فهرست مطالب سیده زهرا امامی رضوی

Lower urinary tract problems, including overactive bladder, are one of the most common diseases that increase with age and impose an enormous economic, psychological, and social burden on society. There are pharmacological and non-pharmacological treatments for this problem. Stimulation of the posterior tibial nerve from the medial malleolus area, which is called percutaneous tibial nerve stimulation (PTNS), is one of the recommended treatment methods for overactive bladder, which has been recently noticed and applied in the treatment of this disease. In this method, the posterior tibial nerve is stimulated from the lower leg (medial malleolus area) using a needle electrode or a surface electrode during consecutive sessions. This method works based on neuromodulation theory, which is minimally invasive and safe but time-consuming. In the available studies, this method has been able to significantly help patients with overactive bladder without underlying causes or even with underlying causes, such as neurological disorders. Considering the beneficial therapeutic effects of this method, in this study, we decided to review the use of PTNS in urinary problems, including overactive bladder, as well as thoroughly explain its performance and side effects.

Post herpetic neuralgia is a chronic neuropathic pain syndrome that it is characterized by pain in the area of ​​the nerve involved distribution after the disappearance of herpes zoster lesions and it may be persistent, refractory and severe. Various treatments including medication, Botox injections, nerve block and physical modalities have been used in the treatment of this syndrome, each has advantages and disadvantages. One of the most widely used methods today is the use of acupuncture. Acupuncture is a low-complication and reproducible treatment that is gaining more and more place in pain management, especially chronic pain. Studies have shown the effect of acupuncture on reducing pain in post-herpetic neuralgia patients. Different parts of acupuncture can be used to reduce pain. The recommended number of sessions is usually 10 to 12 sessions, lasting 20 to 30 minutes. Due to the beneficial effects of acupuncture and its low complication, this method is recommended as one of the treatment methods for postherpetic neuralgia. In this paper, we review the effect of acupuncture on post herpetic neuralgia.

Acupuncture is an ancient medical procedure that is commonly used. It has been used in China for over two thousand years. Acupuncture has gained increasing interest from the public as well as health professionals for a wide range of disorders. This method works through regulation of qi current (life energy in body). Acupuncture has been introduced recently in dermatology for rejuvenation and treatment of facial wrinkles and improving muscle tone and elasticity. Acupuncture is used for treatment of many medical conditions including skin disorders. Tiny, sterile, needles are inserted along meridian lines and acupuncture points to increase blood circulation. Cosmetic acupuncture is a totally natural and holistic anti-ageing treatment that aims to reduce fine lines and wrinkles. Different mechanisms have been proposed for cosmetic acupuncture, including increasing muscle elasticity, and restoring muscle tone. There have been also evidence of increase in skin moisture and lipid.In this method, body points and local facial points are used and usually 10-12 sessions of facial acupunctures are recommended. With the increasing popularity of complementary therapies in the community, acupuncture is also considered as a new therapeutic approach.

The purpose of this study was to introduce a new and noninvasive technique for antidromic electrophysiological evaluation of the feet digital nerves to find normal values of amplitudes and nerve conduction velocity (NCV). Ring electrodes were used to record sensory nerve action potentials from the digits one, two, and three of the foot. The E1 electrode was placed on the proximal phalanx, and the E2 electrode was located 1 cm distal to E1. The nerves were stimulated 10 cm proximal to the E1 electrode on the plantar surface. The 95% confidence intervals (CI) were used to report the normal values of the amplitudes, distal sensory latencies, and nerve conduction velocities. Twenty three healthy volunteers with a mean age of 47.3 ± 8.2 years were recruited in this study. The 95% CI of the sensory amplitudes were 5.2-7.5 μV, 6.0-8.9 μV, and 6.9-10.1 μV for the first, second, and third digits, respectively. There was an inverse relationship between the age and the amplitude (r = -0.48; P = 0.03). The relationship between body mass index (BMI) and amplitude was not significant (r = 0.23; P = 0.41). This new and noninvasive electrodiagnostic technique can be useful in early detection of distal neuropathy of the lower limbs; particularly when the routine electrodiagnostic studies may not be capable of diagnosing the subclinical neuropathy.

Notalgia paresthetica (NP) is a neuropathic complication which occurs within the innervating field of T2-T6 spinal nerves. The patient complains of burning and itching sensation in the lower part of the inner margin of the scapula, and because of frequent itching,signs of skinscratching and hyperpigmentation are observed in the affected area. The definite cause of this pathology is unclear. Available resources have suggested the followings as the possible causes of the disorder: entrapment of the sensory branches within surrounding muscles, postural abnormalities such as scoliosis and kyphosis and degenerative changes of the spine. NP is usually represented as a rare pathology, however, the relatively common clinical incidence suggests a lack of attention to appropriateidentification, diagnosis and treatment ofthe patients. Diagnosis is done through history taking and physical examination, and there is often no need to additional studiesfor confirmation. A wide spectrum of treatment options have been recommended. Although there is often a tendency to prescribe topical and oral medications for treatment of NP, but application of non-pharmacological therapies such as therapeutic exercises to correct abnormal postures, physical agent modalities such as electrical stimulation and also acupuncture can be effective in accelerating the treatment process and increasing the duration of recovery. Given the undeniable importance of the disorder and its impact on patient's quality of life, a comprehensive approach to existing treatment options with an emphasis on the role of physical medicine and rehabilitation specialists will be discussed in this paper.

To determine the serum levels of vitamin D and calcium in patients with spinal cord injuries and their association with the scope of the lesion and the time passed since its inception. The participants were 147 spinal cord injured patients with the required criteria who had referred to our center. A questionnaire was filled for all of them to gather demographic details and then they were examined by a specialist. Blood sample was taken to determine the serum level of their 25-hydroxy vitamin D. The mean of calcium and vitamin D serum levels were 8.33 mg/dL and 15.30 ng/mL, respectively. Of the participants, 64.6% had vitamin D deficiency and 18.4% had insufficient level of vitamin D. Only in 7.5% of the patients the level of vitamin D was sufficient. In addition, 50.3% of the participants were afflicted with hypocalcaemia and the rest had normal level of calcium. According our study many of spinal cord injured patients suffer from vitamin D deficiency. Considering the major complications caused by deficiency of vitamin D, prevention and treatment of this complication appears to be crucial in such patients

Oliban oil is frequently used in daily rheumatologic practice in Traditional Iranian Medicine، but its benefit، remains to be evaluated. Using of Oliban oil offers an alternative to oral treatment and Topical NSAID therapy، with the potential for a reduced knee pain and outcomes. Up to now، there is no research about of Oliban oil effects in knee pain. The objective of this trial was to assess the efficacy and safety of topical Oliban oil in relieving the symptoms of knee pain (vajaol-rakbe). We identified 183 men and women with knee pain that adapted to The American College of Rheumatology clinical criteria for the classification of osteoarthritis and inclusion criteria. The participants were randomly assigned classified into three groups to apply topical treatment their painful knee for 6 weeks: Oliban oil as intervention group، sesame oil as control group and diclofenac gel as usual and positive control group. The degree of knee pain was quantified by visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) Pain. Safety was evaluated with Criteria for Adverse Events (CTCAE) (v4. 2010). Efficacy: In K. O. O. S pain score، The intervention group showed an improvement in the pain and symptoms compared with the control group (P = 0. 04) but Activities of Daily Living (ADL)، Sport and Recreation (Sport/Rec) and Knee-related Quality of Life (QOL) don’t improvement significantly. The V. A. S. scores were significantly better for the patients who applied the the Oliban oil and topical diclofenac gel than for those who applied the sesame oil (p = 0. 02). Furthermore، The intervention group showed an improvement in the pain compared with the diclofenac group (P = 0. 03). Safety: safety assessments showed that topical Oliban oil caused skin pruritus in 1/48 (o. o2%). this controlled drug trial demonstrates the potential efficacy and safety of topical Oliban oil in symptomatic treatment of knee pain and with only minor local skin pruritus.

The relationship between lumbar spine angles and back pain has been considered from past. Little study has been performed on evaluation of all lumbar angles including sacral inclination، lumbosacral، sacral horizontal، lumbar lordosis and segmental lumbar lordosis angles in patients with acute and chronic back pain and normal individuals. The aim of this study was evaluating these angles in the three mentioned groups. This case-control study was performed on back pain patients who referred to the physical medicine clinic of one of Tehran’s hospitals in 2010. Subjects were selected by convenience sampling method and were divided into three normal، acute and chronic back pain groups that each consisted of 35 members. Subjects’ demographic data، history and physical examination were recorded in questionnaires and their height، weight، abdominal circumference and BMI were measured. Radiographic clichés were investigated by a specialist and lumbar angles were recorded. Data was analyzed by ANOVA، independent t-test and Pearson correlation coefficient using SPSS 18 software. The mean range of sacral inclination angle was 42. 40±9. 18 that the difference was not significant in two genders، but was significant in acute and chronic patients and normal individuals. There was no statistical difference regarding other angles among patients and normal individuals. The degree of sacral inclination angle is significantly higher in back pain patients compared to normal people. Paying attention to this angle in patients’ radiographic clichés is of importance and its correction may be beneficial in reducing their symptoms.