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Case presentation: A 20 month-old hypotonic boy with a history of preterm labor at 32 weeks of gestational age, secondary generalized seizures in infancy, hypothyroidism (T4: 2, TSH: 14); motor and speech developmental delay, mild  ataxia and renal failure (chronic kidney disease: CKD) was presented to the clinic of Taleghani pediatric hospital in Gorgan, Northern Iran during 2015. In further evaluation, the patient did not have fix and follow occularly and the head of the left optic nerve was atrophic and congenitally malformed although it seemed the visual prognosis for the right eye was even good with just a slightly pale nerve. The renal ultrasonography showed an increase of general echo which was suggestive for congenital or parenchymal abnormalities. Dialysis was ordered but the patient's family declined. The Image of the infant brain in axial cut using MRI 1.5 Tesla marked molar tooth sign (MTS). The schematic view is also given. Conservative treatment including Scholl, anti-convulsant solution, (30 cc daily), ferrous sulfate (20 drops), calcium tablets carbonate (2 per day) and phenobarbital (5 mg/kg/bw divided in two parts) was administered for the patient.

Diagnosis: Classic Joubert syndrome subtype: CORS (11q12.2 TMEM216)

Joubert syndrome is a rare autosomal recessive disorder affecting the cerebellum and characterized by abnormal respiratory pattern and eye movements, hypotonia, ataxia, developmental retardation with neuropathological defects of cerebellum and brainstem comprising inherited hypoplasia or aplasia of vermis. This clinical entity is possibly under-reported with a prevalence of less than 1 per 100,000. This syndrome is prototype of congenital vermian hypoplasia. Treatment for Joubert syndrome is symptomatic and supportive. Infant stimulation and physical, occupational, speech and hearing therapy may benefit some patients. Infants with abnormal breathing patterns must be monitored.

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Background and Objective: Parents of children with autism have difficulty in their daily activities and social relationships and have a low quality of life. The negative effect of having a low intelligence or disabled child is more likely to cause tension and pressure on mother than the other family members. This study was conducted to determine the quality of life of mothers with autism children compared to mothers with normal children.
Methods: This case-control study was performed on 36 mothers with autistic child and 114 mothers with healthy children in Gorgan (Iran) during 2015. Sampling was done randomly and the data gathering tool was SF-36 quality of life standard questionnaire.
Results: The quality of life of mothers with autistic child had a significant reduction in comparison with the quality of life of mothers with healthy child (P<0.05). Also, items of quality of life including  general health, social function, and role limitation due to psychological, emotional and physical functioning in the group of mothers with autistic children were significantly lower than mothers with healthy ones (P<0.05).
Conclusion: Mothers with autistic children had low quality of life. Therefore, it is recommended to design suitable programs for improving the health status and quality of life as a priority of health care plans.

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Background and Objective: Adhesive capsulitis is one of the most common shoulder disorders, particularly in diabetic patients, and its treatment has been challenging. Adhesive capsulitis begins with a gradual increase in shoulder pain, spontaneous onset, and limitation of active and passive movements of the glenohumeral joint in all directions. In 90% of cases, it responds to conservative treatment; however, if there is no symptomatic improvement after 3-6 months of conservative treatment, surgical treatment, including arthroscopic or open capsular release, should be considered. The current study aimed to compare the efficacy of non-surgical and arthroscopic treatments on shoulder function and pain in diabetic patients with adhesive capsulitis.
Methods: This quasi-experimental study was conducted on 48 diabetic patients (16 males and 32 females; mean age: 53.56±15.93 years) with adhesive capsulitis referring to the orthopedics clinic of 5th Azar Educational and Therapeutic Center in Gorgan, Iran during 2021-2022. Initially, patients were placed under the supervision of shoulder fellowship for conservative treatment for 3 months, and patients without any clinical improvement and with resistant to conservative treatments after 6 months were included in the study. Patients were voluntarily decided to be assigned to one of two treatment groups: Non-surgical (conservative treatment) and arthroscopic surgical (arthroscopic shoulder release). The functional outcomes and limitations of shoulder movement of patients were compared based on the disabilities of the arm, shoulder, and hand (DASH) score in the pre-test and after 3 and 6 months of intervention. The data were presented using descriptive statistical indices. Then, the functional outcomes and limitations of shoulder movement were evaluated.
Results: The mean shoulder function score 3 and 6 months after the intervention was lower in the arthroscopic release surgery group (45.80±19.32 and 43.10±14.12) than in the conservative treatment group (67.89±17.46 and 72.10±15.16) (P<0.05). The mean and standard deviation of symptom scores, such as pain, burning, weakness, and stiffness of the shoulder, 3 and 6 months after the intervention were lower in the arthroscopic release surgery group (12.70±5.66 and 10.02±4.06) than in the conservative treatment group (19.83±8.17 and 21.14±9.37) (P<0.05).
Conclusion: The decreased shoulder function and symptom severity at 3 and 6 months after the intervention was more effective in the arthroscopic release surgery group than in the conservative treatment group.