فهرست مطالب mohammad javaherian

Various treatment protocols have been recommended since the beginning of the COVID-19 pandemic and have gradually evolved. This study aimed to assess the effectiveness and safety of incentive spirometer exercise (ISE) in outcomes of hospitalized patients with moderate-to-severe COVID-19 pneumonia.

A 3-month single-blind, two parallel-armed randomized controlled trial was conducted at Imam Hossein Hospital, Tehran, Iran. Participants aged >18 years with documented COVID-19 pneumonia were randomly allocated to 2 groups of IS (ISE in addition to the usual treatment) and control (usual care alone). The IS group was also asked to perform ISE after discharge for three months. The primary outcomes were peripheral O2 saturation (SpO2), VBG parameters (pCO2, PH, HCO3), dyspnea level measured by Modified Borg Scale (MBS), length of hospital stay (LOS), and respiratory rate (RR). Secondary outcomes included mortality rate, intubation rate (IR), and ICU admission rate.

A total of 160 eligible patients were randomly assigned to either the IS (n = 80) or control (n=80) groups. Although there were no significant differences in primary and secondary outcomes between the groups post-intervention, adjusted analysis showed that participants allocated to the IS group had significantly higher SpO2 levels and lower RR, MBS levels, and LOS. Also, the adjusted model analysis showed a marginal statistically significant difference between groups in secondary outcomes, such as IR, the 1-month mortality rate, and the 3-month mortality rate.

It seems that adding the ISE to usual care in the early treatment setting of COVID-19 patients resulted in a relatively significant increase in SpO2 levels, improved respiratory status, and marginally decreased LOS. Additionally, ISE minimally reduced ICU admissions and intubation rates, with no significant impact on in-hospital or long-term mortality in patients with COVID-19 pneumonia.

Myofascial pain syndrome (MPS) is a clinical disorder with a prevalence of 85%. It is characterized by the presence of trigger points, and all people experience it at least once in their lives. Different physiotherapy and medical methods are used to manage MPS. Intramuscular electrical stimulation (IMES) is a relatively new treatment option for MPS. This study aims to examine the effect of IMES on clinical and ultrasound imaging parameters related to trigger points in patients with MPS.

This is a case series clinical trial. Twelve participants with trigger points in their upper trapezius muscles participated in this study. They were treated three times per week with IMES. Before and after the intervention, pain and cervical spine range of motion (ROM) were measured with the visual analog scale and goniometry. Ultrasonic parameters (longitudinal diameter and the area of trigger points, and the thickness of the upper trapezius muscle) were assessed with B-mode ultrasound imaging technique. The pre-test and post-test values were compared using the paired t-test. The significance level was set at 0.05.

After three sessions of IMES, pain and cervical spine ROM improved significantly (P<0.05). All ultrasound imaging parameters, including trigger points’ longitudinal diameter and area and upper trapezius muscle thickness, decreased significantly compared to baseline (P<0.05).

IMES seems to have promising effects on clinical and ultrasound imaging parameters of patients with MPS. Further studies with larger sample sizes are recommended to investigate the long-term effects of IMES with the inclusion of a matched control group.

The current study aimed to update prior systematic review and meta-analyses (SRMA) in order to determine the effects of supervised exercise-based cardiac rehabilitation (EBCR) and introduce a suitable exercise protocol for management of lipid profile abnormalities in patients with cardiovascular disease (CVD).

PubMed, Scopus, and Web of Science databases were searched from 1980 to December 2018. All published, randomized controlled trials (RCTs) reporting the efficacy of supervised EBCR in patients with CVD and measuring at least 1 component of lipid profile were included. The quality of articles was assessed based on the Physiotherapy Evidence Database (PEDro) scale. Random effect model was used to calculate the effect size of post-intervention data.

Initially 774 RCTs were reviewed, 14 of them were included in the study. In comparison with the control group, supervised EBCR was associated with higher serum levels of high-density lipoprotein (HDL) [weight mean difference (WMD): 1.297; 95% confidence interval (CI): -1.620, 4.214] and lower serum level of low-density lipoprotein (LDL) (WMD: -7.797; 95%CI: -14.005, -1.588), total cholesterol (TC) (WMD: -11.029; 95%CI: -20.716, -1.342), and triglyceride (TG) (WMD: -14.602; 95%CI: -28.992, -0.212).

It seems that EBCR is correlated with an insignificant increase in HDL serum level and a significant decrease in LDL, TC, and TG serum levels. Considering subgroup analysis results, it is suggested that long duration, moderate exercise volume (EV), and combination of aerobic exercise (AE) and resistance exercise (RE) be used to improve HDL and TG serum levels. Short duration, high EV, and AE+RE seem to significantly reduce LDL serum level. Moreover, moderate EV is associated with a significant reduction in TC level.

Using simulated patients (SPs) in clinical skills education is a common method of providing training to students to hone their skills for future client encounters. The aim of this systematic review is to provide an overview of the SP strategy in physical therapy (PT) education.

 PubMed, SCOPUS, and Web of Science databases were searched up to November 2019 with no language restriction. Different keywords related to the topic were selected using MeSh. Any types of quantitative study design which had used simulation-based learning in physical therapy student were eligible for inclusion. Two researchers reviewed studies and appraised them critically.

 A total of 1049 abstracts were retrieved and after reviewing the full-text paper, 11 full-text articles were included. These studies had used simulated patients for various aims including replicate different aspects of knowledge, self-perceived skills real, clinical practice, attitudes, and feasibility. Based on the result of studies, SP as an educational technique, can improve student’s clinical reasoning skills, communication, and motivation in a safe method.

The simulated patient is a useful modality to deliver learning activities in medical education and physical therapy curricula, facilitating feedback on students’ performance with opportunities to interact with realistic patients and environments.

A convenient method for the synthesis of 5-substituted-1H-tetrazoles from organic nitriles and sodium azide in the presence of nano silica melamine trisulfonic acid is reported. A series of aliphatic and aromatic nitriles were underwent a [3+2] cycloaddtion with sodium azide to afford tetrazoles in good to excellent yields and acceptable reaction times. The nano silica melamine trisulfonic acid is an efficient heterogeneous nanocatalyst with high catalytic performance. The nano silica melamine trisulfonic acid is readily prepared, environmentally friendly and reusable. The catalyst was characterized by Powder X-ray diffraction, energy-dispersive X-ray mapping and SEM techniques. The procedure was simple, cost effective that holds potential for further applications in organic syntheses and industrial requirements.

An efficient tandem synthesis of alkyl aryl ethers, including valuable building blocks of dialdehyde and dinitro groups under microwave irradiation and solvent free conditions on potassium carbonate as a mild solid base has been developed. A series of alkyl aryl ethers were obtained from alcohols in excellent yields by following the Williamson ether synthesis protocol under practical mild conditions. Scale up ability of this practical procedure is shown by the preparation of some of the valuable dialdehydes up to 50 mmole from alcohols. The method is simple, rapid, straight-forward and holds potential for further application in organic synthesis and industrial requirements.