alireza ashraf

 Patients with foot drop may need compensatory mechanisms to improve their gait. Although several gait analysis parameters have been studied in these individuals, no prior research has examined their joint contact force. Thus, this study investigated multiple gait analysis parameters and the joint contact force in patients with foot drop.

This experimental study recruited twenty individuals aged 15 to 60 (mean value 56.4 ± 3.68) with foot drop disorders. A control group was also matched with the first group based on age, height, and gender. The participants were instructed to walk along a 12-meter path. A motion analysis system with eight high-speed cameras and a Kistler force plate was used. During gait analysis, various parameters were measured, such as spatiotemporal, peak forces applied on the leg, range of motions, moments applied on the lower limbs, and joint contact forces.

The mean values of stride length and speed for normal subjects were 1.32±0.2 m and 1.24 ± 0.177 m/s, respectively, compared to 0.961±0.24 m and 0.686 ± 0.25 m/s for foot drop subjects (p-value = 0.00). The joint contact force components of the ankle joint increased significantly in foot drop subjects compared to normal subjects.

The joint contact forces of the ankle joint increased significantly in foot drop patients, which should be considered in the rehabilitation treatment of these patients.

Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy. Due to the results of recent studies about the protective effects of L-carnitine on nerves, this study was conducted to evaluate the effects L-carnitine on CTS improvement in terms of patient's function, electrodiagnostic study (EDX), and median nerve sonography.

In this double-blind, randomized, controlled trial, patients with CTS were selected based on the inclusion and exclusion criteria, and then, divided into two groups of placebo and L-carnitine at a dose of 500 mg twice daily for 6 weeks. They were assessed at baseline, and 4 and 6 weeks later using Boston Carpal Tunnel Questionnaire (BCTQ)‎, median nerve conduction study (EDX), and sonography.

There was no statistically significant difference between the intervention and control groups in terms of BCTQ‎ scores, electrodiagnostic findings, and sonographic indexes. Although based on the results of the repeated measures test of the intervention and control groups separately, there was a statistically significant difference in some electrodiagnostic criteria and BCTQ‎ scores. These indexes improved after the intervention.

The effectiveness of L-carnitine on mild to moderate CTS improvement cannot be approve based on the findings of this study and more studies and systematic reviews are required in this regard.

approaches have been proposed for the treatment of carpal tunnel syndrome (CTS) based on its severity. The aim of this study is to determine the optimal management for severe CTS.

 This cross-sectional study was conducted for 22 months from August 2017 to June 2019 in a referral rehabilitation clinic in southern Iran. A total of 117 hands diagnosed with severe CTS were included in 78 patients according to electrodiagnostic study (EDX) reports (considering Sensory Proximal Latency (SPL)>3.6 msec, Sensory Distal Latency (SDL)>5.3 msec, Sensory Nerve Conduction Velocity (SNCV) <30 m/sec, Distal Motor Latency (DML)>6.5 msec as being severe) who refused to undergo surgery. Boston questionnaire was filled out and conventional EDX was carried out at the first and the 1-year follow-up visits.

In patients with a detectable sensory nerve action potential (SNAP), motor amplitude (P<0.002) and latency (p<0.01), SPL (p<0.003) and SNCV (p<0.006), and Boston parameters improved significantly in the 1-year follow-up visit compared with the results at the first visit. However, improvement in patients with absent or low amplitude SNAP at first visit was only observed in proximal sensory latency (p<0.005) and amplitude (p<0.003).

There is a considerable chance for non-surgical improvement of patients with severe CTS in terms of symptom relief, hand function, and EDX parameters in those with detectable SNAP at first visit; however, patients with undetectable SNAP have little, if any, the chance for improvement with conservative measures.

Mechanical neck pain (MNP) is a common health concern. Some studies suggested a relationship between neck pain and visual activity. We assessed the role of myopia as a contributing factor in the development of chronic MNP.

All medical students at Shiraz University School of Medicine, who were 18 to 22 years old, were invited to participate in this retrospective case-control study from March 2016 to March 2017. Numeric Pain Rating Scale (NPRS) was used to assess the average neck pain severity over the past 6 months in order to enroll participants as the case (≥3) or control (<3) groups. Demographic data and medical profile were obtained. After identifying eligible cases, we assigned age- and sex-matched controls, who also met the study criteria. Subsequently, participants completed the Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPDS) questionnaires and were evaluated for myopia severity. Variables were compared between the case and control groups as well as within the case group. P-value<0.05 was considered statistically significant.

From over 700 medical students, around 150 cooperated. Eventually, 31 eligible cases (and 31 controls) were studied. NDI and NPDS were significantly higher in the case group (P<0.001). However, no significant differences were noticed between the groups regarding the severity (P=0.123) and the duration (P=0.417) of myopia. Also, the correlation of myopia severity with NDPS (ρ=0.159, P=0.216) and NDI (ρ=0.201, P=0.116) was non-significant within the case group.

Our findings have not supported the influential role of myopia in the development of chronic MNP.

Splinting is the most common conservative method of treating patients with mild and moderate Carpal Tunnel Syndrome (CTS). The aim of this study was to determine the effectiveness of the limited dynamic wrist splint on the symptoms, function, and strength of women with CTS. In this controlled trial study, the subjects wore a splint of a new design called the “limited dynamic wrist splint”, which allowed the wrist motion in the range (between 15-degree flexion and 15-degree extension) that exerts minimum pressure on the median nerve and prevents extra pressure on the nerve by limiting the range of motions out of the allowed range.
In this study, 24 women diagnosed with mild to moderate CTS were initially evaluated on the basis of the Boston questionnaire, the dexterity test of the Purdue pegboard, grip and pinch strength, distal sensory latency, and sensory nerve conduction velocity. The subjects were randomly divided into two groups, control and treatment. Both groups received routine rehabilitation treatment for six weeks. The treatment group received the limited dynamic wrist splint for about six to eight hours a day. After six weeks, the initial examinations were repeated. The SPSS-16, independent t, and paired t-tests were used for data analysis.
All the variables in the treatment and the control groups showed improvement. The function test of the Boston questionnaire, the Purdue pegboard test, and the pinch strength were significantly improved in the treatment group. The “severity of the symptoms” test of the Boston questionnaire and the pinch strength in the control group showed a statistically significant difference (P This study showed that the use of the limited dynamic wrist splint for about six weeks for six to eight hours a day could have a significant effect on the function, dexterity, and the pinch strength of patients with CTS. Not only can the patients receive treatment by this method, but they can also perform their daily activities to some extent.

Osteoarthritis (OA) is one of the most common diseases of both bone and cartilage. Since calcitonin may have positive effect on both of them.
The current study aimed to evaluate the effect of weekly calcitonin injection on patients with knee osteoarthritis using Western Ontario and McMaster universities arthritis index (WOMAC) questionnaire.
The current prospective cross sectional study, randomly recruited 28 eligible female participants aged 55 - 70 from outpatients referred to rehabilitation clinics. These patients were in stages II and III based on Kellgren-Lawrence grading scale. Patients were requested to fill out the multidimensional WOMAC questionnaire on the day of enrollment into the study (baseline examination) and five weeks after completion of their treatment with calcitonin. Paired T-test was used to assess mean differences of the questionnaire.
Compared to baseline, significant improvement in WOMAC score was observed after five weeks of treatment. Pain, joint stiffness, functional activity and total score of WOMAC showed improvement of 80.6%, 25.3%, 41.9% and 47.91% respectively, which were statistically significant (P value The study results showed that calcitonin can provide proper outcomes such as increased locomotor activity. Although WOMAC parameters increased in all age groups, it had great effect just on 55 - 60 years age group. Therefore, improvement of quality of life and proper rehabilitation, which are the main factors in osteoarthritis patients, were almost achieved in this study.

Context: Carpal tunnel syndrome (CTS) is a prevalent complaint during pregnancy and lactation. During lactation both environment and hormonal changes can contribute to worsening the symptoms. Some authors believe that CTS in lactation is a separate clinical entity which develops in pregnancy. Therefore, the specific conditions of these patients demand a special assessment of their treatment.. Evidence Acquisition: We searched Pubmed, Scopus and Google Scholar regardless of the articles'' publication date. The search was performed using the terms “carpal tunnel syndrome” “median nerve entrapment” or “median nerve neuropathy” which were independently associated (by using «and» in the builder) with breastfeeding, lactation, nursing, postnatal, postpartum, puerperal, and puerperium. We restricted our search to the articles published in English or Persian. The abstracts of references were carefully reviewed and included, if related to CTS and lactation. Finally, the extracted data about therapeutic options available for mothers during breastfeeding were assigned to different areas such as surgical, medical, etc. Related articles were then discussed under the most appropriate topics.. Usually, gradual resolution of the symptoms of CTS occurs after stopping breastfeeding. Reassurance and nursing advice on optimal positions for holding baby and breasts during breastfeeding is the first step of treatment. Intra-carpal steroid injection, diuretics and non-steroidal anti-inflammatory drugs might have some benefits, according to the few observational studies on lactating women with CTS. Splinting as a safe option that does not interfere with breastfeeding with good efficacy is suggested by all authors. Surgical intervention is spared for the patients experiencing severe symptoms for long periods, those with thenar muscles wasting or when conservative treatment fails.. Current evidence suggests that in addition to nursing advice regarding positioning during breastfeeding, similar treatment strategy for CTS in general population is suitable for lactating mothers. However, available studies suffer from many shortcomings and have not evaluated all therapeutic options in this field. Well-designed interventional studies with special focus on this issue are needed to provide evidence based recommendations..

Carpal tunnel syndrome is the most prevalent compression neuropathy of upper extremity which, two of the most important risk factors of that are the female sex and manual works. In the model of international classification of function, disability and health, disease is an impairment, results in functional limitation. The goal of this study is to compare hand function of participants between various severities of carpal tunnel syndrome. In a cross-sectional study, during 6 months period of time, 30 housekeeper women with carpal tunnel syndrome, with the mean age of 47.03 years, were selected through simple sampling. They were assessed for hand function, by Purdue peg board test and Boston questionnaire, after that a professional practitioner had performed Nerve Conductive Velocity (NCV) test and identified the severity of their diseases. Then the data were analyzed with SPSS software, by Kruskal-Wallis test. The mean of Purdue peg board test and Boston questionnaire scores in various clusters of carpal tunnel syndrome severity, were not different (P.Value>0.05). In this research, severity of electrodiagnostic findings of participants, with carpal tunnel syndrome, isnot related to their performance and functional limitations.

Osteoporosis is a common disease characterized by reduction in bone mass, due to depletion of calcium and bone protein. A pivotal role of the sympathetic nervous system in bone remodeling has been considered. On the other hand, elevated central sympathetic activation in postmenopausal women is involved in the creation of vasomotor symptoms. Also, sympathetic skin response (SSR) has been performed for evaluation of the peripheral and central autonomic nervous system dysfunctions. Therefore, to determine the association of the autonomic nervous system and osteoporosis, we evaluated the correlation between the bone mineral density (BMD) with the frequency of vasomotor symptoms and also sympathetic skin responses. This is a cross-sectional study in which thirty-three postmenopausal osteoporosis women, as the case group, and 31 age-matched postmenopausal women with normal BMD, as the control group, were included in our study. To evaluate the autonomic function, we assessed the frequency of vasomotor symptoms with a questionnaire and performed SSR test for the two groups. According to the parametrical or the nonparametrical distribution of the data, Independent Samples t-test or Mann Whitney test, respectively, were used to compare group differences. The onset latencies of SSR recorded from both hands and feet were significantly prolonged in the case group compared with the control group (P<0.001). Amplitudes of SSR in the case group were significantly less than those of the control group (P<0.001). The postmenopausal osteoporotic women reported a significantly higher frequency of hot flashes and night sweats when compared with non-osteoporotic women (P<0.001). The higher frequency of vasomotor symptoms and impaired sympathetic skin responses in postmenopausal osteoporotic women suggests a role of autonomic dysfunction in osteoporosis.

Rheumatoid Arthritis (RA) is a systemic and inflammatory disease of unknown etiology which is mostly characterized by inflammation of the synovial joints. Studies have proved that most people with RA avoid doing physical activities due to fear that it may worsen the pain or cause pressure on joints, resulting in decreased muscle strength and ultimately leading to disability of patients. We aimed to investigate the effects of conditioning exercises on the health status and pain in patients suffering from RA. In this randomized controlled clinical trial, we enrolled 66 women with confirmed RA referred to the rheumatology clinic of Hafez hospital, Shiraz, southwest Iran during May-July 2013. Balanced block randomization method was used to randomize the participants into case and control groups (two groups of 33 each).Data were collected using visual analog scale (VAS), Arthritis Impact Measurement Scales 2 short form (AIMS2-SF), and demographic questionnaire. After obtaining written informed consent, the participants in the case group were asked to participate in conditioning exercise programs including aerobic, isometric, and isotonic exercises and received a training booklet explaining the exercises that they could do at home after the intervention. There was a statistically significant difference between the health status scores of the patients in the case groups before and after the intervention (P=0.001). The pain score also decreased significantly in the case group compared with the control group after the intervention (P=0.003). We concluded that physical training programs, especially conditioning exercises, could improve the health status and reduce pain in patients with RA.

Phonophoresis is a method for topical medications to better penetrate the skin via ultrasound. Its actual mechanism has not been well defined، but it could be due to increased cell permeability from the thermal effects of ultrasound. Some indications for phonophoresis include: osteoarthritis، bursitis، neuromas، adhesions، scar tissues. Here we present a 55 year old woman who was a known case of Grave’s disease presenting with pretibial myxedema. The edema did not respond to common treatments but improved following the use of phonophoresis with clobetasol significantly improved.

Noticing the daily advancement of the role of electromagnetic field generators in human life, examination of the biologic impacts of these waves has come to be extensively appreciated by researchers. During pregnancy, vitamin A is extremely essential for the development of fetus and its lack, insufficiency or excess can result in embryonic malformations. This study investigated the synergetic effects of vitamin A and extremely low frequency electromagnetic fields on the development of embryo skin in Balb/C mice. This study was experimental in nature. Eighteen pregnant mice were divided into control, sham-exposed and experimental groups. The mice in the experimental group were given an intra-peritoneal injection of 15000 IU/kg vitamin A on the 10.5th day of gestation and were, then, exposed to a 50Hz electromagnetic field 4 hours a day from 10 through 12th day of gestation. The animals were dissected and investigated morphologically and histologically on 17.5th day of gestation. The results showed an increase in the mean weight of fetuses in the experimental group in comparison to the sham- exposed group (p<0.05). Also, Crown-Rump of fetuses in the experimental group increased in comparison to those in the sham- exposed group (p<0.001). Epidermis thickness increased significantly in experimental group in comparison to sham- exposed (p<0.05), while the average number of basal, spinous cells and hair follicles decreased significantly in the experimental group compared to the sham- exposed (p<0.001). The findings indicate that vitamin A usage and synergetic exposure to low frequency electromagnetic fields (50Hz) profoundly affect the development and growth of skin epidermis in the fetus of Balb/C mouse.

Angiogenesis the formation of new blood vessels is a dynamic and complex activity which is needed for embryogenesis and other physiological processes. However in many pathological conditions such as solid tumor progression the disease appears to be associated with persistent up-regulated angiogenesis. In this research we used 0.04 T (tesla) electromagnetic field as a synergic treatment with rapamycin on angiogenesis. In this experimental study 70 Ross fertilized eggs were randomly divided into 5 groups as following: 1) control 2) sham-exposed 3) a group treated with rapamycin 4) a group treated with electromagnetic field and 5) a group treated with both rapamycin and electromagnetic field. In day 2 a window was opened on eggs in sterile condition. In day 8 a gelatin sponge was placed on chorioalantoic membrane (CAM) and was soaked with 5 μl rapamycin in group 3 and group5. Groups 4 and group 5 were placed in 400 Gauss magnetic field for 4 hours in day 10. In day 12 CAMs were examined and photographed by research photo-stereomicroscope in all cases. Data were analyzed using ANOVA and Mann-Whitney tests. Comparison between average number and length of vessels in controls and sham-exposed didn’t show any significant differences. In group 3 and 4 a significant decrease was shown in the average number and length compared with controls. Finally comparison between group 3 and group 5 showed a significant decrease in the average number and length of vessels in group 5 which had been treated with both rapamycin and 400 (Gauss) G electromagnetic field. The results of this study showed that 0.04 T magnetic field has an inhibitory effect on angiogenesis in CAM and can enhance the effect of rapamycin as an anti-angiogenesis drug.

During the recent years a large number of microwave radiating appliances, e. g. cell phone, radio, television, electric home appliances, etc, have been produced and used in a wide range. Therefore ٫ researchers in biology have paid special attention to the effects of the waves on the human health and the animal growth process. This research studies the effects of the cell phone waves (940 MHz) on the hematopoietic system of immature Balb/C mice. In this experimental research a microwave generating system (940 MHz) consisting of a special cage with two built-in cell phones was used. Immature mice were exposed to the waves of two active cell phones for 30 min /daily for a period of fifteen days. Having completed the feeding and caring process ٫ the mice from three control, sham-exposed and experimental groups were dissected. To assay blood parameters, blood was taken from the heart and to carry out the histological studies, spleen, liver and bone marrow were prepared for light microscopy studies. The quantitative data were analyzed with SPSS software and one-way ANOVA with the consideration of the significant level of p<0. 05. The cell phone waves (940MHz) have no significant effect on the number of WBC, Hb, MCV, MCH, MCHC (p>0. 05). While a decrease in the number of white pulp lymphocytes, and megakaryocytes in the experimental samples were seen compared to the control and sham-exposed groups (p≤0. 001), the number of white pulp, spleen diameter and diameter of white pulp had no significant difference in control and sham-exposed and experimental groups (p>0. 05). In the liver of experimental mice, the number of mononuclear cell complexes and Kupffer cells had a significant decrease compared to the control group (p≤0. 001). The number of hepatocytes in both control and experimental groups showed no significant difference (p>0. 05). There was an increase in the mean number of bone marrow cells and their division compared to the control samples (p≤0. 001). The cell phones waves have an effect on some cells of liver, spleen and bone marrow in immature BALB/c mice.

The increasing use of the electromagnetic field producer sets in daily living causes concerns about these waves on human health. The effects of extremely low frequency electromagnetic field (50 Hz) on induction of chromosomal damages on bone marrow erythrocytes of male Balb/C mouse has been investigated in this research. This is an experimental study in which the laboratory system of producing electromagnetic with low frequency (50 Hz) was used. Five week old male Balb/C mice were divided into three controls, sham-exposed and experimental groups. The experimental mice exposed were exposed to electromagnetic field (50 gauss) for 4 days (12 hours/day). After treatment, the chromosomal damages were assessed using micronucleus test in polychromatic erythrocytes and resultant quantity data were analyzed using t and Mann-Whitney test. Results showed that frequency of micronucleated polychromatic erythrocytes of experimental group (14/35±1/589) was more than Sham-exposed (8/958±1/049) and control group (7/65±0/768) significantly (p<0/05). Extremely low frequency electromagnetic field (50 Hz) causes chromosomal damages induction in polychromatic erythrocytes of bone marrow male Balb/C mouse.

The increasing users of microwave appliances such as cell phones caused an increasing interest on investigation of its adverse effects on human health and development of animals.This study is done to investigate the effects of simulating cell phone waves on gonads and sex cells of male Balb/C mouse. This is an experimental study in which with the use of generating apparatus of simulating cell phone waves, adult male mice were exposed to cell phone waves for 10 days (4 hours per day). Then structure and ultrastructure of testes and number of sex cells were examined by light and transmission electron microscope. Data was analyzed using t and Mann Whitney testes. The results did not show any significant differences in the size and weight of testes in mice exposed to the simulating cell phone waves. Results also showed that the number of spermatogonia cells and primary spermatocytes and spermatids and sperms were significantly increased in exposed mice (p<0.05), but the number of sertoli cells were significantly decreased (p<0.05). The study of micrographs showed changes in ultrastructure of sexual cells, such as cleft and hetrochromatined nucleus and decrease of cell organelles and vacuolization of cytoplasm. Results indicate the effect of simulating cell phone waves on number and ultrastructure of sex cell in male Balb/C mouse.