فصلنامه علوم پیراپزشکی و توانبخشی
سال هفتم شماره 1 (بهار 1397)

Refractive surgery complications can include refractive errors undercorrection and regression. Based on the studies, undercorrection and regression are the most common complications after refractive surgery. The aim of this study is to determine the refractive and visual results in patients with PRK retreatment.
In this case series study, a total of 30 eyes of 20 patients were studied. The parameters evaluated were visual acuity and refraction. The mean patient’s age were 34.5±5.9 years. The original treatments and subsequent retreatment were performed by the same surgeon at Farabi Eye Hospital. SPSS 20 statistical software was used to analyze the data. At first, the normality of the data distribution has been tested by Kolmogorov-Smirnov test. Subsequently, The Paired-Samples T Test and Wilcoxon signed-rank test have been used to compare the means of variables.
The spherical and astigmatism refractions prior to PRK retreatment were -0.80 ± 0.67 diopters (D) and -0.70 ± 0.36 diopters (D) respectively, and after PRK retreatment were change to -0.16 ± 0.69 diopters (D) and -0.49 ± 0.61 diopters (D) respectively. The Logarithm of MAR uncorrected distance visual acuity (UCVA) and best corrected distance visual acuity (BCVA) prior to PRK retreatment were 0.28367 ± 0.25104, 0.01667 ± 0.06064 respectively and after PRK retreatment were 0.08167 ± 0.241148, 0.04467 ± 0.237149 Log MAR.
PRK retreatment can significantly improve UCVA and decrease residual refractive errors without significant complications. PRK is a useful, safe and effective method for retreatment residual refractive errors.

The family physician program, which was implemented in the country from 2005, was aimed at reforming the health system of the country. The aim of this study was to determine the challenges of rural family physicians from the viewpoint of managers and practitioners working in the North Khorasan province in 1395
This research is a descriptive-analytic study. In this study, a questionnaire was used to determine the challenges of family physician program from the viewpoint of managers and practitioners working, in nine comprehensive planning areas, health insurance system, compensation services, performance evaluation, facilities and amenities, Recruiting and maintaining human resources, information system, culture and financing. The questionnaires were used for all 65 family physician and 86 family physicians from North Khorasan. The findings of this quantitative study were analyzed using descriptive statistics and Chi-square and Mann-Whitney tests at a significant level of 0.05.
The biggest challenge was observed in comprehensive planning (3.79 ± 0.72). Also, Maximum means difference in challenges between director and physicians was in compensation (0.97 ± 0.11).The biggest challenges from the perspective of family doctors was in the areas of compensation (4.01±0.79). The biggest challenges from the perspective of directors were in the areas of finance (3.73±0.77).
Considering that most of the challenges identified in this study are important and approved by managers and physicians. By utilizing the results of this study and similar studies, attention should be paid to the clarity in policy guidelines and memoranda, attention to the motivational needs and educational needs of family physicians, review and improve the methods for collecting environmental information and Evidence-based decision making in order to addresses the issues and challenges of family physician policy.

Unique activation strategy of eccentric contraction predisposes the muscle to damage. Type II muscle fibers are more susceptible to muscle damage, therefore, it seems that velocity interferes in mechanical stress and muscle damage. The purpose of this study was to investigate the effect of contraction velocity of eccentric exercise- induced muscle damage of dominant knee extensor on running economy in trained young females.
Sixteen trained young females randomly assigned into two groups: high velocity (240°. s-1) and low velocity (60°. s-1). In order to induce muscle damage, subjects in high and low velocity groups performed 20 and 5 sets of 15 eccentric contractions respectively, with a load equal to 150٪ of the maximal voluntary isometric torque (MVIT) of dominant knee extensors. Muscle damage indices (MVC, perceived pain, thigh circumference) were recorded before, 1 and 48 hours and running economy were recorded 24 h before and 48 h after eccentric exercise. Statistical analysis was performed with SPSS16, using the between-subject repeated-measures ANOVA, independent t-test and Mann-Whitney U test.
All muscle damage indicators significantly changed one and 48 hours after damage in both groups (p With regard to the same tension time in muscle, contraction velocity (Four-fold difference) of eccentric exercise-induced muscle damage of dominant knee extensor was not a determining factor of changes in running economy in trained young females.

Visual Evoked Potential is an objective method to assess the visual function. The purpose of this study was to evaluate the visual evoked responses in different hemi fields of vision in normal individuals.
The study included 80 eyes of normal subjects aged 18-38 years. All participants were underwent detailed examination including refraction and visual acuity. Pattern reversal VEP responses were recorded in different hemi­ fields. Repeated Measures Analysis of Variance (SPSS statistical software, Version 20) was used to compare responses recorded in different hemi fields, amplitude and latency of VEP.
The averages of maximum and minimum value of P100 amplitude were found in the temporal and inferior retinas, respectively. Moreover, lowest latency was observed in the superior retina and greatest latency was in the nasal retina. The results showed a significant difference in P100 amplitude and latency between different hemi fields.
This study revealed the details of local VEP distribution in the visual field and there was a significant difference in the amplitude and latency of the VEP wave in different hemi fields of vision. In our study, the most visual sensitivity (lowest latency and maximum amplitude) is in the superior and temporal retinas, which has the lowest latency and the highest amplitude, respectively. Superior and temporal areas of the retina seem to have a better response in the PVEP test.

The present study aims to assess the attitudes of executive directors of Ardabil University of Medical Sciences, on effects of information technology in health improvement.
This is a descriptive cross-sectional study conducted in the first half of the current Iranian year, 1395, ending March 21st. A study population of 43 executive directors working in the network management, healthcare and educational deputies, and the administrative and information technology offices of the counties affiliated to Ardabil University of Medical Sciences were selected by means of census method. The data were collected using a standard questionnaire. Then the data were analyzed using statistical software SPSS20.
A total of 95% of participants were male. Their mean age and work experience were 41.09 and 14.44, respectively. In this study, the mean score of the effect of information technology on dimensions of management, education, healthcare, information system improvement, and the proposed solutions for higher effectiveness; were 26.70; 17.26; 26.74; 42.65; 69.33, respectively. Given the executive directors’ attitude in the surveyed aspects, there was no significant difference; however, there were significant relationships in the work experience and health information system improvement aspects.
The positive attitude of the study population indicates that there are appropriate background, context and awareness to execute and develop information technology in order to reach the maximum efficiency in health systems.

Given the importance of early intervention and the role of initial parent-child interactions in the development of language, communicational skills, and social as well as emotional capabilities of deaf children, the development of a family-oriented rehabilitation program to empower parents as the main therapists seems essential.
Sixty two deaf children, who either undergone cochlear implant surgery or were candidates for cochlear implant surgery were selected using purposive sampling. The subjects were then randomly divided into two groups (experimental and control groups). The subjects of the experimental group received the family-based rehabilitation program. To investigate communication and social-emotional skills, Communication and Symbolic Behavior Scale Developmental Profile/infant toddler checklist (CSBSDP), Categories of Auditory Performance (CAP) & Ages and Stages Questionnaire- Social Emotional (ASQ_SE) were used.
Multivariate data analysis with repeated measures design showed that the family-centered rehabilitation program was effective in increasing communication and social-emotional skills of the deaf children participating in this study population. Moreover, in the follow-up, the effect of this program on the dependent variables of the study and their components is stable.
The results are indicative of the effect of the family-based comprehensive rehabilitation program on development of communication and social-emotional skills. Therefore, it is recommended that this program should be used at rehabilitation centers for deaf children.

This paper is a review of wetting contact angle definition and measurement, wettability of contact lens, impact of tear film and contact lens solution on wetting angle. Also, the clinical performance of these parameters will be discussed.
For this review article, the data about contact lens wettability and wetting angle published in the PubMed were used. Based on inclusion (publication year between 1975 and 2017, relevance to the title and the field of study, key references) and exclusion (dissimilarity to the topics) criteria, 66 articles were studied carefully.
Several parameters including oxygen permeability, lens material, edge design, lens rigidity, lens thickness, and surface treatment methods are effective on patient`s comfortability. If all these factors are assumed to be under control and are not subject to any changes, wettability as a variable could be an important factor contributing to patient comfort. The relationships between the contact lens wetting angle, wettability, and comfortability considering multiple factors, are controversial that need more research in this field.

Patellofemoral Pain Syndrome is one of the most common musculoskeletal disorders of the knee. There are various treatment approaches to manage this condition including surgery, physiotherapy and orthoses. The objective of this study was to review the effectiveness of orthotic interventions in patients with patellofemoral pain syndrome.
Papers from 2004 to 2015 were obtained using a systematic search within electronic databases. Keywords used in this study included various combinations of keywords for patellofemoral pain syndrome, orthosis and their synonyms. 67 articles were initially selected after reviewing titles and abstracts. In the next step, the full texts were reviewed in details and finally 31 full-text articles were selected for quality appraisal. Six articles with good and intermediate quality scores were entered to pooled data analyses. Meta-analyses were carried out using RevMan software for immediate and follow-up pain reduction as well as individual function of daily living activity.
From 31 selected articles, 17 papers focused on the effectiveness of foot orthoses (mainly were about the wedge insoles) and 14 papers focused on the knee orthoses (including knee brace, knee sleeve, patellar strap). Five articles also looked at the effects of exercise therapy used as adjacent intervention along with an orthosis. In spite of the low quality of the searched evidences, meta-analysis indicated that knee orthosis induces the pain reduction and functional improvement in patients with patellofemoral pain syndrome.
The results indicates that the application of an orthosis may reduce pain and improve individual function in daily living activities. It was also indicated that orthotic devices improve alignment of the leg and increase the quality of life, however, further robust evidence still required to justify this results for clinical implication. It is not clearly understood if orthotic therapy have had any effect on proprioception, biomechanical re-alignment or reduction of the muscle's fatigue.

Morphological awareness is a metalinguistic skill. It is assessed by manipulation of morphemes that are the smallest meaningful units. Children gradually face with words and morphemes in different context and learn morphological knowledge in third and fourth grades of elementary school. There is no comprehensive test to assess the morphological awareness in Iran. Therefore, there are a few studies that have investigated the relationship between morphological awareness and reading, using from own researcher developed tasks. This review study collected morphological awareness tasks from different studies in English.
Literature search was performed in SID, Iranmedex, Google Scholar, Scopus, Pubmed, Science Direct, Medline databases and American Speech-Language-Hearing Association. The articles were assessed based on the tasks and their psychometric properties.
22 tasks for assessment of morphological awareness were found. The psychometric properties were assessed for all of these tasks. From all of tasks, 20 of them had reliability or internal consistency. The tasks include three types of morphological awareness (inflectional, derivational and compounding process).
Many of these tasks were developed by the researchers based on the aim of studies. These aims were considering the morphological awareness in word and non-word context and study of the effect of phonological knowledge on non-word, comparing between sentences from morphological perspective, morphological innovation and manipulation, compounding of morphemes for construction of new compound word and morphemes reading. Psychometric properties of the tasks were discussed in this article. According to internal consistency quantity, the tasks that have appropriate reliability or internal consistency, including: sentence combining task, sentence completion task, dynamic morpheme production task, comes from task, Judgment of pseudo word inflection task, Morphological relatedness task, rehit task, Phonological and morphological strategies use for reading and spelling, relative task, the morphological spelling test, Derivational suffix choice task, Morphological structure task, the morphological awareness task and TOLD.

Telemedicine is an application of information and communication technology to deliver health care services to people who are far from health care service providers. The aim of this study was to evaluate the literature on telemedicine in Iran. The articles were evaluated in terms of title, abstract and full text. After removing repetitive and unrelated articles, those related to the research goal were included.
This study is a systematic review. As a result of the literature search in databases including SID, Magiran, Iranmedex database, studies conducted in Iran during 80- 94 years included.
From the total of 177 articles, 29 studies were related to the aim of the study including security, architecture and needed features to implement telemedicine, feasibility of implementation in different cities, arising states from the implementation of pilot experiences, the knowledge and attitude towards telemedicine, its application in clinics, use of telenursing in diabetics and the introduction of software in the field of telemedicine.
Today, around the world and in all areas, particularly in health system, information technology is one of the most important means of innovation. Useful capabilities of information and communication technology is widely known to improve health services, and there are existing tools for development of telemedicine in our country, however, it is essential to improve an infrastructure and allocate adequate funding in this field and educate people.