جواد آقازاده

L5 Sacralization is normal variation in lumbar anatomy, but many authors believed this condition because of concentration of pressure in L4/ L5 level can speed up degenerative process (disk degeneration or listhesis…). However no study was compare spondylolisthesis radiological parameters in patient with and without sacralization of L5, our purpose is evaluation of radiological parameters in spondylolistesisL4/L5 in patient with and without L5 sacralization.

In cross sectional study we divided 78 patient with spondylolisthesis of L4/L5 in two group with (n=24) and without (n=54) L5 sacralization and evaluated facet osteoarthritis, degree of listhesis (%), disk degeneration, and facet orientation in two group and result was compared,

There was no significant difference in the degree of anterior slippage of L4 on L5 (17.02±6.21 versus 16.65±4.87, p=0.809), facet orientation (54.99±12.18 versus 56.23±4.35, p=0.642), facet osteoarthritis (3.43±0.59 versus 3.53±0.37, p=0.527), or disc degeneration (4.50±0.51 versus 4.35±0.61, p=0.340) between the two groups

There is no significant relation between radiological parameters in two group and we thought influence of L5 sacralization on degenerative process of L4/L5 less significant than previously expected, but future study with large number of patient need to clarify the role of fixed L5 on degenerative process in lumbar spine.

Intraoperative spinal cord and nerve root monitoring is used to identify an insult to the neural elements with the goal of preventing injury,beacause of high rate of neurological deficit in spinal surgery, the use of intraoprative neuromonitoring can detect the iatrogenic neural deficit  in surgery and help the surgeon to review the operation. We introduced the 51 years old women with a cervical cord meningioma to be operated under intraoprative neuromonitoring.

Pain following surgery can cause physical, cognitive and emotional distress. Clonidine is an alpha-2 agonist that has recently been used to reduce anxiety and pain and it may help prevent postoperative discectomy complications. Our aim was to determine the efficacy and safety of α-2 adrenergic agonists for reducing pain and complications in adults undergoing spine surgery.
In this clinical trial study, 60 patients with lumbar disc herniation were divided into 2 groups of 30 subjects. Clonidine was administered as a dose of 0.2 mg for the intervention group, 60 minutes before the surgery and the control tablet group received placebo with 30 ml of water. Pain levels were recorded on the basis of VAS, before surgery, and at 3, 6, 12, and 24 hours after surgery. As well, the need for morphine at 3, 6, 12, 24 hours after surgery was recorded.
Pain score in clonidine group was significantly lower than placebo group (P = 0.03). Postoperative pain relief was significantly lower in clonidine group after 24 hours. Clonidine reduced postoperative lumbar pain.
Oral clonidine had no significant effect on hemodynamic changes during operation, but significantly reduced the pain and the need for postoperative analgesia. Our study concludes that prophylactic α-2 adrenergic agonists can prevent discectomy pain.

Due to some cultural problems, most people, especially women cannot go to gyms for exercise. Therefore, researchers are trying to design tools, which different individuals can easily exercise at any place and any time. One of these tools is Thera-band. The purpose of this study is to determine the effect of exercise using Thera-band on body composition in the middle-aged women. In this quasi-experimental study, among teachers of Qom city, 20 middle-aged women were randomly divided into two groups of exercise (n=10) and control (n=10). The exercise group exercised for 60minutes per session (3 sessions a week for 8 weeks), while the control group performed their daily activities. The training protocol consisted of upper and lower body exercises using Thera-band. The effects of this training program were assessed using the body composition measuring instruments, before and after training program. Data were analyzed by independent and paired t-tests. The significance level was considered to be less than 0.05. Eight weeks of exercise using Thera-band caused a significant decrease in the body fat percentage and body fat mass. Also, lean body mass significantly increased after 8 weeks of exercise using Thera-band. The results of this study showed that exercise using Thera-band improves body fat percentage, body fat mass, and lean body mass in the middle-aged women.

  Studies have shown that intense exercise training associated conditions with increases levels of free radicals and oxidative stress thus the aim of this study was to investigate effect of intense exercises on Catalase Enzyme Gene Expression in soccer players. Nine male soccer players amateur (16-18age) for Among the players who participated in the study volunteers were randomly selected and participated in this study. blood samples were taken in three stages, before GXT exercise test (graduate exercise test), immediately and 3 hours after exercise to determine mRNA of catalase. Findings showed no significant increase in the mRNA catalase of lymphocyte in young soccer players immediate (p=0.17) and 3 hour after incremental exercise (p=0.08). According to the results of this study, it was determined that intense exercise training causes no significant increase in the mRNA catalase of lymphocyte in young soccer. This may be due to the adaptation process of catalase mRNA transcription lymphocytes in football players.

Prolonged standing in static posture during occupational tasks has been associated with low back pain (LBP). Increased bilateral gluteus medius (GM) muscles co-activation is considered to be the most predisposing factor for LBP development during prolonged standing in asymptomatic individual. Change and modify flooring in occupational environment is common ergonomic intervention to alleviate problems caused by prolonged standing such as LBP. The purpose of this study was to investigate the effect of anti-fatigue floor mat on bilateral GM co-activation pattern and subjective pain in the low back. The study was conducted on 16 asymptomatic participants while they were doing simulated light occupational tasks in two conditions for two hours as follows: 1) standing on a hard floor, 2) standing on an anti-fatigue floor mat. In any standing condition, at the beginning of standing and every 15 minutes until 120 minutes, muscle co-activation of bilateral GM and subjective pain in the low back region has been collected respectively by surface electromyography (EMG) and visual analog scale (VAS). There were no significant difference in bilateral GM co-activation pattern in participants between two conditions (P=0.776), but anti-fatigue floor mat presented a significantly decreased level of subjective pain in the low back. Although 73% of participants were indicating that they would use the anti-fatigue mat if they were in an occupational setting that required prolonged standing work, but results about the effect of anti-fatigue floor mat on LBP based on an increase of >10mm on VAS threshold indicated that this intervention has no significant effect on decreased LBP development and co-activation of bilateral GM muscles in both pain developer and non pain developer groups. Apparently anti-fatigue mat were useful in decreasing LBP, although objectively it did not have any significant changes in muscle activity patterns that associated with LBP.

Based on our limited data about pathophysiologic mechanisms and natural course of arachnoids cysts, surgical indications and nonsurgical interventions still remain controversial. Of course today literature favours endoscopic interventions for this pathology. In this study we retrospectively reviewed 32 cases managed in our neurosurgical ward over 5-years period. After treatment, patients were evaluated clinically and radiologically. Supratentorial cysts were seen in 69% (22 cases) while infratentorial cysts were seen in 31% (10 cases). Hemiparesis in 37%, increased intracranial pressure in 31%, seizure in 31%, macrocephaly in 19%, isolated headache in 6%, developmental delay in 6% and asymptomatic cysts were noted in 12% of cases. 24 cases (75%) were operated, cyst resection was done in10 cases and cystoperitoneal shunting in14 cases. Conservative treatment with regular clinical and imaging control was done in 25% of patients. The mean follow-up period has been 25 months (4 to 38 months). Good outcome was seen in 75% (18 cases) and 25% (6 cases) remained unchanged. With cyst resection the size of 6 cysts became small, two cases disappeared completely and with shunt 10 cases showed improvement. According to this study we could say that surgical intervention of symptomatic arachnoid cysts providing good results.

Parasitic infection of the liver and lungs derived from hydatid cyst is global and it can affect many organs of the body, it encompasses lots of significance. This disease can abide many phenomena its treatment is very expensive and has its own troubles. Recognition of diagnostic methods and mostly, treatment of hydatid cyst according to almost high prevalence of the disease does play an important role on controlling the disease. The definite treatment is surgery. But as a complimentary cure, at present albendazole is the most effective drug for hydatid cyst. After utilization, albendazole fastly absorbs and catalyses to sulfoxide which is the major metabolite of the drug. The goal of this study is to analyze the efficiency of albendazole sulfoxide on different densities and time intervals, in vitro on protoscolexes. This study was conducted interventionally and tentatively. After detachment of hundreds of hydatid cyst infected animals from abattoirs and after enough investigation on productivity of cysts, their protoscolexes were evacuated and were washed with serum physiology and their viability rate was examined under the microscope. On the other side albendazole sulfoxide solution on 25µg/L, 50µg/lit, 100µg/lit densities was prepared. Then precise amount of protosclolexes was added to tubes containing sulfoxide and examinations were done in different time intervals. On the next stage their percentage of survival using microscope according to movements of flame like cells were determined and recorded. Results revealed that time and the amount of drug has straight effects on protoscolexes survival time. In the group that 100µg/L albendazole was used, the drug had no effect up to first 20 minutes but increasing the gain age time to 1hour 60% of protoscolexes were dead. While in the density of 50µg/lit up to 35minutes, the drug did have no effect, but in an hour 40% of protoscolexes were dead.Conclision: According to the results this study and time limitations that surgeons have in operation room, albendazole sulfoxide can not be utilized to eliminate protoscolexes from patients infected organs in the op. process and to avoid recurrence of the illness.

Thuracolumbar Unstable Fractures (T, L.U.F) are common after spine truma. Posterior pedicular fixation is a technique that is use for fixation of these fractures. This study evaluates the accuracy of pedicular screw placement in T, LUF with the assistance of plain radiography in operation rooms. This study is a case-control and analytical study. 35 patients with T, LUF underwent fixation with 180 pedicle screws placement by s33 spinal system with the assistance of plain radiography and anatomic landmarks. The first plain radiography shows that accuracy point and direction of 30 screws were unsuitable. In the second radiography, after correcting the entry point and direction, 10 screws had unsuitable position. In the third radiography, 3 screws had unsuitable but acceptable position. Plain radiography and recognition of spine anatomic landmarks are helpful in accuracy posterior pedicular screw placement.

Perception and Feeling are two parts of each sensory experience. Sensory reception of information proceeding about internal or external environment is conducted by sensory root. Humans inform themselves of their surrounding by receiving and organizing sensory stimulants. This conception and stimulant organization is called sensory reception. When a help seeker is admitted to a health care organization, he/she encounters stimulants which are different in quality and quantity from past stimulants and this causes sensory changes in him. The patient who is admitted to ICU ward is exposed to overburden or sensory deprivation due to some critical situations and complex methods of therapy. This is a descriptive study which was performed on 45 cases using simple random sampling method. A three-part questionnaire was used to collect the data which were analyzed using descriptive statistics. The findings showed that the subjects experienced no, very little or occasional unpleasant sensory reception in more than 80% of the cases (without sensory overburden). But the assessment of emotional reactions indicated 39.8% had experienced pain, 18.5% anxiety, 12% fear, 7.4% anger and 0.9% hating, which probably happened because of sensory deprivation arising from less family visiting and lack of knowledge about disease. Since patients in ICU experience some unpleasant emotional reactions, in order to decrease this experience, it is recommended to educate the patients and increase the duration of visiting time.