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Frequency of Oral Motor Dysfunction during Feeding and Some of Its Effective Factors in Children with Cerebral Palsy

Background: Feeding problems can limit the participation of children with cerebral palsy (CP) in the daily activities of life, especially feeding and eating. The aim of this study was to determine frequency of primary oral reflexes and oral motor dysfunction in children with CP in the city of Arak. Material & Methods: This study was a descriptive-analytic and cross-sectional study that has been done on children with CP 2-15 years old. The participants were chosen by a convenience sampling from the rehabilitation clinics in the city of Arak in 2017. The presence of primary abnormal oral reflexes including Bite, Rooting, and Tongue Thrust was evaluated; and Oral motor assessment scale was used to evaluate oral motor function. . The data were analyzed using statistical tests including chi-squared test. Results: Based on the present results, primitive oral reflexes (bite, rooting, tongue thrust) was found at levels of IV and V Gross Motor Function Classification System Expanded &Revised(GMFCS E&R) and at level of III Manual Abilities Classification System and type of quadriplegia spastic. The highest frequency of passive in oral motor was observed in level of V and functional in oral motor in levels of I and II GMFCS E&R. Furthermore, there was significant difference between gross motor function and oral motor function. Conclusions: The study results demonstrated a significant difference between GMFCS E&R levels and oral motor function. Therefore, it was suggested that particular attention should be paid to oral motor function in terms of evaluations of gross motor function.

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Pulmonary Mucormycosis- A Case Report

Background and Aim: Mucormycosis represents a group of life threatening infections caused by fungi of the order mucorales. Mucormycosis results in higher rates of morbidity and mortality than many other infections. A high index of suspicion and considering risky factors are critical for diagnosis and early initiation of therapy is necessary to optimize outcomes. In this paper, we report a woman with pulmonary mucormycosis. Case Report: A 47-year old woman with a history of uncontrolled diabetes presented with cough, hemoptysis, dyspnea and dysphagia from 3 weeks ago. On physical examination, course crackles, generalized wheezing and stridor were found along with fever. Laboratory testing demonstrated a high-titer ESR, CRP3+ and leukocytosis. The ENT examination revealed a mild erythema of the vocal cords. An initial chest-x-ray was compatible with a pulmonary infiltration in the right middle lobe. Ct-scan of the sinuses was unremarkable. Bronchoscopy findings and lung biopsy was consistent fibrinoleukocytic exudates with extensive necrosis and broad hyphae and was reported fungal infection in favor of mucormycosis. She was eventually treated with amphotericin B. Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1398.48 has been approved by research ethics committee at Arak University of Medical Sciences.Conclusion: Mucormycosis has high mortality in diabetic patients and has even higher rates in uncontrolled diabetics. Therefore, due to underestimation and undertreatment of the condition, mucormycosis must be considered in diabetics underestimate pneumonia.

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