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18, 0.24) had the highest impact on the adolescents' mental health, respectively. There was a direct and indirect relation between academic stress and mental health through the self-concept. On the school level, only family conditions stress had a relation with mental health (P=0.015, b=1.08). Academic self-efficacy showed no significant relation in the model.
The stress from the family is the most important source of stress associated with adolescent mental health. Self-concept unlike academic self-efficacy had an important mediating role in the relation between different sources of academic stress and adolescents' mental health.
The stress from the family is the most important source of stress associated with adolescent mental health. Self-concept unlike academic self-efficacy had an important mediating role in the relation between different sources of academic stress and adolescents' mental health.
Frequency, severity, and duration of attacks are some major parameters in headache management, affected by some other factors. Ignoring these factors in headache-related studies can lead to incorrect results. We aimed to model both socio-demographic characteristics and headache-associated symptoms related to frequency, severity and duration of headache attacks.
A longitudinal panel study.
Overall, 275 migraines or tension Type Headache (TTH) patients were visited at three different times in 2012 in Isfahan, Iran. On the first visit socio-demographic characteristics and headache symptoms of the patients were asked. In all of the visits, headache frequency, severity and attack duration were recorded.
Frequency of headaches was influenced by headache type, age, job status, working hours, residency, disease duration, laterality, and type of pain onset. this website In terms of intensity, headaches were more severe in patients with migraine-type; those suffering from longer headache history; and those who suffered from vomiting, photophobia, and phonophobia. On the other hand patients with migraine, married people, women and patients suffering from vomiting experienced longer headache attacks.
Headache type (migraine/TTH), age, job status, residency, years of headache, laterality, type of onset, nausea, vomiting, photophobia, and phonophobia were the factors to be considered in the studies that would apply frequency, severity, and duration of headache attacks in order to evaluate headache management.
Headache type (migraine/TTH), age, job status, residency, years of headache, laterality, type of onset, nausea, vomiting, photophobia, and phonophobia were the factors to be considered in the studies that would apply frequency, severity, and duration of headache attacks in order to evaluate headache management.
The financial burden of cigarette smoking on households' budget is not well documented in Iran. We aimed to identify the determinants of cigarette consumption and its financial burden among households in Iran.
A cross-sectional study.
A total of 39,864 Iranian's households from 31 provinces were included in the analysis. Data on sociodemographic and socioeconomic characteristics (age, sex, household size, education level, employment status, income and wealth index), living area, number of cigarettes smoked and cigarette expenditures for households were extracted from the 2016 Household Income and Expenditures Survey (HIES). Tobit model was used to identify the determinants of cigarette smoking frequency and expenditures among Iranian households.
The average number of cigarettes smoked and cigarettes expenditures by all household members was 85.25 cigarettes and US$ 2.64 per month. Living in urban areas, wealth index of households, household income, household size and low educational attainment of household members were positively associated with frequency and expenditures of cigarette smoking. Results also indicated increasing patterns in the number of cigarettes smoked and cigarettes expenditures from east to west of the country. East Azerbaijan, Hamadan, Markazi and Chaharmahal va Bakhtiari provinces had higher cigarette smoking frequency and expenditures in Iran.
Tobacco control interventions in Iran should focus more on households living in urban areas and low-educated households. As the frequency of cigarette smoking was higher in the western region of Iran, comprehensive tobacco control policies should be adopted in western provinces.
Tobacco control interventions in Iran should focus more on households living in urban areas and low-educated households. As the frequency of cigarette smoking was higher in the western region of Iran, comprehensive tobacco control policies should be adopted in western provinces.
The residents' perceptions of the crime and lack of safety with their neighborhood environment, associated with stress that confers risk for drinking. While many studies have focused on adult drinking, less is known about how subjective neighborhood crime influences drinking during adolescent. We aimed to determine the association of perceived neighborhood crime and youth alcohol use.
A cross-sectional study.
This study was conducted on 1087 university youths from 30 neighborhood clusters in Northeastern Thailand from May 2019 to Mar 2020. The data were collected by self-administered questionnaire. A multilevel logistic regression model was applied to examine the effect of perceived neighborhood crime on hazardous alcohol use.
Most of youths were female, approximately 60.7% reported hazardous alcohol use, and the average perceived neighborhood crime score was 65.1 (standard deviation, 2.1). The perceived neighborhood crime was associated with hazardous alcohol use; a 1-unit increase in the scores for perceived neighborhood crime corresponded to a 20% increase in hazardous alcohol use. The role of perceived neighborhood crime on alcohol use varied among males, but not females.
The perceived neighborhood crime plays a role in the increase likelihood of hazardous alcohol use. The consideration of neighborhood crime context is important to design the alcohol preventive and intervention strategies.
The perceived neighborhood crime plays a role in the increase likelihood of hazardous alcohol use. The consideration of neighborhood crime context is important to design the alcohol preventive and intervention strategies.Here, we report a case of a 30-year-old man with a diagnosis of complex shoulder instability, who was treated successfully by pectoralis major transfer following a series of failed instability correction surgeries. The patient was admitted to our outpatient clinic with an approximately 6-year history of chronic shoulder instability following several failed operations, including open Bankart repair, open capsular plication and Bankart repair, open capsule repair, arthroscopic Bankart repair, and Bristow-¬Latarjet procedure. Physical examination revealed persistent shoulder pain, weakness, and a limited range of motion. Imaging studies demonstrated complete subscapularis muscle atrophy with Goutallier grade 4 fatty infiltration. The decision for revision surgery was made owing to his shoulder findings and clinical symptoms. The intra-operative assessment revealed the subscapularis muscle to be fully atrophic and irreparable. The pectoralis major muscle was transferred from the intertubercular groove of the humerus to the lesser tuberosity. Postoperatively, the patient had 4 weeks of shoulder immobilization. Physical examination demonstrated an improved shoulder range of motion without evidence of recurrent shoulder instability. The authors encountered no sign of dislocation for 2.5 years of follow-up after the surgery. In conclusion, subscapularis muscle atrophy or insufficiency should be considered in the differential diagnosis of patients with failed shoulder instability surgeries. Pectoralis major tendon transfer may be successfully performed for the surgical treatment of such patients.Vacuum phenomenon is a commonly observed radiological entity in the degenerated intervertebral discs of the lumbar spine in the elderly population. The entity is frequently asymptomatic. Although disc herniation containing gas (DH-CoG) is commonly associated with the vacuum phenomenon, DH-CoG associated with clinical symptoms is a rare condition. There are very few reports which have histologically demonstrated the existence of the gas itself within DH-CoG. Herein, we report a rare case of a 65-year-old female with symptomatic DH-CoG at L5/S1. The patient was admitted to our hospital with a one-month history of pain in the left buttock and leg in addition to neurogenic claudication. Roentgenograms illustrated a degenerative lumbar spine with the vacuum phenomenon at the L5/S1 disc space. Computed tomography showed a round and low-density lesion within the spinal canal at left L5/S1. Additionally, a lesion characterized by an iso- and partially hypointense signal on T1 and hypointense signal on T2 was detected in magnetic resonance imaging (MRI) by the spin-echo method. The decision for posterior lumbar interbody fusion surgery using pedicle screws was made as the symptoms had not responded to the conservative treatment. After a degenerated prolapsed nucleus was carefully extracted, the specimen was sent to the laboratory for histopathological analysis. The prolapsed nucleus of DH-CoG histologically showed many small vacuoles containing degenerated mucopolysaccharides. The left leg pain drastically resolved on the first post-operative day, and no recurrence had been observed. Degenerated mucopolysaccharide may be a precursor of nitrogen or "the gas itself" in DH-CoG. Surgical intervention for DH-CoG should be considered if conservative treatment fails.
This meta-analysis aimed to compare the clinical outcomes of intramedullary fixation with the extramedullary fixation in the surgical management of subtrochanteric fractures by analyzing relevant randomized controlled trials (RCTs) and retrospective cohort studies (RCSs).
The PubMed, Embase, Cochrane Library, Wanfang database, and Chinese National Knowledge Infrastructure (CNKI) were searched from their inception till June 29, 2020. Two reviewers extracted the data, including operation time, intraoperative blood loss, fluoroscopy time, length of stay, union time, nonunion rate, infection rate, implant failure rate, reoperation rate, Harris hip score, and mortality rate. The Cochrane risk-of-bias tool and the Newcastle-Ottawa quality assessment scale were used to evaluate the methodological quality of RCTs and RCSs, respectively. Statistical heterogeneity was quantitatively evaluated with the I2 statistic.
There were no significant differences in operation time, intraoperative blood loss, average length eutic study.
Level II, Therapeutic study.
This study aimed to investigate the effects of morphological changes of the patellar tendon (length, width, and thickness) on the development of anterior knee pain (AKP) after intramedullary nailing (IMN) of tibial shaft fractures.
A total of 39 patients, treated by IMN using the transpatellar approach for tibial shaft fractures, were retrospectively reviewed and included in the study. The patients were then divided into 2 groups based on the presence of AKP group A, patients who developed AKP (9 men, 9 women; mean age=35.39±9.32 years), and group B, patients without AKP (13 men, 8 women; mean age=41.38±14.78 years). To assess the morphological changes in the patellar tendon, magnetic resonance imaging was performed on the operated and unoperated, contralateral knees of the patients. The patellar tendon index (PTI) was calculated using the length, width, and thickness of the patellar tendon, and a set of variables was established to be a proportion of the measurements of the operated knees to those of the unoperated ones (operated/healthy PTI ratio).
