Annals of Medical and Health Sciences Research最新文献

{"title":"Wasting of Extensor Digitorum Brevis as a Decisive Preoperative Clinical Indicator of Lumbar Canal Stenosis: A Single-center Prospective Cohort Study.","authors":"S Munakomi,&nbsp;B M Kumar","doi":"10.4103/amhsr.amhsr_392_15","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_392_15","url":null,"abstract":"<p><strong>Background: </strong>The dilemma in managing patients with low back ache lies in differentiating radiculopathy from lumbar canal stenosis. This has a huge bearing in patients being planned for surgical intervention as underperforming leads to failed back syndrome whereas over-doing leads to instability. There still remains a loophole in clinically diagnosing lumbar canal stenosis.</p><p><strong>Aim: </strong>We opt to utilize a simple bedside clinical examination in routinely assessing patients presenting with low back ache in ruling out underlying canal stenosis.</p><p><strong>Subjects and methods: </strong>We performed a prospective study on 120 consecutive patients presenting with low back ache in the spine clinic. Each of them was neurologically examined and thoroughly assessed for wasting of extensor digitorum brevis (EDB) muscles. These were then correlated with the radio-imaging and the intraoperative findings.</p><p><strong>Results: </strong>Lumbar canal stenosis was mostly observed in the age group of 50-60 years. Diagnosis for L3/4 canal stenosis was made in 44/120 (36.6%), L5-S1 in 52/120 (43.3%), and L3/L4/L5 level in 48/120 (40%) of patients. EDB wasting was seen unilaterally in 72/120 (60%) and bilaterally in 36/120 (30%) of the study group.</p><p><strong>Conclusion: </strong>This study appraises the clinical implication of observing for the wasting of EDB muscle so as to aid in the diagnosis of lumbar canal stenosis. This simple bedside clinical pearl can help us in predicting the need of further imaging studies and also in taking right therapeutic decision.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"296-300"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/3a/AMHSR-6-296.PMC5414442.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Adiponectin Levels are Associated with Microcirculatory Function, but not with Coronary Artery Disease in the Young.","authors":"A De Lorenzo,&nbsp;Asb Moreira,&nbsp;E Guimaraes,&nbsp;Gmm Oliveira,&nbsp;E Maia,&nbsp;E V Tibirica","doi":"10.4103/2141-9248.204050","DOIUrl":"https://doi.org/10.4103/2141-9248.204050","url":null,"abstract":"Adiponectin is secreted in mature adipocytes, has a role in diabetes and obesity and has been studied in coronary artery disease (CAD), considered cardioprotective, what is nonetheless controversial. The assessment of systemic microvascular reactivity is useful for the evaluation of cardiovascular diseases, and laser speckle contrast imaging (LSCI) is an innovative approach, using the cutaneous microcirculation as a representative vascular bed.[4] We evaluated serum adiponectin levels in early-onset CAD (EOCAD) patients and age-matched controls, as well as their association with microvascular function assessed by LSCI. EOCAD was defined as any obstruction ≥50% on coronary angiography, prior myocardial infarction, or myocardial revascularization in patients ≤45 years. Patients with acute coronary syndromes or interventions for <6 months were not included in the study. Controls were adults ≤45 years without CAD or cardiac symptoms. After a 12-h fast, venous blood was collected. Adiponectin was measured in serum by ELISA (Human High Molecular Weight Adiponectin, Millipore, Missouri, USA). Cutaneous microvascular reactivity was evaluated using LSCI (PeriCam; Perimed, Sweden), as previously described,[5] using transdermal iontophoretic delivery of acetylcholine (ACh) or sodium nitroprusside (NPS). Perfusion changes were measured in arbitrary perfusion units and expressed as peak values, representing the maximal vasodilation observed, and area under the curve of vasodilation. The study complied with the 1964 Declaration of Helsinki and its amendments and was approved by the local ethics committee. Informed written consent was obtained from all participants. Categorical variables were expressed as n (%) and compared with Chi-square. Continuous variables were expressed as a mean ± standard deviation or median/ interquartile range, compared with Mann–Whitney’s test. Correlations were evaluated with Spearman’s test. A value of P < 0.05 was considered statistically significant.","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"332-333"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/5e/AMHSR-6-332.PMC5414447.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34993763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adnexal Tumors of Skin: An Experience at a Tertiary Care Center at Delhi.","authors":"M Pujani,&nbsp;G B Madaan,&nbsp;Z S Jairajpuri,&nbsp;S Jetley,&nbsp;M J Hassan,&nbsp;S Khan","doi":"10.4103/amhsr.amhsr_339_14","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_339_14","url":null,"abstract":"Background: Adnexal skin tumors are a heterogeneous group of uncommon tumors usually misdiagnosed clinically due to a huge variety of types and their variants. Histopathology usually helps in establishing the diagnosis. Aims: The study was undertaken to analyze the morphological, clinical, and histological features of adnexal tumors (ATs) of the skin at our center over a period of 4 years. Subjects and Methods: retrospective study was conducted over a period of 4 years (April 2010–March 2014), comprising 25 ATs of skin diagnosed in the Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi. All the consecutively reported AT cases were reviewed and reclassified as AT arising from sebaceous glands, hair follicles, or sweat glands. The concordance of clinical and histopathological diagnosis was also assessed. Results: Most of the ATs were benign (24/25) with head and neck being the most common location (72%). Nearly 56% of the tumors exhibited sweat gland differentiation, 28% hair follicle differentiation, and sebaceous gland tumors accounted for 16%. The most common varieties of tumors encountered in the present study included hidradenoma papilliferum and pilomatricoma. The concordance between clinical and histopathological diagnosis was found to be 50% approximately. Conclusions: ATs of the skin are rare neoplasms with benign tumors being far more common. They are often misdiagnosed clinically, so histopathology remains the gold standard for establishing an accurate diagnosis of skin ATs.","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"280-285"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/cd/AMHSR-6-280.PMC5414439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Malleolar Fractures: An Anatomic Survey Determining the Ideal Screw Length.","authors":"P J Labronici,&nbsp;R E Pires,&nbsp;M V Franco,&nbsp;R Freitas,&nbsp;G C Araújo,&nbsp;R S Pires E Albuquerque,&nbsp;V S Gameiro,&nbsp;K Jeray","doi":"10.4103/amhsr.amhsr_41_16","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_41_16","url":null,"abstract":"<p><strong>Background: </strong>Medial malleolar fractures are frequent, and their treatment is familiar to the orthopedic surgeon. Lag screw fixation using partially threaded screws remains the standard treatment method for medial malleolar fractures. However, the literature lacks a defined method for selecting lag screw length, relying more so on the empiric choice of the surgeon.</p><p><strong>Aim: </strong>The aim of this study is to help define the ideal lag screw length for medial melleolar fracture fixation.</p><p><strong>Materials and methods: </strong>One hundred and sixteen anatomic specimens were included in the study. A transverse cut was performed in the distal third of the tibia, roughly 1 and a half times the distal tibial plafond width from the ankle joint. A coronal cut was then performed using the center of the medial malleolus. Three observers measured the distance between the medial malleolus tip and beginning of the medullary canal in all anatomic specimens. Differences in measurements were statistically compared, level of (<i>P</i> ≤ 0.05). Interclass correlation coefficient (ICC) significance level was set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>Measurement average was 55 mm between the medial malleolus tip and the medullary canal, with a standard deviation of 10 mm. High concordance (ICC: 0.819) was achieved among all pairs of observers (<i>P</i> < 0.01). The systematic difference among measurements was absent, and random distribution around general measurements was observed.</p><p><strong>Conclusion: </strong>The authors recommend a screw length of no more than 45 mm to optimize the location of the screw threads in the best cancellous bone in an effort to obtain the most compression.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"308-310"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/02/AMHSR-6-308.PMC5414444.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtrochanteric and Distal Femur Fractures in a Patient with Femoral Shaft Fracture Malunion and Knee Disarticulation: A Rare and Challenging Case Report.","authors":"R E Pires,&nbsp;E O Santana,&nbsp;P J Labronici,&nbsp;I A Almeida Filho","doi":"10.4103/amhsr.amhsr_86_16","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_86_16","url":null,"abstract":"<p><p>This study aims to describe a rare and challenging case of a patient who presented ipsilateral subtrochanteric and distal femur fractures due to low-energy trauma. The peculiarity of this case is the presence of femoral shaft fracture malunion and knee disarticulation in the same limb resulting from an accident suffered 30 years ago. The patient underwent femoral diaphyseal osteotomy and fixation of the subtrochanteric and distal femur fractures with a long cephalomedullary nail and distal femur locking plate, respectively. Despite the magnitude of the surgical procedure, all fractures healed, preserving the femoral length with the absence of infection and clinical complications. There was an improvement of the preinjury function attributed to the osteotomy of the femoral diaphyseal, which alleviated the anterior thigh discomfort.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"328-331"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/f1/AMHSR-6-328.PMC5414446.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34993765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic Detection and Antibiogram of β-lactamase-producing <i>Proteus</i> Species in a Tertiary Care Hospital, India.","authors":"N Pal,&nbsp;S Hooja,&nbsp;R Sharma,&nbsp;R K Maheshwari","doi":"10.4103/amhsr.amhsr_413_15","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_413_15","url":null,"abstract":"<p><strong>Background: </strong><i>Proteus</i> species cause a variety of community- and hospital-acquired illnesses. Synthesis of β-lactamases is the predominant mechanism for resistance to β-lactam antibiotics. Among the β-lactamases, extended spectrum β-lactamases (ESBLs) and AmpC β-lactamases are the most common.</p><p><strong>Aim: </strong>The objective of this study was to determine the occurrence of ESBL and AmpC β-lactamases in <i>Proteus</i> species among various clinical isolates at a tertiary care hospital, India.</p><p><strong>Materials and methods: </strong>This study was done to identify various species of <i>Proteus</i> from clinical samples (<i>n</i> = 3922). Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method. ESBL production was detected by modified double-disc synergy test and indirect modified three-dimensional tests and AmpC β-lactamase production by AmpC disc test and modified Hodge test.</p><p><strong>Results: </strong><i>Proteus</i> species were isolated in 5.4% (101/1876) specimens. Three <i>Proteus</i> species isolated were <i>Proteus mirabilis</i> 62.4% (63/101), <i>Proteus vulgaris</i> 29.7% (30/101), and <i>Proteus penneri</i> 7.9% (8/101). ESBL producers confirmed by both tests were of 88.1% (89/101). Only AmpC β-lactamase was produced by four isolates. Coproduction of ESBL and AmpC β-lactamase was observed in 58.4% (52/89) of isolates. Twelve isolates were non-β-lactamase producers. Multidrug resistance (MDR) was found in 95.1% (96/101) of isolates, 50.5% (51/101) were possibly extensively drug resistant and none were pan drug resistant. None of the isolates were resistant to piperacillin-tazobactam. <i>P. penneri</i> isolates exhibited high resistance to most of the antibiotics.</p><p><strong>Conclusions: </strong>A high prevalence of ESBL and AmpC β-lactamases was found that concurrently showed MDR. Phenotypic methods for the detection of β-lactamases are easy and simple and can be implemented in routine diagnostic laboratories along with susceptibility testing. These data will assist the clinicians in the management and control of infections.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"267-273"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/ed/AMHSR-6-267.PMC5414437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Serum and Urinary Neopterin Levels as a Biomarker for Occupational Exposure to Crystalline Silica.","authors":"H Mohammadi,&nbsp;S F Dehghan,&nbsp;F Golbabaei,&nbsp;M Ansari,&nbsp;M Yaseri,&nbsp;S Roshani,&nbsp;R Divani","doi":"10.4103/amhsr.amhsr_140_16","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_140_16","url":null,"abstract":"<p><strong>Background: </strong>Crystalline silica is a commonly used mineral in various industries and construction activities, and it is so important introducing potential biomarkers to identify early indicators of biological effects in its high-risk occupational exposures.</p><p><strong>Aim: </strong>The present study was aimed to assess the blood and urinary neopterin as an early biomarker of exposure in the workers of an insulator manufacturing plant who are exposed to crystalline silica.</p><p><strong>Subjects and methods: </strong>This analytical descriptive study was done among two groups of exposed workers (<i>n</i> = 55) and unexposed office workers (<i>n</i> = 38) of an insulator manufacturing plant. Statistical software R was used to determine sample size and select the participants by random sampling among nonsmoker workers. Sampling of airborne silica in breathing zone of participants was done based on the National Institute for Occupational Safety and Health method 7601. The urinary and blood samples were collected and prepared for analysis by high-performance liquid chromatography to determine the level of urinary and serum neopterin. All of the statistical analyses were carried out using SPSS 22.</p><p><strong>Results: </strong>The airborne silica concentration was significantly different between two exposed and unexposed groups (<i>P</i> < 0.001, 0.27 [0.11] vs. 0.0028 [0.0006] mg/m³, respectively). The urinary neopterin in exposed group is significantly higher than the unexposed one (<i>P</i> < 0.001, 97.67 [30.24] vs. 55.52 [2.18] μmol/mol creatinine, respectively). Neopterin level of serum in exposed group is higher than the unexposed group, and there is a significant difference between them (<i>P</i> < 0.001, 6.90 [2.70] vs. 2.20 [1.20] nmol/l, respectively). The positive significant correlations were found between silica exposure concentration with urinary and serum neopterin (<i>P</i> < 0.001, r = 0.36 and 0.59, respectively).</p><p><strong>Conclusions: </strong>Considering the sensitively and easily measurement of neopterin in biological fluid and also the statistically significant positive relationships which were found between the airborne silica concentration and neopterin levels in the present study, the serum and urinary neopterin levels can be considered the potential biomarkers of silica exposure for doing further comprehensive studies in this area.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"274-279"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/e9/AMHSR-6-274.PMC5414438.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34994305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicoradiologic Profile of Involvement and Healing in Tuberculosis of the Spine.","authors":"R Singh,&nbsp;N K Magu,&nbsp;R K Rohilla","doi":"10.4103/amhsr.amhsr_188_15","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_188_15","url":null,"abstract":"<p><strong>Background: </strong>There is no much information about how tuberculous lesions of the spine progress/heal; what clinical and radiological features suggest progression/healing; what is the optimal duration of antitubercular treatment; and what clinical, laboratory, and radiological investigations and their frequency should be done to monitor the disease course.</p><p><strong>Aims: </strong>The present study aimed to evaluate what specific clinicoradiologic features suggest involvement and healing in tuberculosis of the spine.</p><p><strong>Subjects and methods: </strong>Fifty spinal tuberculosis patients (30 males and 20 females) diagnosed clinicoradiologically were enrolled in the study. Patients were evaluated clinically, radiographically, and by magnetic resonance imaging (MRI) at regular intervals to monitor the disease course till 24 months of the initial presentation.</p><p><strong>Results: </strong>Wedge/collapse (23/50 cases), soft tissue mass (29/50 cases), disc narrowing (45/54 discs), and endplate erosions (89/107 endplates) were the plain radiological findings of tubercular spinal involvement. Earliest sign of healing on plain radiography was decrease in fuzziness of endplate, ultimately leading to either sclerosis of endplate or fusion of adjacent vertebrae. Initial MRI findings included bone marrow edema (50/50 cases), discitis (53/62 discs), endplate erosions (105/123 endplates), pre- and para-vertebral collections (45/50 cases), epidural involvement (26/50 cases), epidural spread (77/109 vertebrae), and subligamentous spread (42/50 cases). Earliest feature of healing on magnetic resonance (MR) examination was decrease in inflammatory soft-tissue masses and reduction in marrow edema.</p><p><strong>Conclusions: </strong>Salient features of spinal involvement in tuberculosis on plain radiograph were paradiscal involvement, endplate destruction, and soft tissue masses. Marrow edema, paravertebral collections, subligamentous spread, extradural component, endplate erosion, and discitis suggested tubercular involvement of the spine on MRI. A decrease in these was observed to have prognostic value both in monitoring disease course and response to chemotherapy. Based on the clinicoradiologic findings of the present study, we propose decision-making algorithm, follow-up algorithm, and MR examination protocol for spinal tuberculosis.</p><p><strong>Level of evidence: </strong>This was a Level II study.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 5","pages":"311-327"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/64/AMHSR-6-311.PMC5414445.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34993767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Leiden Score in Predicting Progression of Rheumatoid Arthritis in Undifferentiated Arthritis in Indian Population.","authors":"K Ghosh,&nbsp;A Chatterjee,&nbsp;S Ghosh,&nbsp;S Chakraborty,&nbsp;P Chattopadhyay,&nbsp;A Bhattacharya,&nbsp;M Pal","doi":"10.4103/amhsr.amhsr_339_15","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_339_15","url":null,"abstract":"<p><strong>Background: </strong>Leiden Score, is a very useful tool for predicting future development of rheumatoid arthritis (RA), among undifferentiated arthritis (UA) patients. This score has been validated in various western studies but rarely among south east Asian patients.</p><p><strong>Aims: </strong>To validate the Leiden early arthritis prediction rule in an Indian cohort of patients for predicting rheumatoid arthritis (RA) in undifferentiated arthritis (UA) patients and to formulate any simpler version of prediction score taking only clinical variables of original Leiden prediction rule.</p><p><strong>Subjects and methods: </strong>In a group comparative longitudinal study model, 58 patients with early symmetrical polyarthritis were enrolled and baseline evaluation was done according to Leiden prediction rule and then 3 monthly. After 1 year, Leiden prediction score and chance of evolving into RA were calculated. Patients were divided into two groups: Those who developed RA and who did not. They were selected on random sampling process. Tender joint count (TJC), duration of morning stiffness, and duration of arthritis were selected as clinical variables for linear discriminant analysis with disease outcome being the dependent variable. Discriminant scores (D) for each patient was calculated. A receiver operating characteristic (ROC) curve was constructed with the discriminant score and compared with Leiden prediction score.</p><p><strong>Results: </strong>About 54% (27/50) of patients were diagnosed with RA and 46% (23/50) developed other rheumatologic condition or viral inflammatory arthritis or remained undifferentiated or attained complete remission. None of the patients with UA, who scored the regression coefficients 4 or less progressed to RA, and those who scored 7 or more, almost certainly progressed to RA. Unstandardized canonical discriminant coefficients for TJC (T), duration of morning stiffness (M), and duration of arthritis (A) were calculated. ROC curve was plotted with the formula: D = 0.164 × T + 0.066 × M + 0.012 × A - 2.838. Area under curve (AUC) at 95% confidence interval for our discriminant function was 0.845 (standard error [SE] 0.054). In comparison, AUC of Leiden prediction score was 0.897 (SE 0.043).</p><p><strong>Conclusions: </strong>Leiden prediction rule is highly applicable to UA patients to predict progression of RA in Indian patients and larger multi-center study with larger cohorts is needed to validate the formulation we derived to predict RA.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 4","pages":"205-210"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/42/AMHSR-6-205.PMC5405631.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34974560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Lavender Aromatherapy on the Pain Severity of Primary Dysmenorrhea: A Triple-blind Randomized Clinical Trial.","authors":"R Nikjou,&nbsp;R Kazemzadeh,&nbsp;M Rostamnegad,&nbsp;S Moshfegi,&nbsp;M Karimollahi,&nbsp;H Salehi","doi":"10.4103/amhsr.amhsr_527_14","DOIUrl":"https://doi.org/10.4103/amhsr.amhsr_527_14","url":null,"abstract":"<p><strong>Background: </strong>Primary dysmenorrhea is the most common complaint in adolescents and adult young women that disturbs their daily life performance.</p><p><strong>Aim: </strong>The current study investigated the effect of lavender aromatherapy on pain severity in primary dysmenorrhea.</p><p><strong>Subjects and methods: </strong>This triple-blind randomized clinical trial was conducted on 200 students of Ardabil University of Medical Sciences, Iran. Subjects were allocated randomly into intervention (lavender) and control (placebo) groups. The researcher assistant asked the participants to smell the lavender in the first 3 days of menstruation, 30 min in a day in two menstrual cycles. Control group was also administered placebo (diluted milk) to be used as lavender in treatment group. Pain severity was scored by visual analog scale in the first 3 days of menstruation before intervention and 2 months after intervention. Data were analyzed through descriptive statistics and independent and paired samples <i>t</i>-tests.</p><p><strong>Results: </strong>There was a significant difference in average pain severity between treatment and control groups after intervention. However, students in the treatment group reported significantly less pain severity 2 months after intervention (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>Using lavender aromatherapy for 2 months may be effective in decreasing the pain severity of primary dysmenorrhea.</p>","PeriodicalId":8186,"journal":{"name":"Annals of Medical and Health Sciences Research","volume":"6 4","pages":"211-215"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/8c/AMHSR-6-211.PMC5405632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34974562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}