain (31.2%). Substance abuse was observed in 8.8% of cases. Overall, ~25% in our cases were employed after TSCI. Secondary divorce was also much more frequent than normal matched controls. CONCLUSION: MVA was the most common cause for TSCI. The elderly subjects were less frequent among our patients than more developed countries. The high rate of unemployment and divorce in our cases deserves special consideration.

Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury.

STUDY DESIGN: Prospective study. OBJECTIVES: The objective of this study was to determine whether an integrated and an intensive outpatient program would result in functional improvement of spinal cord injury (SCI) patients with American Spinal Injury Association Impairment Scale (AIS) A injuries as measured by the Spinal Cord Independence Measure (SCIM III). SETTING: Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Repair Research Centre (BASIR), Tehran, Iran. METHODS: Observed SCIM III scores and SCI Ability Realization Measurement Index changes were used to measure the change in 134 patients with complete SCI (AIS A), after participation in an outpatient rehabilitation program consisting of a bimonthly multidisciplinary education program, combined with a twice-weekly occupational therapy, physical therapy and home nursing as a rehabilitation package for a 6-month period. RESULTS: A significant increase in median total SCIM III scores following comparison of 'pre-treatment' scores and final 'post-treatment' scores (9.5 score, P<0.001) was found. The increase in final SCIM III scores was highest in lower cervical (8.75 scores) and thoracic cases (13.5 scores). With the exception of high cervical patients, all subgroups had a significant SCIM III score improvement. CONCLUSION: Multidisciplinary, outpatient rehabilitation programs are recommended as a safe and an effective post-injury rehabilitation for AIS A SCI patients. Such programs may complement inpatient rehabilitation and promote functional recovery. Multidisciplinary outpatient programs are effective in achieving long-term independence in SCI patients and reducing the cost of care for developing countries. This study suggests that high cervical injuries benefit more from inpatient programs.

Association between Food Insecurity and Vision Impairment among Older Adults: A Pooled Analysis of Data from Six Low- and Middle-Income Countries.

OBJECTIVES: Food insecurity has gained attention as a potential risk factor for vision impairment. However, research on this topic is limited. This objective of this study was to investigate the relationship between food insecurity and visual impairment among adults aged 50 years or older using data from six low-and middle-income countries (LMIC). DESIGN AND SETTING: Data from the longitudinal Study on global AGEing and adult health (SAGE) were analyzed in a community-based, cross-sectional, and nationally representative sample. PARTICIPANTS: Adults aged 50 years or older from six low- and middle-income countries (LMICs) including China, India, Mexico, Russia, South Africa, and Ghana. MEASUREMENTS: Food insecurity was evaluated using a questionnaire comprised of two questions that addressed the frequency of eating inadequately and hunger due to a lack of food in last 12 months. Distance and/or near vision impairment was considered as a visual acuity score of less than 6/18 in the eye with better vision. RESULTS: The analytical sample consisted of 29,804 adults (mean (SD) for age: 63.2 (9.54) years; 54.3% female). The prevalence of food insecurity, near vision and distance vision impairment in the sample was 16.4%, 36.7%, and 13.9%, respectively. Adjusted pooled analyses across countries revealed a significant association between food insecurity and distance (OR: 1.16; 95% CI: 1.01, 1.33; P=0.04, significant individually in India and South Africa) and near (OR: 1.12; 95% CI: 1.02, 1.22; P=0.01, significant individually in South Africa) vision impairment, and a between-country heterogeneity of 46.30% and 25.99%, respectively. CONCLUSION: Food insecurity was associated with both distance and near vision impairment in adults aged 50 years or older across six LMIC. Food policies and intervention programs targeted at decreasing food insecurity in vulnerable households are essential.

Customized birthweight standard for an Iranian population.

OBJECTIVE: To produce a customized birthweight standard for Iran. METHOD: Retrospective study of a pregnancy database collected from five hospitals across Iran. The cohort consisted of 4994 consecutive term births with complete data, delivered between July 2013 and November 2014. Coefficients were derived using a backwards stepwise multiple regression technique. RESULTS: Maternal height, weight in early pregnancy and parity as well as the baby's sex were identified as significant physiological variables affecting birthweight. Paternal height and weight were also significant although weaker factors. The expected 280-day birthweight, free from pathological influences, of a standard size mother (height 163 cm, weight 64 kg) in her first pregnancy was 3390 g. Pathological factors found to affect birthweight in this cohort included village housing, anemia, preexisting and gestational diabetes and preeclampsia. CONCLUSION: The analysis confirmed the main physiological variables that affect birthweight in other countries and shows paternal factors also to be significant variables. Development of a country-specific customized birthweight standard will aid clinicians in Iran to distinguish between fetuses that are either constitutionally or pathologically small, thereby avoiding unnecessary interventions, and improving identification of at-risk pregnancies and perinatal outcome.

Pivotal Role of Cervical Rotation for Rehabilitation Outcomes in Patients with Subaxial Cervical Spinal Cord Injury.

BACKGROUND: Limitation of active cervical range of motion as a sequel of both spinal instrumentation and neurological injury may occur after Cervical Spinal Cord Injury (CSCI) surgery. The majority of tasks performed in daily life require a minimum of Active Cervical Range of Motion (ACROM). The aim of this study was to report ACROM in patients with subaxial CSCI, and in a control group with asymptomatic cervical spine. METHODS: A cross-sectional study was performed in 46 cases of traumatic complete motor CSCI and 41 asymptomatic cases. Patients underwent quantitative measurement of ACROM on six movements, using an analogue inclinometer, and rehabilitation status assessment on the Spinal Cord Independence Measure (SCIM) III. RESULTS: Forty-six CSCI cases and 41 asymptomatic controls were included. Mean flexion, extension, rotation, and lateral inclination were significantly lower in the CSCI group than in controls (P<0.0001). SCIMIII self-care subscores in the CSCI group showed significant correlation with mean cervical rotation (correlation coefficient, +0.508, P=0.0003). Regression analysis on mean ACROM in the CSCI group, yielded significant a negative correlation with age (P=0.037). CONCLUSIONS: CSCI significantly affected ACROM. Also, restriction of cervical rotation had significant negative correlation with SCIM-III self-care subscores.

The frequency of fungi isolated from the skin and hair of asymptomatic cats in rural area of Meshkin-shahr-Iran.

BACKGROUND: Dermatophytosis is a frequent cutaneous infection affecting the keratinized tissues of humans, pets and livestock. Animals can carry dermatophytic elements asymptomatically and are considered to play an important role in the epidemiology of the disease. As exposure to any infected lesion free animals, especially cats, may lead to the development of infection in humans. OBJECTIVES: This study was done to determine the frequency of fungal agents isolated from skin and hair of cats living in rural areas of Meshkin-shahr, Iran. ANIMALS: A total of 103 asymptomatic cats living in rural areas of the region were studied. METHODS: This cross-sectional descriptive study was performed in Medical Mycology Laboratory, School of Public Health, Tehran University of Medical Sciences from February 2015 to July 2016. A total of 103 asymptomatic cats were studied. Mycological analysis including direct examination and culture on SC, SCC and DTM of the collected samples were conducted. For molecular confirmation when needed, panfungal PCR targeting the ITS1 region of the rDNA gene cluster using primers ITS1 and ITS4 were performed. Gender and age were also recorded. RESULTS: None of the 103 cats examined were positive for fungal elements on direct examination. However, 15 (14.5%) cases showed dermatophytes growth. T. verrucosum was the most common etiologic agents of dermatophytosis. Although the gender of the cats had not significant association with dermatophytosis prevalence, age was a significant influential risk factor (P=0.019). Aspergillus spp., Alternaria spp., Rhizopus spp., Penicillium spp.and paecilomyces spp. in descending frequency were the most predominantly identified saprophytic fungi. CONCLUSION: Our findings clearly highlighted the epidemiological role of asymptomatic cats in spreading dermatophytosis to humans and other animals.

A comprehensive study on the major mutations in glucose-6-phosphate dehydrogenase-deficient polymorphic variants identified in the coastal provinces of Caspian Sea in the north of Iran.

BACKGROUND: The aim of this study was the molecular analysis of G6PD patients for G6PD mutations in the coastal provinces of the Caspian Sea in north of Iran. METHODS: Studies on G6PD deficiency in the coastal provinces of the Caspian Sea in Iran were performed in 248 patients with a history of favism, in Mazandaran, Golestan and Gillan provinces, which contributed 74, 71 and 103 samples, respectively. Three different major polymorphic variants were determined by molecular analysis, using SSCP, sequencing and PCR-RFLP methods. Firstly, all Mazandaranian samples were searched for the Mediterranean mutation by PCR-RFLP method. The remaining samples of the Mazandaran province were analysed by SSCP followed by sequencing for other mutations. Then, our research was expanded in two other provinces, Golestan and Gillan, by the PCR-RFLP method. RESULTS: Three different major polymorphic variants were found: G6PD Mediterranean 75.4% (187 out of 248), G6PD Chatham 19.76% (49 out of 248), G6PD Cosenza 2.02% (5 out of 248) and 7 samples out of 248 remained unknown. Also, there was no significant difference in the incidence of various G6PD polymorphic variants with mean age, and various blood work values such as Hb, WBC and MCV between two major variants (p>0.20). CONCLUSIONS: These results which are the first molecular investigation in north of Iran indicate a higher prevalence of G6PD Chatham in this large Iranian population than anywhere else in the world. The distribution of these G6PD variants is more similar to that found in an Italian population (80-84% for Mediterranean, 20% for Chatham and 1.9% for Cosenza mutation). Although the origin of Iranian population is rather uncertain, the closer similarity of the mutation spectrum to Italian rather than Middle Eastern population may indicate that these populations have a common ancestral origin.