عباسعلی پورمومنی

Over activity of Bladder (OAB) is a syndrome with symptoms in urinary storage phase and it appears with the increase of the frequency of urination or emergency condition. During the recent years, using Posterior Tibial Nerve Stimulation (PTNS) has been introduced as a simple, noninvasive, without-the-side-effect method for the treatment of OAB. The purpose of the present study was evaluation of the effect of PTNS with kegel exercises on women with over activity of bladder.

The current study was a randomized, double-blind, placebo controlled trial including 67 female participants with OAB syndrome divided in two groups of test and control. During 12 sessions, kegel exercise was taught to patients and PTNS was performed for the two groups but the flow rate was zero for the control group. The perineometry device was used to evaluate the pelvic floor muscles strength and three questionnaires of 1-assess quality of life 2- ICIQ-OAB, and 3- ICIQ-UI SF, as well as voiding diary form was used to evaluate the symptoms and severity of the disease, before and after the intervention.

Analysis of the results with paired sample t test in the two groups showed that the strength of pelvic floor muscles increased and the quality of life improved (P≤0/05). The use of the independent samples t-test showed increase of the pelvic floor muscles strength and improvement of quality of life and the decrease of scores of urinary symptoms in the test group was significantly greater than those of the control group (P≤ 0/05).

According to the results of the study, the PTNS with kegel exercises caused increase of the pelvic floor muscles strength and the improvement of the quality of life in women with OAB syndrome.

Dyssynergic defecation does not respond appropriately to routine treatments of constipation. Re-cently, researches have shown that biofeedback therapy is useful in anorectal dyssynergia. This study compared two treatment modalities for these patients.

Fifty nine subjects with dyssynergic defecation were recruited. They allocated randomly to two groups of balloon defecation training and biofeedback therapy. In the first group, a balloon was inserted into the rectum and inflated with water injection; so that the patient had the sensation of full rectum and thus the need to defecate; then the patient was asked to reject the balloon. In the biofeedback group, the pen electrode of EMG biofeedback was inserted into rectum and the patient tried to increase abdominal pressure and relax rectal muscles accordingly.

The findings of the study showed a reduction in constipation of both groups. The ability to reject bal-loon (volume and time) was significantly better in post-intervention measurements; better results were found in biofeedback arm of the study. Patient satisfaction after treatment reached to 52% by balloon training and 79% in biofeedback group. Report of incomplete evacuation and need for digital use during defecation stayed constant after treatment in balloon trained cases.

Biofeedback seems to be superior to balloon defecation training and did made measurable changes in subjective and objective variables of dyssynergia.

The most commonest entrapment mononeuropathy is carpal tunnel syndrome. This syndrome is associated with hypothyroidism, acromegaly, amyloidosis, pregnancy, obesity, diabetes, … and idiopathic. The aim of this study was evaluation and prevalence of sign and symptom in this sundrome. All patients with upper extremity pain were referred to EMG lab studied. Inclusion criteria was conduction study and exclusion criteria was other Entrapments and radiculopathies . 1024 hands from 745 patient were selected. In this study T females were affected more than males. Most age (8/1) was 36 to 50 years(48.4%). Right hand 44.3% and left hand 21.3% and bilateral 35.4%. Neoturnal pain was dominate sign (74%), phalen test 62%, paresthesia in hand 57%, tinel sign 47.9%. Different sensory between index & little finger was 43.1%. There is significant correlation between distal)motor 7 sensory) and phalen test. Also there is significant relation phalen test 7 tunnel sign.