فهرست مطالب محدثه آزادواری

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.

Cervical spine pain is one of the most common problems of the spine and upper limbs, which can be axial or radicular. The present study aimed to electrodiagnostically evaluate cervical root involvement among patients presenting with radicular pain. The population was selected using simple random sampling from patients complaining of cervical radicular pain and unilateral or bilateral upper extremity that met the inclusion criteria. Out of 120 patients studied, 21 patients (17.5%) had cervical nerve root involvement, of which 14 were women (13.7% of patients) and 7 were men (38.8% of patients). The highest and lowest prevalence was related to C7 (37.1%) and C8 and T1 cervical roots (11.4% and 4.2), respectively. Four patients (19%) had only left cervical root involvement and 3 patients (14.2%) had right cervical root involvement and 14 patients (66.6% of patients) had bilateral cervical root involvement. The most common neurological finding associated with CTS cervical radiculopathy was about 52%. Based on the findings, most patients complaining of cervical radicular pain and upper extremity to investigate cervical root involvement often have no cervical radiculopathy and may have neurological causes such as carpal tunnel syndrome or musculoskeletal causes such as myofascial pain. Radicular pain and some other causes of these disorders can be simultaneously observed, which emphasizes the proper and timely use of electrodiagnostic tests and accurate examinations to diagnose nerve root damage.

An applicable tool for professionals, who are involved in curing musculoskeletal disorders, including physical medicine and rehabilitation specialists and orthopedic surgeons, is recognition the process of muscle tissue growth and determining the areas which are vulnerable to different types of injuries or rupture. In this study, by considering hyper-elastic behavior for materials of the muscle, the finite growth relations have been applied using the decomposition of deformation gradient tensor to two parts of the elastic and growth. Consequently, the continuum relations were combined with the growth evolution equation and a series of mechanobiological relations were obtained. To solve them, a user material subroutine UMAT code was written in FORTRAN based on finite element software ABAQUS. Then the biceps femoris – long head muscle was modeled as a cylinder and the simulation was based on a 6-week period and a 10% increase in initial length. As a result of the simulation, it was found that maximum stretches occur in the surfaces, and not inside the muscle and they reach 1.04 in near the proximal muscle-tendon junction in the posterior layer and 1.06 in distal muscle- muscle-tendon junction in the posterior layer and 1.06 in distal muscle-junction in interior layer. Also, by examining how the growth dispersed, it was found that the muscle grows heterogeneously. This numerical simulation provides valuable results, such as; correct and optimal diagnosis of treatment, helping patient’s rehabilitation, and orthopedic surgeries.

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.

Eosinophilic granuloma is a rare disease that more occurs in children especially bays. It usually presents in flat and long bones. Sometimes skull and vertebral spine is affected. Case Report: The Case was a 6 years old boy that had back pain from 20 days ago. In physical exam we found a local tenderness on tenth thoracic vertebra. Imaging study includes X-ray and MRI revealed vertebra plana on tenth thoracic vertebra without any periostic reaction or bone formation. Bone scintigraphy showed increased radiotracer uptake only in the tenth thoracic vertebra. With attention to age، gender، clinical features، lab data and imaging study we suspected an eosinophilic granuloma for this patient that histological examination confirmed it. With considering to patient’s signs، conservative treatment include thoracolumbosacral brace and long term follow up was used.

One of the differentional diagnosis of backpain in children specially in boys is Eosinophilic granuloma.