javad moghimi

Economic structures are among the factors influencing the formation of the political system and the way in which a political system is formed and sustained. Therefore, economic structures may lead to the formation of authoritarian ideas and militaristic tendencies in developing societies, including Iranian society. The present study has dealt with this issue in the first Pahlavi period.

This research is of theoretical type. The research method is descriptive-analytical and the method of data collection is library and has been done by referring to documents, books and articles.

 In the various stages of writing this article, while respecting the originality of the texts, the principles of honesty and trustworthiness have also been observed.

Disturbed economic conditions, lack of central economic system, lack of proper financial system to generate government revenue and spending on public affairs are among the reasons that led to the emergence of Reza Shah in the post-Qajar era. Also, the support of intellectuals and political elites for a powerful king has been one of the factors in the emergence and continuation of Reza Shah's rule.

Several conditions affected the continuity of militaristic and authoritarian thought in Reza Shah's time, including rent structure, the existence of a new landlord-based system based on the rise of the military and a circle close to Reza Shah, huge central government revenues from taxes, customs and oil, including There were factors that led to the independence of the Pahlavi government from the people and the tendency towards authoritarianism and militaristic thought.

The present study seeks to examine the causes of passivity of political elites in the second Pahlavi period and to show its impact on the crisis of efficiency and accountability. Accordingly, the question of the present study is: What factors influenced the passivity of political elites in the Pahlavi period and what effect did it have on the crisis of efficiency and accountability in the period of Mohammad Reza Shah? The hypothesis is: Mohammad Reza Shah's psychological characteristics such as the need for obedience, submission and acceptance of flatterers on the one hand and ideological alignment, common class and group interests of instrumental political elites, on the other hand cause the passivity of critical political elites and increase the gap between the masses and Was ruled. In fact, the findings of the present study from an elite perspective point to the gap between the political elites in society and the people and their connection with the Pahlavi government apparatus, which ultimately led to the expansion of government distance from the public interest and destroys government accountability. Which eventually led to a crisis of efficiency and accountability. Mohammad Reza Shah's psychological characteristics are another factor in the crisis of accountability due to narcissism and social approval by the instrumental elites. The present study uses a descriptive-analytical method, which finally collects information in a documentary and library manner and examines the issue from an analytical perspective.

Achieving civil rights is one of the most difficult and practical issues for political and social systems. Considering the effectiveness of the principle of accountability in the realization of citizenship rights, the present study addresses the issue of how the principle of accountability can affect the realization of citizenship rights?

The method used in this study is descriptive-analytical, which has been collected by using documentary and library sources, information needed to discuss the principle of accountability and citizenship rights.

The findings show that the principle of accountability is through transparency in political affairs, creating competition based on party ideas, freedom of action of civil society, freedom of criticism, decentralization of government activities and actions, transfer of power and Relationships are also based on trust in society, so that both the performance of citizens towards each other and the performance of political leaders towards the people are subject to the principle of responsibility.

Ethical considerations:

 In writing the contents of the present article, the principles of referral and fidelity have been observed and it is considered a genuine research.

The results show that the realization of citizenship rights requires change in terms of quantity and quality. On a small scale, reducing government power, decentralizing, empowering civil society, the existence of multiple parties and groups, as well as shifting the power of political and administrative officials can promote the principle of accountability and steer the political system in line with the real demands of citizens. But in the qualitative dimension, we need to build relationships based on trust between citizens (vertical trust) and relationships based on trust between citizens and rulers (horizontal trust). In addition, the principle of accountability, if there is proper education and cultural principles based on equality and freedom of citizenship, can lead to the realization of citizenship rights.

Maintaining proper size and rotation of components of total knee arthroplasty is mandatory for optimal longevity. Ethnical differences may affect the fitness of prostheses that were manufactured mainly based on Caucasian dimensions.
To evaluate the distal femur morphology of the Iranian population at the level of standard cuts simulated via computed tomography.
Patients and During 2013, 150 consecutive patients (96 males and 54 females) from the outpatient Department of Orthopedic Surgery of Rasoul Akram Hospital with knee CT scans were studied. We entered cases with apparent normal extremity alignment and bone maturity. Exclusion criteria were history of fracture or conditions affecting knee profile. Standard cuts were simulated on the CT scan using the Marco Pacs program. For each bone, anteroposterior (AP), mediolateral (ML), and aspect ratio (ML/AP) were measured. Values were compared with the sizing of four currently available prostheses.
The mean age of the patients was 43 years (range: 17 to 80). All isolated parameters were higher in men significantly (P Our findings may be applied by manufacturers to design prostheses more compatible with Asian populations. Alterations to the shape of components should be considered to provide optimal coverage.

Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery.

Total knee arthroplasty is a complex procedure aiming to relieve pain and improve function. It is critical to select prosthesis that best cover the bone surfaces. Ethnicity may affect fitness of the components mainly designed for Caucasian populations. This study aimed to evaluate morphometric features of proximal tibia in Iranian population. During 2013, 150 consecutive patients (96 males and 54 females) form orthopedics department of Rasoul-Akram hospital with knee CT scan were randomly enrolled. We entered cases with apparent normal extremity alignment and bone maturity. Cases with history of fracture or conditions affecting knee profile were excluded. Standard cuts were simulated on CT scan. Anteroposterior (AP), mediolateral (ML) and aspect ratio (ML/AP) were measured for general morphology. Medial and lateral AP distance of tibia and their distance to tibial center were measured for checking symmetry. Mean age was 43.0± 10.4 years (rang 11-80). Males showed significantly larger values in ML dimension and aspect ratio than females under a given AP value (p<0.001). However, the aspect ratio was suggestive of similar configuration of proximal tibia profiles among genders. Totally, close correlations were observed among simulated cuts and size-matched tibial components of the prostheses. However, better coverage was provided by some brands via designing interchangeable components for a given dimension. Medial and lateral condyles of tibia were almost symmetrical. Our findings indicated that some alterations in the shape of the components are needed to provide optimal coverage in Iranian population. We propose symmetrical configuration in designing tibial components as well.

Proper rotation of components in total knee arthroplasty (TKA) will largely affect the postoperative outcome. Ethnical variation may affect rotational profile. We aimed to evaluate distal femur rotation in Iranian population using transepicondylar axes. From a total of 450 knee CT scans and via consecutive sampling, 150 qualified subjects with normal lower extremities alignment were selected comprising 96 (64%) males and 54 (36%) females aging 17-80 years. The posterior condylar angle and condylar twist angles were defined as angles between either surgical epicondylar axis (line connecting lateral epicondylar prominence and the medial sulcus) or clinical epicondylar axis (line connecting most prominent points of both epicondyle) and posterior conylar line. Data were compared among genders. Average age of our samples was 43 years (ranging 11-80). Mean (±sd) values for posterior condylar angle and condylar twist angles were 2.35º(±1.34) and 5.77º(±1.70), respectively. The former variable was not discernible in twenty of our subjects because of obscure medial sulcus. Our findings were totally appeared similar to studies from other ethnicities and the observed minor differences may have originated from amount of osteoarthritis and malalignment. Overall, Iranian distal femur rotational profile was similar to other reports. Some minor observed differences may be partially due to samples’ age and different amount of knee osteoarthritis. It is proposed to rely on several methods for determining rotational profile while performing TKA. Moreover, preoperative computed tomography should be fully scrutinized especially in severely osteoarthitic knees.

As an established method of treatment for medial unicompartmental knee osteoarthritis, we aimed to evaluate results of short-term follow up of closed and open wedge high tibial osteotomy. In teaching hospital of Rasoul-e-Akram and during 2001-2009, we retrospectively surveyed docu-ments of 41 cases with osteoarthritis of the knee and genu varum deformity that underwent high tibial osteoto-my. Radiographic evaluation of knee alignment was performed using lower extremity scanogram in three measurements of preoperation, postoperation and last follow up visit (average of 2 years). Improvement of pain was assessed via visual scales. From a total of 13 closed and 28 open wedge high tibial osteotomies, the femorotibial angles were calculated varus of 7.7±2.5° preoperatively, valgus of 7±2.3° postoperatively and reached valgus of 6.1±3° at the final follow-up. In open-wedge osteotomies, loss of correction was meaningful during follow-up, mainly in patients without fixation. Higher amount of preoperative knee varus (>10°) was accompanied with more loss of correction postoperatively. About 80% of patients were satisfied of pain relief with average knee flexion of 125 degrees. Our major complications were two cases of intra-articular fracture. Open wedge cases without plate fixation experienced more failure of correction. With proper patient selection and applying appropriate technique plus sufficient correction, high tibial osteotomy can be an effective treatment for medial knee osteoarthritis with genu varum. It may diminish the need for knee arthroplasty or at least delay the surgery.

We aimed to evaluate clinical, high resolution computed tomography (HRCT) and pulmonary function test (PFT) findings after 18-23 years of exposure in veterans of sulphur mustard (SM) exposure. We performed a cross-sectional study of 106 patients. Inclusion criteria were 1: documented exposure to SM as confirmed by toxicological analysis of their urine and vesicular fluid after exposure 2: single exposure to SM that cause skin blisters and subsequent transient or permanent sequel. Cigarette smoking and pre-exposure lung diseases were of exclusion criteria. After taking history and thorough respiratory examination, patients underwent high resolution computed tomography and spirometry. Clinical diagnoses were made considering the findings. More than 85% of the patients were complaining of dyspnea and cough. Obstructive pattern (56.6%) was main finding in spirometry followed by restrictive and normal patterns. HRCT revealed air trapping (65.09%) and mosaic parenchymal attenuation patterns (58.49%) as most common results. Established diagnoses mainly were chronic obstructive pulmonary disease (COPD) (54.71%), bronchiolitis obliterans (27.35%) and asthmatic bronchitis (8.49%). There were not any significant association between the clinical findings and results of PFT and HRCT imaging and also between PFT and HRCT findings (P-values were more than 0.05). Considering debilitating and progressive nature of the respiratory complications of SM exposure, attempts are needed for appropriate diagnosis and treatment.