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Background and Objective: Plantar fasciitis is due to irritation and inflammation of the plantar fascia, which may occur in patients aged 30-60 years old. The aim of this study was to investigate the effect of new modified foot orthosis on improving the quality of daily life, sport and recreational activities in patients with plantar fasciitis.

Materials and Methods: This clinical trial study was done at orthotics and prosthetics clinics in Tehran during Aug 2007 to May 2008. 15 patients with plantar fasciitis including 4 male and 11 female with ranging age 25-45 yrs old (35±5.02) were selected by non probability sampling. Patients used new modified foot orthosis. FAOS questionnaire was used for evaluating the activity daily life and sport and recreational activities. 2 stages included: once before intervention and the second stage after 4 weeks after intervention. Data analysis has been done with paired T-Test , Smironov-Kolomogrov by SPSS-13.

Results: Quality of daily life was 44.30±10.16 before interventional treatment and 61.08±16.26 after intervention and difference between two stages was not statistically significant. The results for sport and recreational activity were 26.50±10.09 before interventional treatment and 52.50±12.23 after intervention and difference between two stages was statistically significant (P<0.05).

Conclusion: This study showed that the new modified foot orthosis was no effective on improving of activity daily life but, was effective in sport and recreational activities in patients with plantar fasciitis.

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Background and Objective: Acute appendicitis is one of the most common surgical emergencies. Preoperative diagnosis of acute appendicitis remains challenging, despite improvements in history taking and clinical examination. Methods advocated to assist in the diagnosis of appendicitis include laparoscopy, ultrasonography, computed tomography and magnetic resonance imaging. The purpose of this study was to assess the accuracy of ultrasonography in the diagnosis of acute appendicitis. Materials and Methods: This prospective descriptive study was done to evaluate 265 patients suspected to have acute appendicitis and admitted to the emergency department of 5 Azar hospital of Gorgan from Aug 2005 to Aug 2006. Suspected patients visited by the general surgeon and ultrasonography of the appendix was performed subsequently. The ultrasonography examination was done using high graded-compression ultrasongraphy with 5 MHz variable focus linear array transducer. The sonographic data were compared with clinical, operative and pathological findings. Results: The sensivity and specifity of ultrasonography was 66% and 4%, respectively. Also positive and negative predictive value of ultrasonography was 98% and 40%, respectively. Conclusion: This study showed that ultrasonography is a useful method in the diagnosis of acute appendicitis. It also increase diagnostic accuracy of acute appendicitis and minimize negative laparotomy and prevent unnecessary appendectomy.

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Background and Objective: Asthma is the most prevalent chronic disease during childhood and it is estimated that 4.8 million children involved in asthma all over the world and its prevalence and incidence is increasing. The aim of this study was to identify the peak-flow meter application on quality of life in asthmatic children. Materials and Methods: This clinical trial study was done on 80 asthmatic children between 7 to 15 years old which referred to Shahid Beheshti hospital clinic in Kashan, Iran during 2009. Susan Sylvia questionnaire included 3 parts, was filled for every child. The questions in any section had three options in which there were 5 items in activity limitation, 13 questions in symptoms and 6 questions in emotional functions. Every question had 1 to 3 points and whole questionnaire taken 23 to 69 points. The children were learnt to measure their PEFR (Peak Expiratory Flow Rate) 3 times a day using Peak flow meter device and upon the results, the management procedure was changed. After 3 months the outcome were evaluated and data analyzed by SPSS-15 and paired t-test. Results: Mean age of patients was 8.82±2.75 years old. Thirty three subjects (41.3%) were girl. The average score in emotional functions was 13.1±3.07 before and 14.35±3.7 after using peak-flow meter (P<0.05). The average score in activity limitation was 7.33±1.57 and 8.47±0.67 before and after using peak-flow meter, respectively (P<0.05). The average score in symptoms before and after pek-flow meter was 28.81±5.13 and 32.02±5.62, respectively (P<0.05). Finally total score of quality of life showed significant increase in children after using peak-flow meter (P<0.05). Conclusion: This study showed that the application of pek-flow meter increase emotional functions, decrease limitation of activity and symptoms in asthmatic children. Therefore, it is suggested pek-flow meter dievice taking into account in asthma management of asthmatic patients particularly in children.

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Background and Objective: Anterior Cruciate Ligament (ACL) tear is One of the most common injuries at knee joint. Threshold of motion sense included inputs that are received by mechanical receptors at dynamic position. The objection of present study was to find the effect of functional brace on the Kinesthesia motion sense in patients with ACL rupture.

Materials and Methods: In this Quasi- experimental study, 20 patients with ACL tear, with aging range between 18 to 44 years old were recruited. Patients were selected in a simple non probability sampling manner. Using Continuous passive motion for testing the Kinesthesia motion sense, as a dependent variable. Data was analyzed with Paired t-test and Colmogrof-Smirnof tests.

Results: Threshold of motion sense at affected knee before and after bracing was 3.93±1.67, 4.45±1.86 in open eyes and 3.82±1.61, 4.13±1.96 in closed eyes (P<0.05).

Conclusion: This study showed that the functional brace did not play in important role in the improvement of threshold of motion sense in patients with ACL tear.

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Background and Objective: The reduction of shoe heel height can increase abdominal muscles activity. This study was conducted to evaluate the effect of low shoe heel height on the trunk muscle activity in young healthy females. Materials and Methods: In this quasi- experimental (Pre-post ) study, 48 healthy females were evaluated at University of social welfare and rehabilitation at 2009-2010. Females were selected in a non probability sampling manner and divided randomly into two groups. Subjects in the first group (12 females) were used low heel height shoes(less than 3.4 cm) for six months. The second group (12 female) was used standard heel shoes height (3.5-5 cm) for six months. After the end of the first step of study, females in first group were used standard heel shoes height (3.5-5 cm) for six months. The Kinsiologic Electromyography instrument was used to test the Electromyography magnitude of rectus abdominal and external oblique activity. Data was analyzed with Paired and independent T student and Kolmogorrov-Smirnov tests. Results: Muscle activity in first and second groups at external oblique was 9.72±3.15 μν and 7.87±2.47 μν and at rectus abdominal was 11.60±3.58 μν and 9.81±3.46 μν respectively. Muscle activity before and after using standard shoe heel height was significant (p<0.05). Conclusion: It seems that using lower heel shoes height increase the trunk muscle activity.

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Background and Objective: According to world health organization statistics, at least 5.2% of world population is carrier for a main hemoglobin disorder. Previous reports showed that more than 10% of people are carrier for beta-thalassemia Northern Iran. This study was done to determine the prevalance of hemoglobinopathies in premarriage individuals referred to Babolsar, Iran.

Materials and Methods: This descriptive study was carried out on 8500 individuals  (4200 women and 4300 men) whome were attended the thalassemia counseling program in Babolsar, North of Iran during 2006-09. After performing the CBC test, for those MCV and MCH were less than 80 and 27 respectively, Hemoglobin A2 was evaluated. Subjects whome were volunteers for more comprehensive tests, basic and acidic electrophoresis and genetic tests were applied, subsequently.

Results: 1200 (14.11%) subjects had low hematological indexes. 474 (5.57%) subjects had high HbA2 and were classified as beta-thalassemia carriers and 726 (8.54%) had normal HbA2 level and were classified as alpha-thalassemia carriers. 6 (1.2%) subjects were identified with HbF level more than 10 and were identified as carriers for beta-gene cluster deletion carrier. Also, 16 (3.2%) individuals had HbE, 16 (3.2%) had HbS, 4 had HbD and 4 had HbH (0.33% in 1200 and 0.047% in 8500 subjects). Genetic study of 317 individuals for beta carriers and 145 subjects for alpha-carriers showed IVSII-1G>A (74.5%) in beta-globin and single gene deletion of 3.7 (47.5%) in alpha-globin genes were the most frequent mutations.

Conclusion: This study showed that carriers for alpha - thalassemia (8.5%) are more frequent compared with beta- thalassemia (5.57%). Also other hemoglobin variants included HbS, HbE, HbD or different beta-gene cluster deletions in the region are considerable and should be screened.

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Background and Objective: The first carpometacarpal joint osteoarthritis reduced the ability of upper limb in elderly with subsequent disability in physical activities. This study was carried out to determine the effect of prefabricated and custom-made splints on quality of life in the first carpometacarpal joint osteoarthritis. Materials and Methods: This quasi-experimental study was done on 24 elderly (>60 years of age) patients with the first carpometacarpal joint osteoarthritis and 12 matched healthy subjects in Tehran rehabilitation University during 2010-11. Patients assigned randomly in two groups with 8 weeks treatment period, prefabricated thumb and custom-made splints. Persian version of The Short Form 36 quastioner (SF36) was used to assess the quality of life. Data were analyzed using SPSS-16 and paired t-test. Results: There were significant differences between osteoarthritis patients and healthy subjects in the quality of life according to SF36 score physical health problem (P<0.05), general health (P<0.05), limitations of activities (P<0.05), emotional health problem (P<0.05), social activities (P<0.05), pain (P<0.05), energy and emotions (P<0.05). Using splints significantly improved the quality of life of patients, but there was no significant difference between two splints in improving the quality of life. Conclusion: Prefabricated and custom-made

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Background and Objective: Fungal ear infection is common diseases in tropical areas with manifestation of acute and chronic clinical symptoms in external ear canal. This study was done to compare the fungal flora in external ear canal in chronic otitis media and subjects without otitis media. Method: This case-control study was done on 63 patients with chronic otitis media and 63 subjects without otitis media. Samples were taken from external ear canal with a sterile swab and were placed in the sterile tubes containing normal saline. The direct smear was prepared and samples were cultured in S, SCC and CMA (corn meal agar) media. Identification of genus and species were established using slide culture method and Germ-tube assay. Results: Positive fungi culture in external ear canal was seen in 77.78% and 17.46% of case and control groups, respectively (P<0.05). The most common type of fungi was Saprophyts (57.33%) followed by yeast (20.59%) and dermatophytes (17.32%). The most prevalent fungi in the subgroup of Saprophyts and dermatophytes was Aspergillusnigra (41.66%) and Trichophytonmentagrophytes (36.37%), respectively. The most common subgroup in yeast was Candida SPP with 53.85%. Conclusion: This study showed that the positive fungi culture in external ear canal is more prevalent in patients with chronic otitis media.

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Background and Objective: Mycoplasma Hominis is the smallest pathogenic bacteria, with no cell wall and free living organisms. It grows slowly and the conventional clinical microbiology techniques can not be applied due to difficulties in cultivation in particular slow growth incubation. This study was done to compare the culture and PCR methods for diagnosis of vaginal infection due to Mycoplasma Hominis. Methods: This laboratory test evaluation study was done on 150 patients with bacterial vaginosis and 50 healthy people with no infection as control, whom refereed to Imam Khomeini and Imam Zaman Hospitals in Tehran. Samples were collected in PPLO culture for growth and PBS to perform PCR method. Results: 35.3% and 76% of patients were positive using culture and PCR methods, respectively. Using PCR method 8% of control subjects was positive. There was no significant association between PCR method with abortion, place of residence and also level of educations. There was a significant association between the age (P<0.05), times of changing under wear cloths (P<0.05) and parity (P<0.05). Conclusion: PCR method is a more reliable technique to detect the vaginal infection due to Mycoplasma Hominis compared to culturing.

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Background and Objective: Patients with psychological disorders including depression, anxiety and patients with choronic psychological diseases are not suitable for cosmetic rhinoplasty.This study was done to evaluate the mental health status before and after cosmetic rhinoplasty.

Methods: This quasi- experimental study was done on 100 women and men with mean age of 26.85±6.60 which candidated for cosmetic rhinoplasty. Subjects filled out psychological disorder symptom questianare (SCL-90-R) before and 3-6 months after cosmetic rhinoplasty.

Results: Women had more symptom (P<0.05) of depression (7.24 versus 10.79), somatization (4.64 versus 7.35), obsessive-compulsive (5.67 versus 8.51), interpersonal sensitivity (5.48 versus 7.52), anxiety (5.26 versus 8.07), symptom distress index (0.58 versus 0.79) and totally positive symptoms (32.29 versus 41.06) in comparison with men. The main effect of time factor showed that there was not significant difference between symptoms of psychological disorder before and 3-6 months after cosmetic rhinoplasty. Interactional effect of gender and time was not significant for each psychological disorder symptom.

Conclusion: The differences of deviation of psychological disorder symptoms, before cosmetic rhinoplasty and 3-6 months after cosmetic rhinoplasty were not significant. This finding can denotes existence of psychological symptoms before cosmetic surgery. Cosmetic surgery strengthens psychological symptoms in women the assessment and psychological intermediate with the aim of reducing psychological symptoms especially at time range of 3-6 months should be done.

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Background and Objective: Enterococci is gram positive bacteria which is the inhabitants of gastrointestinal tract. Hospital infections and antibiotic resistance to enterococci is increased. This study was done to determine the molecular evaluation of vanA and vanB genes of enterococci isolates resistant to Vancomycin and Teicoplanin.

Methods: In this descriptive study, 113 isolates samples were collected and identified according to biochemical test and cultural characteristics in Ali ibn Abi Talib hospital in Zahedan, Iran. Antibiogram test was done to determine antibiotic resistance pattern. E-test strip was used to evaluate the minimum inhibitory of concentration (MIC). PCR was used to detect the vanA and vanB genotype in Vancomycin and Teicoplanin resistance enterococci.

Results: 92%, 6.2% and 1.8% of isolated samles collocted from urine, blood culture and pleura fluid, respectively. According to phenotype, 18.6% and 17.69% were resistance to Vancomycin and Teicoplanin, respectively. Resistance was observed in strains of Enterococcus faecalis and Enterococcus faecium. VanA genotype was seen in all of the resistance isolated species.

Conclusion: This study showed that strains of Enterococcus faecalis and Enterococcus faecium have more antibiotic resistance to the Vancomycin and Teicoplanin, morever vanA genotype precence in all of resistance isolated samples.

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Background and Objective: Stroke and cerebral ischemia are the second leading causes of death in the world. Currently, there are limited therapeutic interventions for patients with ischemia / reperfusion. This study was performed to determine the protective effect of aerobic exercise and adenosine on changes in inflammation mediators after transient ischemia of common carotid arteries in male Wistar rats.
Methods: In this experimental study, fifty male Wistar rats were randomly allocated into to 5 groups: control, cerebral ischemic control, aerobic exercise + cerebral ischemia, adenosine + cerebral ischemia and aerobic exercise + adenosine + cerebral ischemia. Ischemia was performed by blocking the common carotid artery for 45 minutes after a period of exercise and injection of adenosine. Neuronal structure was examined by Nissel tissue staining. The expression of NGF and Glutamate genes were measured in CA1 region of hippocampal tissue samples.
Results: Cell death was increased in neurons in the CA1 region of the hippocampus in the ischemia / reperfusion group, While a significant reduction in cell death in the adenosine + ischemia / reperfusion and aerobic exercise + ischemia /reperfusion groups was due to adenosine administration and aerobic exercise (P<0.05). NGF and glutamate gene expression in the adenosine + ischemia/reperfusion and adenosine + aerobic exersice + ischemia/reperfusion groups significantly increased and reduced compared to the ischemia/reperfusion control, respectively (P<0.05).
Conclusion: Co-administration of adenosine combined with aerobic exercise increase the protective effect of aerobic exercise on improving the neuronal damage after ischemic / reperfusion.

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Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.
 

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Background and Objective: Ventilator-associated pneumonia (VAP) is an important complication in intensive care unit (ICU) patients with endotracheal intubation. Finding potential early indicators of this condition can aid in reducing the disease burden. We aimed to investigate the relationship between VAP occurrence and serum levels of C-reactive protein (CRP), procalcitonin (PCT), and hemoglobin (Hgb) during ICU hospitalization of brain trauma patients.
Method: This descriptive-analytical study was carried out on brain trauma patients (99 male, 39 female), referring to the 5th Azar hospital in Gorgan, Iran, in the course of 2017. The patients were hospitalized in ICU with endotracheal intubation and mechanical ventilation. The diagnosis of VAP was confirmed by a 12-score rating based on chest radiographs, body temperature, white blood cell count, and sputum culture. After admission, serum CRP, PCT, and Hgb were documented daily for 6 days.
Results: According to the diagnostic criteria, VAP was confirmed in 41 patients (30%). Serum CRP and PCT levels on the 6th-day post-admission were significantly associated with VAP diagnosis, while Hgb levels did not differ significantly between VAP and non-VAP patients. Serum levels of CRP, PCT, and Hgb on the 6th day were not associated with age or sex.
Conclusion: Our results indicate that serum CRP and PCT levels are associated with the occurrence of VAP in ICU patients receiving mechanical ventilation. Therefore, these biomarkers could be utilized to warn physicians about the possibility of VAP, thereby reducing mortality rate and hospitalization length.
 

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Background and Objective: Acrylamide is a neurotoxic agent that increases oxidative stress by creating an imbalance between the production and removal of free radicals, which in turn contributes to the pathogenesis of some neurodegenerative disorders. Thymoquinone extracted from Nigella satvia has prominent antioxidant effects. The objective of this study was to evaluate the effects of thymoquinone on hippocampal oxidative stress and neuronal density following acrylamide administration in male rats.
Methods: In this experimental study, 28 male Wistar rats aged 10-12 weeks and weighing 180-200 g were randomly divided into 4 groups of 7 rats: control, acrylamide, acrylamide + thymoquinone treatment (1 mg/kg), and acrylamide + thymoquinone treatment (5 mg/kg). For induction of brain injury, 50 mg/kg of acrylamide was injected intraperitoneally. Two days after the acrylamide injection, the rats were sacrificed, and malondialdehyde (MDA), glutathione (GSH), and catalase levels were measured in hippocampal homogenate. Evaluation of neuronal density in hippocampal CA1 region was also performed by Nissl staining.
Results: Acrylamide injection significantly increased MDA level and reduced GSH content and catalase activity in comparison with the control group (P<0.05). Administration of 5 mg/kg thymoquinone significantly reduced MDA level (P<0.05) but improved GSH and catalase activity in comparison with the acrylamide group (P<0.05). In addition, neuron density of hippocampal CA1 region did not differ significantly between the groups.
Conclusion: Thymoquinone can attenuate oxidative stress markers in a dose-dependent manner.
 

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Background and Objective: Celiac disease is a malabsorption disorder that could result in various psychological consequences if patients do not adhere to a gluten-free diet. This study aimed to determine the frequency of major depressive disorder and its relationship with adherence to a gluten-free diet among patients with celiac disease.
Methods: This descriptive-analytical study was conducted on 47 patients with celiac disease (30 women and 17 men) with an average age of 40.88 ± 10.7 years who had been referred to the Golestan Research Center of Gastroenterology and Hepatology during the summer of 2019. Patients were invited to complete a 13-item Beck Inventory. Celiac Dietary Adherence Test (CDAT) was used to assess adherence from the patients' point of view, and Standardized Dietician Evaluation (SDE) was used to evaluate adherence to the diet from the interviewer's perspective.
Results: Overall, 28 people (59.6%) with celiac disease reported some degree of depression. Based on the SDE, the adherence rate of patients to a gluten-free diet was 83%. The association between adherence to a gluten-free diet and the prevalence of depression was not significant. There was also no significant association between the prevalence of depression and the gender and age of patients.
Conclusion: Based on the results, a high percentage of patients with celiac disease have symptoms of depression. However, there is no significant relationship between adherence to a gluten-free diet and the prevalence of depression.