فهرست مطالب مریم منتظری

 Functional electrical stimulation (FES) is a promising technique for rehabilitation and increasing the level of movement in paraplegic subjects. In this method, the movement in the hindlimbs can be restored by controlling the electrical current pulses and stimulating the intraspinal motor neurons or muscular fibers below the spinal lesion. In FES, functional control signals are received from a controller that creates a motor function for the paraplegic subject. By changing the pulse width or pulse amplitude of the current pulses (control input), the level of the contraction for generating the functional movement of the hindlimb joints can be altered. The electrodes are inserted into the spinal cord to stimulate the desired movement by stimulating the flexor and extensor muscles and motor neurons connected to the desired joint. Therefore, the superposition of torque in flexor and extensor muscles is applied to the musculoskeletal system and joint moves.

 In FES, a model of the musculoskeletal system that acts on simultaneous movement of the hip and knee joints (multi–joint) is used as the virtual patient. In general, the skeletal segment of the model consists of a planar swinging pendulum model of a two–link rigid robotic manipulator with nonlinear constraints on the hip and knee joint movements. A biarticular model of six muscles is used to generate the torques of the skeletal part of the model. Four muscles are considered for flexing and extending the hip and knee joints (one for flexing the joint and one for extending), and two biarticular muscles work on flexing the hip (knee) joint and extending the knee (hip) joint synergically. On the other hand, excellent tracking performance can be obtained with high precision, and the controllers can automatically switch between control inputs and the muscles by regulating the stimulation pulse width. The stimulation pulse width of muscles is continuous, nonsingular, with low chattering. The model dynamics can be assumed unknown and identified online without the controller's requirement for offline calibration. The controller robustly and rapidly switched the activation between the muscles to track the desired trajectory of the knee and hip joint. Various control methods, such as combining fuzzy adaptive or neural networks with classic sliding mode control, have generated FES control signals. Such hybrid methods have led to the chattering phenomenon, the control signal's singularity, and the controller's low speed outside and on the sliding surface.

 Rehabilitation movement in paralyzed limbs of paraplegic subjects based on FES in their muscles is associated with problems such as reflection in the spinal cord and unwanted movements, joint disturbances, fatigue, etc.

 The controller could automatically regulate the stimulation pulse width without considering the effect of the applied ground reaction force so that, by switching between muscles synergically, excellent tracking results were obtained in the presence of external unit step disturbance and muscle fatigue. The major challenges for developing an appropriate control method for stimulating paralyzed limbs include high–order nonlinear and time–varying properties of the neuromusculoskeletal system, spasms, and muscle fatigue. These drawbacks limit using prespecified stimulation patterns and open–loop control systems in the FES application.

The pharmacological approach of abortion is a safe and effective alternative to surgical procedures that is associated with a high level of patient's satisfaction. The present study was performed with aim to evaluate the effect of misoprostol with and without letrozole in the treatment of successful medical abortion and its relationship with BHCG titration level and cervical length.

This two-group randomized clinical trial study was performed in 2021 on 168 pregnant women under 18 weeks of gestation who were candidates for termination of pregnancy. The patients were randomly divided into two groups: A (misoprostol and letrozole) and B (misoprostol and placebo). Initial tests, βHCG titration, ultrasound and cervical length were performed for all patients on the first day of hospitalization. After receiving the drug, all patients underwent ultrasound on the fifth day to evaluate complete abortion and removal of pregnancy residues. Data were analyzed by SPSS software (version 22) and Chi-square, independent t and logistic regression tests. P<0.05 was considered statistically significant.

The results showed that misoprostol + letrozole had a more successful abortion rate than misoprostol + placebo (88.1% vs. 59.5%). Increased cervical length was associated with a higher probability of miscarriage (P <0.001), while BHCG titration did not show a predictive role in induction of abortion (p>0.05).

Adding letrozole to misoprostol for inducing abortion leads to an increase in the percentage of successful abortion and a reduction in the use of curettage.

Nursing is a care profession and nurses, due to their professional nature, need moral courage to provide safe and professional care to clients. On the other hand, one of the needs of nursing education is to improve the professional ethics skills of nurses in order to provide nursing care based on professional standards and ultimately to ensure proper clinical care. Therefore, this study was conducted to investigate the relationship between clinical competence and moral courage of nurses working in the intensive care units' hospitals of Tehran University of Medical Sciences at 2020.

This multicenter Cross-sectional Study was conducted on 350 nurses working in the intensive care units' hospitals of Tehran hospitals who were selected by quota method. The data collection tools of the study included demographic questionnaire, clinical competency questionnaire of intensive care unit nurses and moral courage questionnaire of Sekerka et al.

The mean scores of total moral courage and clinical competence in intensive care unit nurses were 74.24±12.22 and 155.10±23.37, respectively. There is a strong and significant direct relationship between moral courage and clinical competence of nurses (r=0.81 and p=0.001). Clinical competence in nurses with more work experience, older, working in the morning and day shifts and with formal and contract employment status was significantly higher than other nurses (p<0.001). Also, moral courage in male nurses, married, with more work experience, older, working in the morning and day shifts and with formal and contract employment status was significantly higher than other nurses (p<0.001).

According to the results of the present study, moral courage increases with increasing the clinical competence of nurses. Therefore, it requires the attention of as many officials as possible in this regard.

During the socialization process, individuals internalize some attitudes and beliefs on social and political occasions, in line with the prevailing culture of the case. In this study, the attitude toward active political participation of women between male and female students has been examined. The sample size according to Cochran's formula is equal to 370 male and female students living in Tehran. Data were analyzed using Pearson correlation coefficient, simultaneous regression and Fisher's test using survey method and questionnaire technique. ‌ Findings showed that there was no significant relationship between socio-economic status and attitudes toward women's active participation and among the variables affecting students' attitudes toward women's active political participation were variables such as a feeling of political effectiveness (women: r = 0.43 and men: r = 0.29), the existence of gender stereotypes (women: r = -0.50 and men: r = -0.35), belief in patriarchy (women: r = -0.58 and men: r = -0.37) and glass ceiling (female: r = -0.52 and men:r = -0.34) showed the most effect and gender analysis emphasized the effect of the mentioned cases among female students more than male students. The low presence of women in politics can be due to political socialization, which has seen politics as masculine and marginalized women.

Diabetes mellitus, like any other chronic and debilitating illness, causes the person with the disease, especially children and adolescents, to experience problems that affect all aspects of the daily life of the individual. This study aimed to evaluate the effectiveness of cognitive-behavioral therapy on insulin induced anxiety in children and adolescents with type 1 diabetes. The research design was quasi-experimental with a pre-test-post-test design with the control group and a follow-up stage of 1.5 months. The statistical population of the study included all children and adolescents aged 8 to 13 years with type 1 diabetes in Isfahan province. Twenty-five subjects was selected by purposive sampling method and randomly divided into experimental (10) and control (15) groups. The case group received cognitive-behavioral therapy during the eight sessions of 45 minutes, and the control group did not receive any specific treatment during this period. Elliott et al.'s (1987) Observational Scale of Behavioral Distress Questionnaire was completed by mothers of children and adolescents in three stages: pre-test, post-test, and follow-up. Data were analyzed using repeated measure analysis. A significant reduction of insulin-induced anxiety in the case group compared to the control group was observed in the post-test phase. (P <0.01). The results of follow-up also showed that the effect of treatment lasted over time. Therefore, Cognitive-behavioral therapy was considered an effective intervention in reducing insulin-induced anxiety in children with type 1 diabetes mellitus. So, it is recommended that endocrinologists and diabetes associations include psychological interventions, including cognitive-behavioral therapy, in the care program of children with diabetes.

Diabetes is a metabolic disease that disrupts metabolism of sugars and fats in the body. The aim of present study was to investigate the effect of isatin-schiff base derivatives on blood glucose and lipid levels in streptozotocin-induced type II diabetic rats.

Drugs (insulin, glibenclamide, Schiff base I and Schiff base II) were injected intraperitoneally for 14 days. After 14 days, blood samples were taken from all groups and blood glucose and lipid profiles were measured.

Streptozotocin injection significantly increased blood sugar, triglyceride, cholesterol and LDL, but significantly decreased blood HDL compared to the control group. Also, injection of insulin, glibenclamide, Schiff base I and different doses of Schiff base II (for 14 days) in the diabetic group significantly reduced blood sugar, triglycerides, cholesterol and LDL, but significantly increased blood HDL compared to the sham diabetic group. Injection of the lowest dose of Schiff base II (25 mg/kg) with glibenclamide (5 mg/kg) significantly reduced blood sugar compared to the control or glibenclamide group, but had no significant effect on triglyceride, cholesterol, HDL and LDL compared to the control, insulin or glibenclamide groups.

These results indicate that the derivatives of E)) - 3- (H1-imidazole-4-yl) -2 - ((2-oxindolin-3-ylidine) amino) propanoic acid may be effective in the treatment of diabetes. The effect of Schiff base I and Schiff base II are probably due to the presence of isatin or imidazole ring and their antioxidant properties.

Silica Nanoparticles (MCM41) are silica mesopores (MSNs), which have large pores and relatively low density. The purpose of this study was to load Econazole onto silica nanoparticles (MCM41-NH2 and MCM41) And release of econazole in human skin (Ex-Vivo) then the antifungal effect of loaded econazole on silica nanoparticles was investigated.

In this study, MCM41 was prepared, then MCM41-NH2 nanoparticles were provided by using amine cetyltrimethylammonium bromide and finally, the drug econazole was loaded on it. The morphology of the nanoparticles was determined by SEM and drug loading by FT-IR. Francescell and UV-Vis were used to measure the release. The release cream from the skin containing 1/1 drug and nanoparticles was prepared. Finally, the anti-fungal effect of ECO/MSNs was investigated in three ways. Francescell device was also used to check skin release.

Silica nanoparticles were prepared about 300 nanometers Release of the drug into the skin showed that during the first 8 hours 80% release and then up to 24 hours of continuous drug release. Antifungal effect by disk diffusion method showed that ECO/MCM41 had a larger inhibitory effect and also minimal inhibition of fungal growth (MIC) 75 mg/ml. Antifungal tests showed that no fungus grew after 72 hours.the antifungal effect as well as ECO / MCM41 (MIC) was greater in methanol.

The antifungal effect of the newest agar method was not suitable for this drug. Therefore, as a suitable drug in the cream, a drug loaded with methanol is recommended.

Chronic diseases, such as diabetes mellitus, are among the healthcare issues in new communities. Diabetes, like any other chronic and debilitating diseases, poses some problems for the patients, especially the children, thereby affecting all aspects of their daily life. The purpose of this study was to evaluate the effectiveness of cognitive-behavioral therapy in social anxiety among children with type I diabetes mellitus.

The present quasi-experimental study was conducted using a pretest-posttest design with a control group and follow-up. The study population corresponded to a group of 25 children aged 8 to 13 years with type I diabetes as diagnosed by an endocrinologist. The participants were selected using purposive sampling technique and then randomly assigned into control and intervention groups. The intervention group received 8 cognitive-behavioral therapy sessions of 45 min within 2 months. On the other hand, the control group was placed on the waiting list. The subjects completed the Social Anxiety Scale for Children-Revised (La Greca & Stone, 1993) at the pre-test and post-test stages, as well as after 45 days of follow-up. The data were analyzed using repeated measures ANOVA.

The results of this study showed a significant difference among the mean scores of social anxiety obtained at the pre-test, post-test, and follow-up (P<0.01). In addition, there was a significant difference between the intervention and control groups regarding the mean scores of social anxiety dimensions (P <0.05).

As the results of this study indicated, cognitive-behavioral therapy was considered an effective intervention in reducing social anxiety in children with type I diabetes mellitus, and the treatment effects were maintained until follow-up.

This study was performed to evaluate the cytotoxic effects of hydroalcoholic extract of Artemisia sieberi and its effect on the cell cycle in the SKBr3 breast cancer cell line.

In this study, hydroalcoholic extract of Artemisia was prepared. SKBr3 cells were exposed to different concentrations (1, 10, 100, 1000 µgml-1) of extract at two different time intervals of 24 and 48 h. We employed MTT assay and flow cytometry analysis to evaluate effects of the prepared extract on the cell cycle characteristics and its cytotoxic properties.

Based on the data obtained from the MTT test, the highest toxicity of the extract observed at the concentration of 1000 µgml-1 within 48 h after the extract exposure. The IC50 of hydroalcoholic extract was 150 and 50 µgml-1 at 24 and 48 h, respectively. According to the data obtained from flow cytometry analysis, the extract arrests cell cycle in 24 and 48 h treatment groups.

The hydroalcoholic extract of Artemisia at certain concentrations inhibits the growth of SKBr3 breast cancer cells by ceasing cell cycle step.

Type 1 diabetes is one of the most common metabolic abnormalities in childhood, with one in every 400 to 600 children affected by the disease. The aim of study was to evaluate the effectiveness of cognitive-behavioral therapy on emotional regulation of children with type 1 diabetes. The research design was a quasi-experimental design with pre-test, post-test and follow-up and control group. The sample of 25 children aged 8 to 13 years with type 1 diabetes was diagnosed by endocrinologist. They were randomly assigned control (n = 15) and experimental (n = 10) groups. Subjects completed an cognitive emotion regulation questionnaire (Garnefski et al., 2007) in a pre-test, post-test, and one month and a half follow-up. Data were analyzed using repeated measure analysis of variances. The results of this study showed that there was a significant difference between the mean scores of emotional regulation in pre-test, post-test and follow-up (P <0.01). Also, there was a significant difference between emotional regulation in the experimental and control groups (P <0.05). Cognitive-behavioral therapy can be considered as an effective intervention to regulate the excitement of children with diabetes.

Cardiovascular Events occur at different ages for different reasons, One of the uncommon causes of sudden cardiac arrest that can be fatal in humans, is Brugada syndrome. The victims are often young men Appearance quite healthy. Its prevalence is high in Southeast Asia.The best treatment method in patients with ECG recognize But without a history of sudden cardiac death, Is that prognosis of clinical variables And ECG in patients with ECG Compatible with Brugada syndrome without previous history of cardiac arrest Effectively be analyzed.
The patient is a young man who in the early morning after waking up from sleep with Syncope and decreased level of consciousness And was brought to hospital emergency. On initial examination, patient had no pulse rate and electrocardiogram showed a straight line And bilateral pupillary dilation And had no reaction to light immediately (CPR) started after about 40 minutes rhythm of the patient was converted to sine and was transferred to the ICU . After transfer to the ICU and perform E.C.G characteristic changes Brugada syndrome was observed. In about a month hospitalization in ICU , and after tracheotomy and insertion(N.G Tube) patient was discharged and transferred to home and through a gastric tube feeding for a long time, he continued, And then with the help of those around him began oral feeding. Currently the patient is not able to mobility and activities and with the help of others continue to vegetative state life.

This paper presents a control approach to the fuzzy-adaptive control scheme for rigid manipulators with unknown parameters. Lagrange’s method is employed for computing robot motion dynamics. Stability analysis guaranteed through Lyapunov’s theory using some suitable adaptive rules that make sure all signals in the closed-loop system are bounded and tracking error ones asymptotically reaches to zero. Compared with other controllers، there are some numerical simulations that verify effectiveness of the proposed method. Also، simulation results verify that the proposed controller can deal with uncertainties in the system.

Among the fields of ethics, medical ethics has a special place, because of the special status of the medical profession. Justice is one of the four principles of biomedical ethics that is often considered synonymous with fairness and moral obligation to act according to its fair judgments in medical domains. In Islamic ethics Justice means putting everything in its proper place and is entitled to the right level. In this paper we have attempted to study the principle of justice as one of the four principles of medical ethics. In a comparative study, advantages and challenges of religious and non-religious view to justice and its place in medical ethics have been analyzed and evaluated.This article is the result of a cross. We have used valid books and Internet sources and articles for data collection.After explaining the concepts and principles of justice in medical ethics, also Islamic Virtue Ethics, subscriptions and moral differences between the two devices in concept of justice are expressed.Regardless of the emphasis on the necessity and importance of professional ethics, Justice in the concept that Islamic ethics emphasis on it, is more comprehensive than medical ethics. Because justice in medical ethics is derived from social justice that is available by appropriate and balanced legislation and guidelines. But in religion justice is an institutionalized in human and includes all personal and social aspects of his life.

Today, the new developments in biology, poses new ethical challenges in front of the various religions and considering them is one of the basic needs. To solve these problems, international dialogs are needed. In this regard, comparative study of religions is not limited only to the extent of interpretation and hadith and jurisprudence and theology and in this regard adopting the studies in laws, economy, sociology and psychology has a great importance. Answering the present ethical equivocations on the basis of the common language of belief will reduce most of the conflicts in the area of ethical decision making. Other non- Abrahamic religions are spread in the vast geography of the world and they mainly include Iranian, Hindu and Chinese religions. Reviewing the basics of bioethical in religions and to study the joint points and separate points of them to create the opportunity of ethical dialog is an unavoidable need.

Many cancer cells during the chemotherapy procedure become resistance to several drugs the phenomenon which is called multidrug resistance (MDR). One of the important mechanisms responsible for MDR is the over expression of ABC transporter genes. One of the most extensively studied genes involved in MDR is multidrug resistance protein 1 (MRP1). Over expression of this gene has been detected in many cell lines and cancer cells with MDR phenotype. Two known mechanism inducing over expression of this gene is gene amplification and the presence of SNPs. We have shown that the over expression of this gene is associated with the MDR in Iranian leukemic patients. However, MRP1 gene amplification could not be identified in any of those patients. We aimed to investigate the possible association between the expression level of MRP1 and occurrence of MDR in leukemic patients. Furthermore, we wished to test the hypothesis that MRP1 polymorphisms would be predictive of MDR in patients with acute leukemia. mRNA level of MRP1 was determined in 111 patients with acute leukemia (including 52 patients with AML and 59 patients with ALL) by quantitative real time RT–PCR and compared to the type of response to chemotherapy. We typed G816A, T825C, G2168A, C2217T, G2268A, G1299T,G-260C, A-275G MRP1 polymorphisms in 24 patients classified as drug-resistant and normal control. We found that high expression of MRP1 was associated with MDR phenotype in both AML and ALL patients. There was no effect of a particular genotype on the expression level of the MRP1 gene. This could show the lack of dependency of any of these genotypes on the chemosensivity in this group of patients.

The human Y chromosome contains genes that are located on three major intervals defined as AZFa, AZFb, AZFc. Deletions in these genes may result in spermatogenic failure in patients with oligospermia and azoospermia. The main perpose of this study is the investigation Prevalence partial microdeletion of Y chromosome (gr/gr, b1/b3, b2/b3) in oligospermia Males. In this study 30 oligospermia infertile mail with sperm count <10× 106 and 50 fertile men was investigated. Multiplex PCR were performed for investigation gr/gr, b1/b3, b2/b3 microdeletions. Totally, 5 patients (17%) and 6 healthy individual (12%) had deletions. 4 patients (13/7%) with gr/gr and 1patient with b2/b3 (3/4%) had shown. In healthy individual were 5 cases (10%) with gr/gr partial and 1 case (2%) with b2/b3. Our findings suggest that knowing the prevalence of AZF microdeletions in Iranian infertile men will be informative before starting assistend reproductive treatments.

Genetic factors cause about 10% of male infertility. Cystic fibrosis conductance regulator (CFTR) gene mutations are among relatively frequent causes of male infertility. Therefore, these mutations can cause Cystic fibrosis (CF), which is the most common autosomal recessive disorder, characterized by chronic lung disease, pancreatic exocrine insufficiency, and male infertility. The aim of the present study was to evaluate the effect of CFTR gene mutations in non-obstructive azoospermia. In this study, we examined the occurrence of common CFTR gene mutations in 106 non obstructive azoospermic patients as test group and 50 fertile individuals as control group. The investigated mutations were ΔF508, G542X, N1303K, W1282X, R117H, also IVS-5T polymorphism, and probable mutations in exons 4, 7, 10, 11, 20 and 21 in the CFTR gene, using ARMS-PCR, PCR-RFLP and SSCP methods. Patient’s samples were collected from Yazd Research & Clinical Centre for infertility, Kowsar Infertility Centre and IVF section of Day Hospital during July 2007 till June 2008. Thirteen patients (21.26%) showed 406-6T>C, A120T, I148T, ΔF508, 1525-18A>G G542X, L1304M mutations and IVS8-5T polymorphism. To the best of our knowledge, this is the first report on the L1304M mutation worldwide. None of the CFTR gene mutations were observed in the control group. The allelic frequency of IVS8-5T was 3% in controls. The present study indicates that there is a relationship between CFTR gene mutations and developing non-obstructive azoospermia. Therefore, the couples undergoing assisted reproductive technologies such as intra cytoplasmic sperm injection (ICSI) are advised to be screened for these gene mutations.