Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522IndexIndex14618FAJournal Article20151004Click to download the index of this issue.Click to download the index of this issue.https://jims.mui.ac.ir/article_14618_030d13e49bb7d1add5ac5ea2e4a43231.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522The Effects of Rollover Shoes on Instability during Prolonged StandingThe Effects of Rollover Shoes on Instability during Prolonged Standing58559514619FARaziehTahmasebiDepartment of Orthotics and Prosthetics, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, IranMohammad TaghiKarimiAssociate Professor, Musculoskeletal Research Centre, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, IranSaeedForghanyAssociate Professor, Musculoskeletal Research Centre, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20150218Background: Today, rollover footwears are widely used throughout the world for their therapeutic purposes. Many studies have been conducted on the effect of these shoes on balance, but the results are inconsistent with each other and do not provide accurate information on the effect of these shoes on the balance. Additionally, the researches were to evaluate the short-time frame that is not enough for the conclusion of the balance of individuals. So, this study aimed to investigate the effect of rollover shoes on static balance during prolonged standing.Methods: In this study, 30 healthy subjects with age range of 20-30 years were recruited and their static balance, was studied in four situations: 1) barefoot and eyes opened, 2) barefoot and eyes closed, 3) rollover shoes and eyes opened and 4) rollover shoes and eyes closed. Participants stood for 5 minutes on a kistler force plate operating at 100 Hz. The data were parted in to 20-second frames and balance parameters were determined in each frame. The studied parameters included the center of pressure (COP) excursion and velocity in anteroposterior (AP) and mediolateral (ML) plans and total path length.Findings: Rollover shoes made a significant difference in the excursion and velocity of the center of pressure in anteroposterior direction in all frames (P < 0.001); but in mediolateral plan, significant differences were observed only in some frames. The total path length of the center of pressure with rollover shoes, was significantly more than the bare feet (P = 0.002). In addition, about the visual effect on balance, no significant differences were observed.Conclusion: The results show that in this group of participants, the use of rollover shoes cause significant instability especially, in anteroposterior plane which can increase the risk of falling. It is necessary to consider the instability effect of these shoes in prescribing them in subjects with balance disorders, particularly the elderly.Background: Today, rollover footwears are widely used throughout the world for their therapeutic purposes. Many studies have been conducted on the effect of these shoes on balance, but the results are inconsistent with each other and do not provide accurate information on the effect of these shoes on the balance. Additionally, the researches were to evaluate the short-time frame that is not enough for the conclusion of the balance of individuals. So, this study aimed to investigate the effect of rollover shoes on static balance during prolonged standing.Methods: In this study, 30 healthy subjects with age range of 20-30 years were recruited and their static balance, was studied in four situations: 1) barefoot and eyes opened, 2) barefoot and eyes closed, 3) rollover shoes and eyes opened and 4) rollover shoes and eyes closed. Participants stood for 5 minutes on a kistler force plate operating at 100 Hz. The data were parted in to 20-second frames and balance parameters were determined in each frame. The studied parameters included the center of pressure (COP) excursion and velocity in anteroposterior (AP) and mediolateral (ML) plans and total path length.Findings: Rollover shoes made a significant difference in the excursion and velocity of the center of pressure in anteroposterior direction in all frames (P < 0.001); but in mediolateral plan, significant differences were observed only in some frames. The total path length of the center of pressure with rollover shoes, was significantly more than the bare feet (P = 0.002). In addition, about the visual effect on balance, no significant differences were observed.Conclusion: The results show that in this group of participants, the use of rollover shoes cause significant instability especially, in anteroposterior plane which can increase the risk of falling. It is necessary to consider the instability effect of these shoes in prescribing them in subjects with balance disorders, particularly the elderly.https://jims.mui.ac.ir/article_14619_6bbd80b04535d39be5e02dbfd8730469.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522Assessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary TuberculosisAssessment of Related Factors on Delay in Diagnosis of Patients with Smear-Positive Pulmonary Tuberculosis59660314620FASalmanKhazaeiDepartment of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranGhodratollahRoshanaeiAssistant Professor, Health Sciences Research Center AND Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranZahraKousehlouDepartment of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IranAliZahiriDeputy for Health, Hamadan University of Medical Sciences, Hamadan, IranAbdollahMohammadian-HafshejaniEpidemiologist, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan AND PhD Student, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, IranHamidSalehiniyaResearcher, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences AND PhD Student, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranJournal Article20141115Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system.Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software.Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51% (221 patients) were men and 49% (219 patients) were women. 57% (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67% higher than in rural areas, which were both statistically significant.Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas.Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system.Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software.Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51% (221 patients) were men and 49% (219 patients) were women. 57% (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67% higher than in rural areas, which were both statistically significant.Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas.https://jims.mui.ac.ir/article_14620_e626afbcdb83368b3491c0c473da19f1.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522Depression and Cognitive Performances in Patients with Multiple SclerosisDepression and Cognitive Performances in Patients with Multiple Sclerosis60461414621FAMahgolTavakoliAssistant Professor, Department of Psychology, School of Psychology and Educational Science, University of Isfahan, Isfahan, IranMaryamSharifiPhD Student, Department of Psychology, School of Psychology and Educational Science, University of Isfahan, Isfahan, IranVahidShaygannejadAssociate Professor, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0002-9732-4153Journal Article20141126Background: Cognitive deficits are common complaints voiced by patients with multiple sclerosis (MS). Several studies have confirmed these deficits. In the other hand, depression has considerable evidence in these patients; whereas, depression can affect the cognitive performances; it is possible that some of these confirmed cognitive deficits had been caused by depression. This study investigated and compared the cognitive performances of depressed and non-depressed patients with multiple sclerosis and healthy controls.Methods: In this causal-comparative research, 52 patients with multiple sclerosis (26 depressed and 26 non-depressed patients) from Kashani hospital in Isfahan, Iran, and 26 healthy controls were selected. They were assessed through the Beck Depression Inventory (BDI-II), Color Trail Test (CTT), verbal memory test and visual memory test. The data was analyzed using covariance method.Findings: There were significant differences in attention, immediate and delayed (recall) verbal memory performance between the depressed patients with multiple sclerosis and the two other groups (P = 0.002). In additon, there were significant differences in delayed (recall and recognition) visual memory performance between healthy group and the two other groups (P = 0.020). But, there were no significant differences, in immediate visual and delayed (recognition) verbal memory performances, between the three groups.Conclusion: The cognitive performance of the patients with multiple sclerosis not only is affected by neurologic injuries but also it is affected by depression. Depression can cause or intensify the cognitive deficits of the patients with multiple sclerosis.Background: Cognitive deficits are common complaints voiced by patients with multiple sclerosis (MS). Several studies have confirmed these deficits. In the other hand, depression has considerable evidence in these patients; whereas, depression can affect the cognitive performances; it is possible that some of these confirmed cognitive deficits had been caused by depression. This study investigated and compared the cognitive performances of depressed and non-depressed patients with multiple sclerosis and healthy controls.Methods: In this causal-comparative research, 52 patients with multiple sclerosis (26 depressed and 26 non-depressed patients) from Kashani hospital in Isfahan, Iran, and 26 healthy controls were selected. They were assessed through the Beck Depression Inventory (BDI-II), Color Trail Test (CTT), verbal memory test and visual memory test. The data was analyzed using covariance method.Findings: There were significant differences in attention, immediate and delayed (recall) verbal memory performance between the depressed patients with multiple sclerosis and the two other groups (P = 0.002). In additon, there were significant differences in delayed (recall and recognition) visual memory performance between healthy group and the two other groups (P = 0.020). But, there were no significant differences, in immediate visual and delayed (recognition) verbal memory performances, between the three groups.Conclusion: The cognitive performance of the patients with multiple sclerosis not only is affected by neurologic injuries but also it is affected by depression. Depression can cause or intensify the cognitive deficits of the patients with multiple sclerosis.https://jims.mui.ac.ir/article_14621_f7ff233e4ed3e6b13c5d5c7a9201e4ec.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522The Relationship between the Soil Cadmium and Multiple SclerosisThe Relationship between the Soil Cadmium and Multiple Sclerosis61562114622FAMehranHoudajiAssociate Professor, Department of Soil Science, School of Agriculture, Islamic Azad University, Khorasgan (Isfahan) Branch, Isfahan, IranElhamKhosraviPhD Student, Department of Health, Shakhes Pajouh Research Institute, University of Isfahan, Isfahan, IranRezaRouzbahaniAssistant Professor, Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20140707Background: Surveying the interrelationships between the environment and human health says about the human health. So, surveying how environmental factors affect the environment and ultimately human health is the concern of geologists and medical ecologists. Multiple sclerosis (MS) is a debilitating disease which cause is unknown yet. This research aimed to to use geographic information systems (GIS) to explore a possible link between the disease and environmental factors.Methods: In this study, several soil samples were taken from Najaf Abad, Mobarake and Lenjan Counties (West of Isfahan, Iran). The level of cadmium concentration was measured via atomic absorption spectrophotometer model “Pye Unicam, SPQ". In addition, the epidemiology of multiple sclerosis (MS) in 2012 was obtained from Isfahan Health Center and the blood samples of 15 patients were tested for heavy metals. Finally, using Geographic Information System software, the distribution map of cadmium and the disease was drawn.Findings: A significant portion of multiple sclerosis was consistent with soil cadmium distribution in the study areas.Conclusion: The mapping showed that areas with a high prevalence of multiple sclerosis are highly consistent with contaminations such as cadmium. This adaptation shows the disease association with environmental factors and contaminations.Background: Surveying the interrelationships between the environment and human health says about the human health. So, surveying how environmental factors affect the environment and ultimately human health is the concern of geologists and medical ecologists. Multiple sclerosis (MS) is a debilitating disease which cause is unknown yet. This research aimed to to use geographic information systems (GIS) to explore a possible link between the disease and environmental factors.Methods: In this study, several soil samples were taken from Najaf Abad, Mobarake and Lenjan Counties (West of Isfahan, Iran). The level of cadmium concentration was measured via atomic absorption spectrophotometer model “Pye Unicam, SPQ". In addition, the epidemiology of multiple sclerosis (MS) in 2012 was obtained from Isfahan Health Center and the blood samples of 15 patients were tested for heavy metals. Finally, using Geographic Information System software, the distribution map of cadmium and the disease was drawn.Findings: A significant portion of multiple sclerosis was consistent with soil cadmium distribution in the study areas.Conclusion: The mapping showed that areas with a high prevalence of multiple sclerosis are highly consistent with contaminations such as cadmium. This adaptation shows the disease association with environmental factors and contaminations.https://jims.mui.ac.ir/article_14622_a1c71b134d46d7f7ff00f488874a8d43.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953333220150522Effects of 12-Weeks Combined Trainings with Vitamin D Supplement on the Sensory-Motor Neuropathy in Women with Type 2 DiabetesEffects of 12-Weeks Combined Trainings with Vitamin D Supplement on the Sensory-Motor Neuropathy in Women with Type 2 Diabetes62263014623FAMaryamNadiMSc Student, Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Isfahan, Isfahan, IranSeyed MohammadMarandiAssistant Professor, Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran0000-0003-3877-870XFahimehEsfarjaniAssociate Professor, Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Isfahan, Isfahan, IranMahboobehMohammadiGeneral Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranFatemehAhmadiMSc Student, Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Isfahan, Isfahan, IranJournal Article20140518Background: Peripheral neuropathy is a common complaint of diabetes. This complication is created because of the many consequences of disability among patients, as a debilitating disease known. The purpose of this study was investigating the effects of 12-weeks combined training with vitamin D supplement on improvement of sensory-motor neuropathy in women with type 2 diabetes.Methods: This clinical trial study was conducted in Isfahan province, Iran, during 2013-2014. 90 patients were selected and randomly divided in two groups. 9 patients (included 5 intervention, and 4 control patients) were excluded and finally 81 adult females with type 2 diabetes aged 20-55 years were entered to the study. The control group had no training but, received vitamin D. The experimental group, received vitamin D and 12-weeks training program (3 days a week, 60 minutes per session) including aerobic exercises, strength and flexibility. Aerobic exercise intensity was set at 60-70% of maximum heart rate and resistance training intensity was determined by 50 percent of 10 RM (Rep Max). The intensity of neuropathy was measured using Michigan neuropathy screening instrument (MNSI); reflex hammer and tuning fork 128 Hz were used for pre- and post-test.Findings: Followed three months of combined trainings and supplementation with vitamin D, significant reductions in numbness (P = 0.001), pain (P = 0.002), tingling (P = 0.001) and weakness (P = 0.002) in the lower limb was seen. In addition, increases in the sense of touch intervention (P = 0.005), detecting the position of the fingers (P = 0.001) and vibration perception (P = 0.001) in the tissues after the training was noted. Knee reflexes (P = 0.770) and ankles (P = 0.470) did not significantly change after the interventions.Conclusion: It seems that participation in combined trainings and supplementation with vitamin D can decrease the symptoms of sensory-motor neuropathy.Background: Peripheral neuropathy is a common complaint of diabetes. This complication is created because of the many consequences of disability among patients, as a debilitating disease known. The purpose of this study was investigating the effects of 12-weeks combined training with vitamin D supplement on improvement of sensory-motor neuropathy in women with type 2 diabetes.Methods: This clinical trial study was conducted in Isfahan province, Iran, during 2013-2014. 90 patients were selected and randomly divided in two groups. 9 patients (included 5 intervention, and 4 control patients) were excluded and finally 81 adult females with type 2 diabetes aged 20-55 years were entered to the study. The control group had no training but, received vitamin D. The experimental group, received vitamin D and 12-weeks training program (3 days a week, 60 minutes per session) including aerobic exercises, strength and flexibility. Aerobic exercise intensity was set at 60-70% of maximum heart rate and resistance training intensity was determined by 50 percent of 10 RM (Rep Max). The intensity of neuropathy was measured using Michigan neuropathy screening instrument (MNSI); reflex hammer and tuning fork 128 Hz were used for pre- and post-test.Findings: Followed three months of combined trainings and supplementation with vitamin D, significant reductions in numbness (P = 0.001), pain (P = 0.002), tingling (P = 0.001) and weakness (P = 0.002) in the lower limb was seen. In addition, increases in the sense of touch intervention (P = 0.005), detecting the position of the fingers (P = 0.001) and vibration perception (P = 0.001) in the tissues after the training was noted. Knee reflexes (P = 0.770) and ankles (P = 0.470) did not significantly change after the interventions.Conclusion: It seems that participation in combined trainings and supplementation with vitamin D can decrease the symptoms of sensory-motor neuropathy.https://jims.mui.ac.ir/article_14623_2e3517ba49c2a7c999b9c8381185ae4e.pdf