Isfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219IndexIndex15128FAJournalIndex0000-0003-0874-1906Journal Article20170502Click to download the index of this issue.Click to download the index of this issue.https://jims.mui.ac.ir/article_15128_05e51be563129e4c14ac285dee4986e8.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219Prevalence of Musculoskeletal Disorders and Postural Assessment during Endoscopy and Colonoscopy among Gastroenterologists in Isfahan City, IranPrevalence of Musculoskeletal Disorders and Postural Assessment during Endoscopy and Colonoscopy among Gastroenterologists in Isfahan City, Iran1573158115129FABabakVahdatpourAssociate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMostafaSayed-MirramazaniGeneral Practitioner, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20150220Background: Gastroenterologists may be susceptible to various musculoskeletal disorders in the absence of proper position, because of working in various positions in offices and hospitals. This study aimed to assess the relationship between the posture and musculoskeletal disorders among gastroenterologists in Isfahan city, Iran.Methods: Three methods of posture evaluating are self-report, observational method and direct measurement. Based on studies, the validity and reliability of the observational method is more than others. In this study, gastroenterologists' postures during endoscopy and colonoscopy were analyzed using two observational methods of Rapid Upper Limb Assessment (RULA) and Ovako Working Posture Assessment System (OWAS). They also completed Nordic questionnaire for assessment of musculoskeletal disorders.Findings: Based on OWAS, the posture risk was 1 in 22.2% and 2 in 77.8% of gastroenterologists; while based on RULA, this risk was 4 in 38.9%, 5 in 38.9% and 6 in 22.2% of them. Musculoskeletal disorders had a direct relationship with the level of risk based on RULA, but had no significant association with the level of risk based on OWAS. The level of risk based on RULA had a direct relationship with the number of procedures per day. In addition, the rate of musculoskeletal disorders had a direct relationship with the number of procedures per day and body mass index (BMI). The level of risk based on RULA had a direct relationship with incidence of musculoskeletal disorders in the neck, upper back and knees.Conclusion: Musculoskeletal disorders are highly prevalent among gastroenterologists in Isfahan city. Postural analysis results showed that the risk of incidence of these disorders is to a large extent, too. High body mass index was one of the factors contributing to the occurrence of musculoskeletal disorders. Since about half of the target group were overweight, losing weight can help to reduce the incidence of musculoskeletal disorders. In addition, the high number of procedures per day increases the risk of posture and musculoskeletal problems simultaneously. So, reducing the number of procedures or increasing the rest time between appointments, discontinuous endoscopy and colonoscopy, increasing precision and accurate positioning and using Tele-Robotic techniques instead of manually ones, would be effective for gastroenterologists that have more workload.Background: Gastroenterologists may be susceptible to various musculoskeletal disorders in the absence of proper position, because of working in various positions in offices and hospitals. This study aimed to assess the relationship between the posture and musculoskeletal disorders among gastroenterologists in Isfahan city, Iran.Methods: Three methods of posture evaluating are self-report, observational method and direct measurement. Based on studies, the validity and reliability of the observational method is more than others. In this study, gastroenterologists' postures during endoscopy and colonoscopy were analyzed using two observational methods of Rapid Upper Limb Assessment (RULA) and Ovako Working Posture Assessment System (OWAS). They also completed Nordic questionnaire for assessment of musculoskeletal disorders.Findings: Based on OWAS, the posture risk was 1 in 22.2% and 2 in 77.8% of gastroenterologists; while based on RULA, this risk was 4 in 38.9%, 5 in 38.9% and 6 in 22.2% of them. Musculoskeletal disorders had a direct relationship with the level of risk based on RULA, but had no significant association with the level of risk based on OWAS. The level of risk based on RULA had a direct relationship with the number of procedures per day. In addition, the rate of musculoskeletal disorders had a direct relationship with the number of procedures per day and body mass index (BMI). The level of risk based on RULA had a direct relationship with incidence of musculoskeletal disorders in the neck, upper back and knees.Conclusion: Musculoskeletal disorders are highly prevalent among gastroenterologists in Isfahan city. Postural analysis results showed that the risk of incidence of these disorders is to a large extent, too. High body mass index was one of the factors contributing to the occurrence of musculoskeletal disorders. Since about half of the target group were overweight, losing weight can help to reduce the incidence of musculoskeletal disorders. In addition, the high number of procedures per day increases the risk of posture and musculoskeletal problems simultaneously. So, reducing the number of procedures or increasing the rest time between appointments, discontinuous endoscopy and colonoscopy, increasing precision and accurate positioning and using Tele-Robotic techniques instead of manually ones, would be effective for gastroenterologists that have more workload.https://jims.mui.ac.ir/article_15129_cfa31d8130bef0e6643e5de9d0a0cac9.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219Identification of Cutaneous Leishmaniasis Species in the Dargaz City, IranIdentification of Cutaneous Leishmaniasis Species in the Dargaz City, Iran1582158915130FAAbdolmajidFataProfessor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-5175-529XAbdolrahimRezaeiProfessor, Department of Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranElhamMoghaddasAssistant Professor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFaezeh SadatMousavi-VafaMSc Student, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranSeyed AliakbarShamsianAssociate Professor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-5048-4857Journal Article20160917Background: Cutaneous leishmaniasis is a parasitic skin disease that is endemic in many parts of the world, particularly in Iran. Although the microscopic technique is a common method of diagnosis of leishmaniasis, species of leishmania cannot be differentiated by this method. So, molecular methods have special importance.Methods: In this study, kinetoplast-DNA polymerase chain reaction (kDNA-PCR) method was used to diagnose the leishmania species in Dargaz city, Iran. Direct slide smears were obtained from skin lesions of 94 patients suspected to the leishmaniasis referred to health centers of this city. Smears were stained using Gimsa method. PCR method was performed using specific kDNA primers. Data were analyzed using SPSS software.Findings: Among 94 subjects with skin ulcers suspected to cutaneous leishmaniasis, 82 (87.2%) were positive by direct microscopic smear and 85 (90.4%) by PCR in which 22 patients (26%) had Leishmania tropica and 63 (74%) had Leishmania major. Sensitivity and specificity of direct microscopic examination were calculated as 96% and 100%, respectively. There were statistically significant differences between disease occurrence and seasons (P = 0.045), habitat (P = 0.004), new or old building (new or old) (P = 0.003), and distance to rodents' living sites (P = 0.025).Conclusion: Dargaz city is a known site of zoonotic leishmaniasis in Iran; but this study shows that there are some new sites of anthroponotic leishmaniasis in this city, too. Leishmania major is the dominant species in Dargaz city but there is Leishmania tropica foci in this area, too.Background: Cutaneous leishmaniasis is a parasitic skin disease that is endemic in many parts of the world, particularly in Iran. Although the microscopic technique is a common method of diagnosis of leishmaniasis, species of leishmania cannot be differentiated by this method. So, molecular methods have special importance.Methods: In this study, kinetoplast-DNA polymerase chain reaction (kDNA-PCR) method was used to diagnose the leishmania species in Dargaz city, Iran. Direct slide smears were obtained from skin lesions of 94 patients suspected to the leishmaniasis referred to health centers of this city. Smears were stained using Gimsa method. PCR method was performed using specific kDNA primers. Data were analyzed using SPSS software.Findings: Among 94 subjects with skin ulcers suspected to cutaneous leishmaniasis, 82 (87.2%) were positive by direct microscopic smear and 85 (90.4%) by PCR in which 22 patients (26%) had Leishmania tropica and 63 (74%) had Leishmania major. Sensitivity and specificity of direct microscopic examination were calculated as 96% and 100%, respectively. There were statistically significant differences between disease occurrence and seasons (P = 0.045), habitat (P = 0.004), new or old building (new or old) (P = 0.003), and distance to rodents' living sites (P = 0.025).Conclusion: Dargaz city is a known site of zoonotic leishmaniasis in Iran; but this study shows that there are some new sites of anthroponotic leishmaniasis in this city, too. Leishmania major is the dominant species in Dargaz city but there is Leishmania tropica foci in this area, too.https://jims.mui.ac.ir/article_15130_44500587629a61f9c6ad74ec7cf4d5c6.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219Investigation of absorbed dose and estimation the risk of secondary thyroid cancer in whole brain radiotherapyInvestigation of absorbed dose and estimation the risk of secondary thyroid cancer in whole brain radiotherapy1590159415131FAMahtabAhmadiMSc Student, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranMohammad BagherTavakoliProfessor, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran0000-0001-8721-4922AlirezaAmouheidariRadiation Oncologist, Department Radiation-Oncology, Isfahan Milad Hospital, Isfahan, Iran0000-0001-5329-9438ZahraAlirezaeiPhD Student, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranJournal Article20160923Background: After the surgery, radiation therapy is the most important part of treating brain tumors. Thyroid cancer is the second most prevalent malignancy, as a result of radiation therapy of head and neck. Therefore, in whole-brain radiation therapy, determining the absorption dose of thyroid and the risk of secondary thyroid cancer is important. The aim of this study was to calculate the absorption dose of thyroid and the risk of secondary thyroid cancer in whole-brain radiation therapy.Methods: The study included 50 patients undergoing whole-brain radiation therapy, with a mean age of less than 30 years old, in Isfahan Milad Hospital, Iran, using the ONCOR accelerator and 6-MV photon. Thermoluminescence dosimeter (TLD) was used to determine the dose received by the thyroid. Then, to calculate the risk of secondary thyroid cancer, the method of calculating risk in Biological Effected of Ionizing Radiation Committee (BEIR VII) report and the suggested quantity of International Commission on Radiological Protection (ICRP), which means excessive relative risk (ERR), were used.Findings: The calculated mean absorbed dose was 1.976 ± 0.611 and 2.213 ± 1.041 cGy in women and men, respectively. The mean risk of secondary cancer of the thyroid 3, 5, 10, 15 and 20 years after whole-brain radiation therapy was 4.601 ± 1.614, 1.559 ± 0.595, 0.176 ± 0.063, 0.050 ± 0.018, and 0.022 ± 0.009, in women and 3.253 ± 1.721, 1.150 ± 0.516, 0.125 ± 0.066, 0.035 ± 0.019, 0.016 ± 0.008 in men, respectively. The absorption dose of thyroid was not related to age (P = 0.743).Conclusion: The risk of secondary cancer of the thyroid is associated with sex and is 1.4 times more in women. In addition, by increasing the age after radiation the mean risk of induced cancer had a reducing behavior.Background: After the surgery, radiation therapy is the most important part of treating brain tumors. Thyroid cancer is the second most prevalent malignancy, as a result of radiation therapy of head and neck. Therefore, in whole-brain radiation therapy, determining the absorption dose of thyroid and the risk of secondary thyroid cancer is important. The aim of this study was to calculate the absorption dose of thyroid and the risk of secondary thyroid cancer in whole-brain radiation therapy.Methods: The study included 50 patients undergoing whole-brain radiation therapy, with a mean age of less than 30 years old, in Isfahan Milad Hospital, Iran, using the ONCOR accelerator and 6-MV photon. Thermoluminescence dosimeter (TLD) was used to determine the dose received by the thyroid. Then, to calculate the risk of secondary thyroid cancer, the method of calculating risk in Biological Effected of Ionizing Radiation Committee (BEIR VII) report and the suggested quantity of International Commission on Radiological Protection (ICRP), which means excessive relative risk (ERR), were used.Findings: The calculated mean absorbed dose was 1.976 ± 0.611 and 2.213 ± 1.041 cGy in women and men, respectively. The mean risk of secondary cancer of the thyroid 3, 5, 10, 15 and 20 years after whole-brain radiation therapy was 4.601 ± 1.614, 1.559 ± 0.595, 0.176 ± 0.063, 0.050 ± 0.018, and 0.022 ± 0.009, in women and 3.253 ± 1.721, 1.150 ± 0.516, 0.125 ± 0.066, 0.035 ± 0.019, 0.016 ± 0.008 in men, respectively. The absorption dose of thyroid was not related to age (P = 0.743).Conclusion: The risk of secondary cancer of the thyroid is associated with sex and is 1.4 times more in women. In addition, by increasing the age after radiation the mean risk of induced cancer had a reducing behavior.https://jims.mui.ac.ir/article_15131_9e0151c8f821210edb9b5d5d622dec61.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219The Structural Model of Relationships between Pain Vulnerability, Catastrophizing, Fear and Pain Adjustment in Patients with Chronic Musculoskeletal PainThe Structural Model of Relationships between Pain Vulnerability, Catastrophizing, Fear and Pain Adjustment in Patients with Chronic Musculoskeletal Pain1595160615132FAFazlolahMirdrikvandAssistant Professor, Department of Psychology,School of Literature, Lorestan University, Khorramabad, IranAlirezaShirazitehraniPhD Student, Department of Psychology, School of Literature, Lorestan University, Khorramabad, IranMohammad AliSepahvandiAssistant Professor, Department of Psychology,School of Literature, Lorestan University, Khorramabad, IranJournal Article20161119Background: Nowadays, fear-avoidance model is the best model for the assessment and treatment of chronic musculoskeletal pain in which, the role of the pain vulnerability (neuroticism, experiential avoidance and negative affect) is not well defined. The purpose of present study was to evaluate the structural pattern of the relationships between the pain vulnerability, catastrophizing, fear of pain and pain adjustment (pain intensity and inability) in the framework fear-avoidance model.Methods: Patients with chronic musculoskeletal pain were selected from hospitals and private clinics in Isfahan city, Iran, during 2015 using convenience sampling method. They participated in the research by filling out six questionnaires: NEO Five-Factor Inventory (NEO-FFI), Positive and Negative Affect Schedule (PANAS), Acceptance and Action Questionnaire (AAQ), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia (TSK) and Graded Chronic Pain Scale (GCP). Data were analyzed using structural equation modeling method.Findings: Pain vulnerability had significant direct effects on catastrophizing and catastrophizing on fear of pain and fear of pain on pain adjustment (P < 0.001 for all). In addition, catastrophizing through pain vulnerability and fear of paintrough catastrophizing had indirect effects on pain adjustment; while the direct relationship between vulnerability and pain adjustment was not confirmed.Conclusion: The results of this research showed that pain vulnerability could predict pain adjustment in the framework fear-avoidance model. Therefore, reducing pain vulnerability can reduce pain intensity and inability in patients with chronic musculoskeletal pain.Background: Nowadays, fear-avoidance model is the best model for the assessment and treatment of chronic musculoskeletal pain in which, the role of the pain vulnerability (neuroticism, experiential avoidance and negative affect) is not well defined. The purpose of present study was to evaluate the structural pattern of the relationships between the pain vulnerability, catastrophizing, fear of pain and pain adjustment (pain intensity and inability) in the framework fear-avoidance model.Methods: Patients with chronic musculoskeletal pain were selected from hospitals and private clinics in Isfahan city, Iran, during 2015 using convenience sampling method. They participated in the research by filling out six questionnaires: NEO Five-Factor Inventory (NEO-FFI), Positive and Negative Affect Schedule (PANAS), Acceptance and Action Questionnaire (AAQ), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia (TSK) and Graded Chronic Pain Scale (GCP). Data were analyzed using structural equation modeling method.Findings: Pain vulnerability had significant direct effects on catastrophizing and catastrophizing on fear of pain and fear of pain on pain adjustment (P < 0.001 for all). In addition, catastrophizing through pain vulnerability and fear of paintrough catastrophizing had indirect effects on pain adjustment; while the direct relationship between vulnerability and pain adjustment was not confirmed.Conclusion: The results of this research showed that pain vulnerability could predict pain adjustment in the framework fear-avoidance model. Therefore, reducing pain vulnerability can reduce pain intensity and inability in patients with chronic musculoskeletal pain.https://jims.mui.ac.ir/article_15132_25e828afe5f637410a84442d27029c38.pdfIsfahan University of Medical SciencesJournal of Isfahan Medical School1027-75953441320170219Letter to Editor: Some Comments on "Effects of Zero- and 90-Degree Abduction of Glenohumeral Joint on the Upper Extremity Nerve Conduction Velocity (NCV) in Patients with Diabetes Undergoing Coronary Artery Bypass Graft Surgery"Letter to Editor: Some Comments on "Effects of Zero- and 90-Degree Abduction of Glenohumeral Joint on the Upper Extremity Nerve Conduction Velocity (NCV) in Patients with Diabetes Undergoing Coronary Artery Bypass Graft Surgery"1607160915133FAMasaudehBabakhanianSocial Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran0000-0002-6128-8023MehrnoushKosaryanProfessor, Hemoglobinopathy Institute, Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, IranJournal Article20161030Dear Editor-in-Chief, Journal of Isfahan Medical SchoolWith due respect, in the 373rd issue of the journal, pages 190-196, a paper has been published with the title as: Letter to Editor: Effects of Zero- and 90-Degree Abduction of Glenohumeral Joint on the Upper Extremity Nerve Conduction Velocity (NCV) in Patients with Diabetes Undergoing Coronary Artery Bypass Graft Surgery. We appreciate the effort of the editors; still we have some comments regarding this paper.Dear Editor-in-Chief, Journal of Isfahan Medical SchoolWith due respect, in the 373rd issue of the journal, pages 190-196, a paper has been published with the title as: Letter to Editor: Effects of Zero- and 90-Degree Abduction of Glenohumeral Joint on the Upper Extremity Nerve Conduction Velocity (NCV) in Patients with Diabetes Undergoing Coronary Artery Bypass Graft Surgery. We appreciate the effort of the editors; still we have some comments regarding this paper.https://jims.mui.ac.ir/article_15133_a47ad724599e11d59272b02d08d0dbd7.pdf