ebrahim sadeghi

The present study seeks to scrutinize a two bosonic atoms system in a two-dimensional anharmonic and a short range interatomic potentials. Wave functions and energies are analytically stated, and the effect of anharmonic term on the energy for different strengths of interaction is calculated. The results show that the energy of relative motion and correction energy have different behaviours with the interaction strength. To investigate the dynamics of system, the fidelity for different coupling strengths is also calculated. The results are in agreement to other works.

This research aimed to estimate how sample thickness (3, 5, and 7 mm), air velocity (0.5, 1.25, and 2 ms^(-1)), and infrared lamp power (1000, 1500, and 2000 W) affected the drying characteristics of zucchini slices in a far-infrared dryer. The design of drying tests, which illustrates the relation between input and output variables, was carried out by response surface methodology. Then, the effect of these independent factors on the moisture content (drying time), water activity, total phenolic content, potassium content and total color change was determined. To predict the responses, the most accurate mathematical models were selected using analysis of variance. The results revealed the drying time declined by decreasing the sample thickness and air velocity and increasing the infrared lamp power. Total phenolic content and potassium content had increased multifold after the drying process. An enhancement in sample thickness and infrared lamp power had a positive effect on both of these contents. The minimum and maximum values of total color change were 5.54 and 13.96, respectively. The dried zucchini produced by far-infrared drying is a high-value product that has the potential to be used in food and pharmaceutical industries or in the treatment of diseases as a booster meal.

Group A beta-hemolytic streptococcus is the most important bacterial pathogen in pharyngitis. Although the disease is seen in all age groups, it is one of the most common bacterial infections in children. The aim of this study was to determine the frequency of Beta Hemolytic Group a Streptococcus colonization in the throat of 5 to 15 year-old children without respiratory symptoms, referred to children’s Clinics in Urmia, Iran.

This cross-sectional study was performed on children aged 5 to 15 years, referring to specialized pediatric clinics at Urmia University of Medical Sciences on 260 people from Jun 2021 to June 2022 in a row and available has been taken. Demographic information and clinical status were evaluated and then while taking a throat swab sample, the results were evaluated with positive culture in terms of sensitivity to common antibiotics.

The results of the present study showed that the prevalence of health carriers was 7.3%. There was a significant relationship between the father's job and the frequency of health carriers P=0.039. The most sensitive antibiotics were penicillin and ceftriaxone, and high resistance to erythromycin and chloramphenicol were observed.

Despite all the limitations of the present study, it seems that the prevalence of health carriers was moderate to low. The presence of antibiotic resistance indicates the lack of proper management of consumption, and the necessary measures should be taken to further control and monitor prescription and usage of antibiotics.

Mycoplasma pneumoniae is one of the main causes of community acquired pneumonia in children with an incidence of nearly 40%.
The aim of this study was to evaluate the serum levels of IgM and IgG antibodies to identify Mycoplasma pneumoniae in laboratory samples of in asymptomatic preschool aged children in Urmia, Iran.

The present cross-sectional study was performed on 260 preschool children who referred to the pediatric clinic of Shahid Motahari Hospital in Urmia in January 2018 without any respiratory symptoms. Detection of IgM and IgG antibodies against Mycoplasma pneumonia was performed on the samples using specific ELISA kit, according to the manufacturer's instructions. IgM and IgG antibody titers more than 12 U / mL considered as positive, less than 8 U / mL as negative, and between 8 and 12 U / mL as intermediate result (. SPSS 21 software was used for data analysis.

According to the results of this study, 25.8 percent of children had at least one episode of mycoplasma pneumonia infection. Statistically significant relationship was detected between the positivity of IgG and IgM and attending kindergarten in the studied children (P=0.001). There was no significant relationship between positivity of IgG and IgM with sex (P values = 0.14 and 0.60, respectively), age (P values = 0.58 and 0.54, respectively), and age group (P values = 0.19 and 0.49, respectively) of the children.

There was a significant relationship between positive IgG and IgM antibody titers and presence in kindergarten, but there was no significant relationship between IgG and IgM antibody positivity with sex and age group.

Health care-associated infections (HCAIs) are a major patient safety concern, and consequently prevention should be a top priority for institutions. Hand hygiene is the most effective way to reduce nosocomial infections.

296 medical students in different wards of university hospitals in Urmia participated in this descriptive study. They completed a hand wash checklist and a hand hygiene questionnaire. Finally, the obtained data were analyzed using SPSS25 software.

The results showed that 48% were male and 52% were female with an average age of 24.5 ± 2.9 years. Most of the participants were recruited from Imam Khomeini Hospital (%35) while only%5/8 of the participants were recruited from Razi Hospital. 34.7% of the participants were extern, 44.6% were intern and 20.6% were resident. The average level of awareness of hand hygiene was 47%, the minimum level of awareness was 31% and the maximum level of awareness was 69%. The average attitude toward hand hygiene principles among medical students was 31% (weak), the lowest attitude was 22% (weak) and the highest attitude was 58% (good). The average performance of hand hygiene practice principles was 39% (weak), the lowest was 22% (weak) and the highest was 51% (good). The average level of awareness of hand hygiene principles among female and male medical students were 50% and 44%, respectively. The average attitude among female medical students was 40% and average attitude among male medical students was 26%. The average performance of the principles of manual health practice among female and male medical students were 26% and 23% (acceptable), respectively. The average level of awareness, attitude, and performance of hand hygiene principles among students of external course, internship, and residency were 51%, 40% and 35%; 45%, 28% and 17%,; and 47%, 38% and 25%, respectively. In general, the average performance of hand hygiene principles among students in the ICU, surgical department and internal medicine department were 48%, 40%, and 27%, respectively.

Due to low-level attitude and knowledge of medical students regarding hand hygiene and the necessity of hand hygiene in preventing infection, as well as the importance of patient health during the hospitalization period, it is essential to hold in-service training classes in the field of hand hygiene to improve and promote hand hygiene.

Respiratory problems are the most commonly reported illness in children under the age of 5 years and are the leading cause of mortality in developed countries, with about 25-75% of children under 5 years old. Therefore, we decided that due to the importance of the issue and the high prevalence of hospitalization of children with respiratory problems and the lack of similar study in the region, this study examined the clinical signs and paraclinical information of pediatric patients referring to respiratory infections in Orumiyeh Shahid Motahari Hospital in Urmia Letchr('39')s examine.

Method & Materials: 

This is a descriptive cross-sectional study with the aim of evaluating clinical signs and paraclinical evidence in children with respiratory problems in Motahari Hospital. The number of patients under study was based on the findings of 403 patients and the records of the patients were evaluated for clinical signs and paraclinical information. Data were analyzed using SPSS 20 software.

Among the patients under study, 54% of patients were admitted to pneumonia, 20% were bronchiolitis, and 25% were HRAD crouped patients. Cough was the main clinical symptom in the hospitalized patients. There was no mortality among patients among the patientschr('39') experiments, only one positive blood culture was reported

Our results showed that in patients treated with laboratory data and other paraclinical information, there are significant differences in the studies that have to be taken into account because they can be important in determining the treatment route for these patients.

Lymphadenitis is a type of inflammatory lymphadenopathy that is caused by the infiltration of inflammatory cells that can occur with or without the formation of abscesses inside the lymph node. Infectious acute lymphadenitis causes are mostly associated with acute viral and bacterial infection. The purpose of this study was to provide a more comprehensive description of the causes and evaluations performed and the effective treatment for patients referred to Shahid Motahari Hospital with cervical infectious lymphadenitis.

This retrospective study was performed on 191 children aged 3 months to 14 years admitted to Urmia Shahid Motahari Hospital who were diagnosed with cervical lymphadenitis between 2013 and 2018. Disease records, biological information, type of antibiotic treatment, aggressive procedure, contrast-enhanced CT scan information, treatment duration, and clinical symptoms were collected and a checklist was filled out.

107 patients (56%) were male and 84 patients (44%) were female. The mean age of patients was 46.65±35.05 months (range 3–168 months). Mean hospitalization duration was 5.54±3.19 days (range 1–22). The most common clinical symptom of the patients referred to the hospital was fever, which was present in 151 patients (79.1%). In 135 patients (70.7%) no aggressive procedure was taken. Abscess drainage was performed in 40 patients (20.9%), mass biopsy in 14 patients (7.3%), and surgery in 2 patients (1%). Thirty-nine patients (20.4%) had cultures that reported negative results in all cases.

The most common diagnosis in children is acute inflammatory lymphadenitis and occurs usually in spring and urban children. It is common in boys under 5 years of age. The most commonly used antibiotic is clindamycin. In cases of abscess, surgical drainage is performed for treatment.

Unwanted drug-related reactions have remained a challenge in modern health care due to the increasing complexity of treatments and the increasing population of the world. Due to the lack of a similar study in this area, this study was conducted to investigate the unwanted drug-related skin reactions in children hospitalized in Motahari Hospital of Urmia from 2012 to 2016.

In this retrospective descriptive study, the medical records of all children hospitalized in Motahari Hospital in Urmia with the diagnosis of unwanted drug-related skin complications from the beginning of 2012 to the end of 2016 were studied. All the information was entered into an organized checklist designed already for this purpose. Data were analyzed by SPSS 19.

Our study showed that 76 (58.5%) of the children were male and 54 (41.5%) were female. The results of this study showed that phenobarbital is the most common drug that causes skin complications (In 90 cases (69.2%)). Maculopapular rash was the most common skin complication in the studied patients (In 96 cases (73.8%)).

The results of our study showed that skin complications in children are rare but potentially dangerous and special attention should be paid to them and immediate medical measures should be taken for these patients.

A successful cardiopulmonary resuscitation depends on various factors such as age, sex, patient, etiology of cardiopulmonary arrest, CPR onset, and so on. The aim of this study was to evaluate the status of cardiopulmonary resuscitation and its related factors in Shahid Motahhari Hospital of Marvdasht.

In this cross-sectional descriptive study, all cases of cardiopulmonary resuscitation during one year from April 2014 to April 2105 were evaluated in all treatment units. This study included all factors associated with cardiopulmonary resuscitation, including age, sex, underlying disease, etiology of respiratory arrest, timing of CPR, presence or absence of related features, presence or absence of specialist or general practitioner, outcome of CPR, and complications It was examined. Data were analyzed using descriptive and inferential tests.

46.7% of CPRs were successful. There was a significant relationship between age and CPR success (P = 0.018). There was a significant relationship between gender and CPR success (P = 0.001). The success rate of CPR in women was significantly higher than in men. The most common reason for CPR failure was due to the failure of the CPR team or physician to arrive on time.

The rate of successful CPRs in Marvdasht hospital is in a good level compared to similar studies. Therefore, it is recommended to improve the CPR success rate by better planning and considering the results of this study.

Post-anesthesia shivering causes discomfort in the patient. Many drugs have tried to prevent or reduce shivering, but the ideal drug has not been finalized yet. The purpose of this study was todetermine the effect of dexodomodinewith bupivacaine in spinal anesthesia to prevent shivering in orthopedic fracture surgeryof femur and tibia.

This randomized clinical trial study was performed on 60 patients 18-50 years old with ASA class 1 and 2 who were candidates for tibia and femur orthopedic fracture surgeryin 2018. Patients were randomly divided into two groups; Intervention group: 12.5 mg bupivacaine (2.5 cc) and 5 μgdexmedetomidine (0.5 ml) and control group: 12.5 mg bupivacaine and 0.5 ml normal. Systolic, diastolic, and mean arterial blood pressure and blood O2% saturationwere recorded before spinal anesthesia, after anesthesia and then every 15 minutes until surgery and recovery time. At 2, 4, 8, 12 and 24 hours postoperatively shivering was evaluated. Data were analyzed using descriptive statistics indices (mean, percentage and standard deviation) and inferential statistical tests (chi-square, t-test, and Mann-Whitneyu) using SPSS 21 software.

The mean age of patients in the control group was 36.6 ±14.7 years and the intervention group was 32.7± 8.6 years. There was no significant difference in the frequency of shivering between the control and intervention groups at 2(4.3% vs. 7.1%) and 4(4.5% vs. 24.1%).Although, intervention subjects had no any shivering state at hours of 8, 12 and 24, but there was no significantly different compared to control group (7.1%, 3.6% and 3.6%, respectively).
 

The results of study showed that addition of 5 μgdexmedetomidine to bupivacaine in spinal anesthesia reduces the incidence of postoperative shivering, but this difference was not statistically significant. Thus, in this subject seems bee need to studies with whole and large sample of participants.

Adherence to the standard process of obtaining informed consent from patients in the field of therapeutic activities can play an important role in reducing the complaints of physicians and other therapists and consequently reducing legal and judicial interventions. The purpose of this study was to evaluate the level of knowledge of Jahrom clinicians about patient satisfaction and acquittal (2018).
Methods and Materials:This is a descriptive cross-sectional study. Twenty-five clinicians participated in the study in 2018. Data gathering tool was standard satisfaction and acquittal questionnaire. Data were analyzed using descriptive and inferential statistical tests.

The mean level of knowledge was 11.12 2± 2.44. Also, the lowest level of knowledge was 6 and the highest was 16. The level of knowledge in 4 people (16%) was unacceptable, 19 (76%) moderate and only 2 (8%) were unacceptable. The overwhelming majority of specialists (91.7%) had liability insurance and 39.1% stated that they were risk-takers and 56.5% stated that they were somewhat risk-takers and only 4.3% stated that they were not.

The results of this study showed that 76% of participants in this study had moderate knowledge. Lack of familiarity with consent can lead to problems for the medical community and endanger the health of the community. Therefore, legal training should be provided through retraining programs and workshops designed to enhance the information of clinical professionals.

Many people with multiple sclerosis (MS) experience difficulty with balance and walking, which can make daily activities difficult. Recent studies in rehabilitation procedures emphasize on functional suspension training using body weight resistance against gravity by unstable tools and equipment that are similar to daily activities. Therefore, the purpose of this study was to determine the effect of total body resistance exercise (TRX) suspension training on functional balance in patients with MS. This study included 34 females with MS and expanded disability status scale of 1-4 as well as the age range of 20-50 years who referred to Isfahan MS Society. The participants were intentionally selected and assigned nonrandomly into two groups of control (n=15) and experimental (n=19). The training protocol included 8 TRX movements with four difficulty levels from simple to difficult for 8 weeks, 3 sessions per week, and each session lasting 45 minutes. The functional balance was measured through using Timed Up and Go (TUG), 10-Metre Walk Test (10MWT), and forward and lateral functional reach tests. Data were analyzed using ANCOVA. P-value less than 0.05 were considered statistically significant. Ethics code: IR.UI.REC.1396.014, Clinical trial: IRCT20180521039762N1 The results obtained from the posttest showed a significant improvement in functional balance of the experimental group, compared to the control group in terms of the TUG test (P=0.001), 10MWT (P=0.001), and lateral functional reach tests to the left and right (P=0.013). However, there was no significant difference between the two groups regarding forward functional reach test (P=0.053). According to the results, it can be concluded that TRX suspension training improves functional balance, walking speed, and balance during walking in patients with MS. Therefore, it is recommended to perform TRX training as a functional training intervention to improve functional balance and walking in MS patients.

Diarrhea is a major health problem in developing countries; and on a global scale, it is the most common cause of death after heart diseases and cancer in many populations. Gastroenteritis is a symptom of the gastrointestinal infection (GI) which is caused by pathogenic bacterial, viral or parasitic infections. In some centers, without complete diagnostic tests to approve bacterial infection, antibiotics are prescribed; and antibiotic therapy is stopped after diagnosing non-bacterial infection. Antibiotics should not be prescribed arbitrarily without medical indications due to complications associated with antibiotic therapy, such as antibiotic-resistant strains that would create problems in the future treatment of diseases resistant to antibiotic treatment. The current study was conducted to investigate the pattern of antibiotic usage for nonbacterial (viral) gastroenteritis in patients hospitalized at Motahari Hospital In this retrospective study, all the information was collected from the available medical records in Hospital archives and the results are presented by tables and the average frequency graphs. Children were divided into three age groups (6 months to 3 years - 3 years to 5 years - over 5 years). Data from the medical records of patients including demographic characteristics, duration of diarrhea, fever, clinical symptoms, the results of laboratory tests (analysis, stool cultures, biochemistry, urine analysis) and the antibiotics prescribed in the instructions sheet were all recorded and the related data were analyzed using SPSS. Of 104 patients, 81 patients (77.9%) were six months to three years and 16 patients (15.4%) were three years to five years, and 7 patients (6.7%) were over five years. Sixty patients (57.7%) were males and 44 patients (42.3%) were female. Most patients were male and aged six months to one year (49 patients). Ceftriaxone was the most commonly prescribed antibiotic and 83 patients (79.8%) received it, and 6 patients (5.8%) received ceftizoxime, and 15 patients (14.4) did not receive any antibiotic. The maximum length of hospital stay and antibiotic therapy was 9 days. However, with stool, urine and blood tests being normal, the fever of age groups were 45%, 35%, and 32%, respectively. In order to avoid imposing additional costs and to prevent microbial resistance in diarrhea, it is recommended and urged to prescribe antibiotic for suitable and necessary cases based on laboratory results (culture, stool analysis tests), since the major cause of gastroenteritis is viral infection.

Hydatid disease is a zoonotic parasitic infection that affects humans in many parts of the world, including Iran. It is caused by the larval stage of a tapeworm called Echinococcus. Human is an intermediate host infected accidentally by the ingestion of eggs excreted in the feces of dogs. This infection most commonly involves the liver and lung. Other site localizations are rare including kidney that is seen in 2% to 4% of cases.
Here we report a 9-year-old boy with kidney involvement in a village near Poldasht city, West Azerbaijan, Iran, admitted on Jan 2013. He referred to our hospital with a left upper quadrant (LUQ) mass without any other symptoms, which was discovered by his mother accidentally. Sonography and CT scan with and without contrast revealed large hypodense fluid containing a mass arising from the left kidney that stretched renal parenchyma. Surgery consult was done and radical nephrectomy with left adrenalectomy and retroperitoneal lymphadenectomy due to the suspicion of malignancy was performed. In addition to surgery, he received the first dose of chemotherapy for Wilms tumor and after the pathologic report, albendazole started for him. A definitive presurgery diagnosis is not always possible by radiographic evidence. Therefore, the hydatid disease should be in the differential diagnosis of renal mass. Only surgery and pathologic findings can confirm the diagnosis. In our case, due to the lack of a definitive radiologic evidence for hydatid diagnosis, we did not start albendazole presurgery and albendazole started and continued for six months after the pathologic report confirmed the hydatid disease.
We recommend that albendazole starts in endemic areas for abdominal masses with a non-definitive diagnosis.

Cytomegalovirus (CMV) and Human Herpes Virus-6 (HHV-6) activation after liver transplantation have been associated with increased graft rejection and adverse outcomes. This study aimed at investigating the development and timing of CMV infection after liver transplantation and its relation to post-transplantation HHV-6 activation.
Patients undergoing liver transplantation were enrolled, regardless of their age, place of residence, or their liver failure etiology. Blood samples were collected at baseline and every week for a period of 12 weeks and were tested for anti-CMV IgG and anti-HHV-6 IgG, CMV pp65 antigenemia, as well as CMV and HHV-6 DNA using the Polymerase Chain Reaction (PCR) method.
Among 46 liver transplant recipients, 17 (36.9%) developed CMV infection within 3 months after transplantation. Before transplantation, 42 (91.3%) and 41 (89.1%) recipients were seropositive for CMV and HHV-6, respectively. Fifty percent of patients were positive for CMV antigenemia, among which 73.9% became symptomatic for CMV infection. Half of the patients had positive test results for CMV PCR with a significant relationship between the CMV viral load and the development of symptomatic CMV infection (P = 0.001). Twenty-five (54.3%) patients had positive test results for HHV-6 PCR with a significant relationship between HHV-6 positivity and the development of clinical presentation (P = 0.002). The average post-transplantation time to HHV-6 and CMV activation was 19.4 ± 86.5 and 28.4 ± 60.5 days, respectively, with a linear relationship in the regression analysis.
The HHV-6 infection, either as primary infection or reactivation, leads to an increased risk of CMV infection and symptomatic disease after liver transplantation. Activation of HHV-6 precedes the CMV activation in time.

The vision is preferred system of sensory information that it is plays important role in postural control and movement. The purpose of current study was to examine the effect of Prismatic adaptation on the postural control and dart throwing precision. For this purpose, 17 healthy male and female participants with age range 20- 41 years old were divided into experimental and control groups, based on the throwing precision. The groups threw 480 darts in eight consecutive days. The experimental group used prismatic eyeglasses that divert the sight to the left. Before and after the training period, the static balance in open and closed eyes states was recorded via force platform and the throwing precision was measured as well. Data was analyzed using mix analysis of variance and analysis of covariance. The results showed that speed and displacement of anterior-posterior sway (P=0.002) and the overall speed and displacement center of pressure reduced in the experimental group (P=0.006). There was no significant difference between closed and open eye (P>0.05). Also, there was no significant difference in group by vision factors interaction (P>0.05). The precision index showed no difference in the post-test but in the retention test, the precision variable was significantly better in the experimental group (P=0.02). The results indicate that challenge caused by visual adaptation can improve the throw precision and individual’s postural control.

This study was conducted to investigate the mediating role of academic self-concept in the relationship between family communication patterns and achievement motivation. The present study is correlational type of study. The study population included 13000 students of Kerman Shahid Bahonar University, which 380 (150 males, 230 females) were selected by multistage cluster sampling. Participants completed the Family Communication Patterns Questionnaire (Fitzpatrick and Ritchie, 1997), Academic Self-concept Questionnaire (Li Yu and Wang, 2005), and Achievement Motivation Questionnaire (Herman, 1970). Data were analyzed using descriptive statistics and path analysis test. The results showed that family communication patterns positively and significantly predict the academic self-concept and academic self-concept positively and significantly predict the achievement motivation. Communication patterns through a mediator variable of academic self-concept predict the achievement motivation. As a result, as general effects of two direct and non-direct paths increase, dimensions of family communication patterns and academic self-concept will have a mediating role for academic self-concepts in the relationship between communication patterns and achievement motivation. It is concluded that by training and paying more attention to the relationship between the family and self-concept of people, we can increase the achievement motivation of people.

Vitamin D deficiency is known as a one of the underlying causes of Idiopathic musculoskeletal pain (IMSP). This study aimed to evaluate the correlation between serum vitamin D (Cholecalciferol) status in patient with Non-specific Musculoskeletal Pain and healthy children.
Seventy-seven children (aged 3–14 years), with IMSP were included as cases and 90 healthy subjects were selected for control group. Demographic characteristics and biochemical levels of vitamin D and Parathyroid hormone (PTH), were obtained. Data were analysis using SPSS version 17.0 software.
Results showed that vitamin D means levels of patients and healthy children were significantly different (19.5 8.84 ng/mL versus 12.7 11.89 ng/mL), respectively (P Deficiency of vitamin D was suggested as the probable identified risk factors for IMSP in children. The results of our study did not reveal clear correlation between vitamin D deficiencies in children which suffer IMSP compared the healthy children.

Nasal Colonization with Methicillin Resistant Staphylococcus aureus (MRSA) is known as an important risk factor in the development of dangerous infections.
The present study seeks to investigate the prevalence of MRSA nasal colonization among the preschool and school children under 14 in Urmia. To do so, specimens for culture were obtained from 400 children. Cultures and antibiograms with oxacillin discs were performed in Shahid Motahari hospital of Urmia.
81 cases (47 females, 34 males) out of 400, nasal colonization were observed. Of which 12 (5 females, 7 males) were resistant to methicillin. Colonization was slightly higher among the females with no statistically significant difference (P.value>1).
The results indicate that colonization with MRSA is present among healthy children in the studied population. Fortunately, the respective prevalence was not higher compared to other areas. Further attention is required by the health authorities to prevent the transmission of such organisms among children.

Balance disorders are major motor complications in children with autism spectrum disorder (ASD). Physical exercise can improve motor complications in patients with this disorder. The aim of this study was to investigate the effect of basic gymnastics exercises on the postural stability in children with autism spectrum disorder.
20 boys with autism spectrum disorder participated in a controlled pre-post clinical trial study. Participants were divided in two 10-participant groups of case and control based on their scores in Gilliam Autism Rating Scale-II. The participants in the case group were trained with basic gymnastic exercises for 12 weeks (three sessions per week), each session lasted 45 minutes. The control group did not participate in any exercise during this time. Postural stability was measured using a force plate. Data were analyzed using multivariate ANOVA test while significant level was set at 0.05.
In post-test, less center of pressure oscillation was observed in the case group (657 ± 143 mm) compared to control group (1057 ± 311 mm) (P = 0.013). In the case group, the center of pressure oscillation was significantly reduced after gymnastic exercise (P = 0.001); but the changes were not significant in control group (P > 0.05).
It seems that gymnastic training improves the postural stability through the reduction in the length of postural sway.

Foot insoles are widely used to reduce excessive pressure exerted on the plantar surface of the foot and prevent diabetic foot ulceration. The objective of this study was to investigate the effects of the metatarsal pad on pressure on the forefoot area.
This randomized crossover clinical trial was conducted on 18 volunteers (5 women and 13 men) with diabetic peripheral neuropathy. Plantar pressure was recorded while participants walked over a plantar pressure platform in three random conditions of barefoot, with a placebo intervention, and with a metatarsal pad. The processed variables were statistically analyzed using repeated measure one-way ANOVA.
The metatarsal pad caused a significant reduction in mean pressure on the forefoot compared to the barefoot and placebo conditions (P The metatarsal pad transfers the forefoot load to the midfoot area, thereby, reducing the pressure exerted on the forefoot. This finding implies that using a metatarsal pad can be an effective intervention to prevent diabetic foot ulceration.

Abstract: High heel shoes alters the kinematics and muscle activity pattersn of the lower extrimities and spine. These changes in the biomechanical characristics of the body could be a challenging issue for postural stability system. The objective of this study was to investigate the effects of different heel heights on the postural sway in healthy young women.
Thirty-two female students who aged 22.3±1.4 years volunterred in this randomized cross-over trial. The center of pressure parameters were recorderd while participants stood upright on a forceplate in four randon conditions: barefoor, zero heel-height shoes, 3 cm heel-height shoes, and 6 cm heel-height shoes. The recoded data was statistically analyzed.
The results of repeated measures ANOVA indicated statistically significant differences in the range, path length, and velocity of the body sway in different conditions of this study.
Heel height raising caused some alteration in the boy sway parameters which cpuld induce a postural instability.

Postural instability is a major complication of Parkinson’s disease (PD) leads to the reduced mobility and poor quality of life in patients. Physical activity and exercise is a part of treatment plan to reduce the symptoms of the disease. Water-based exercise is recommended for patients with a lower level of mobility. This study aimed to compare the effects of water- and land-based exercises on patients with Parkinson’s disease. 20 patients who were diagnosed to have idiopathic Parkinson’s disease by a neurologist were equally divided into two 10-people groups based on their severity of complications. Both groups completed an 8-weeks (3 sessions per week) exercise program. Postural stability and quality of life (QoL) parameters were recorded using a force-plate and questionnaire in pre- and post-test sessions. Recorded outcomes were analyzed and compared using analysis of covariance statistical test. Postural stability and quality of life parameters improved at the post-test session compared to pre-test in both groups. The improvement of these outcomes was significantly greater in the water-based group. Water-based exercises can be more beneficial to improve the balance ability and quality of life in patients with Parkinson’s disease.

The plantar sensory impairments has an impact on the balance. Textured insoles are being used to improve foot sensation and balance. The majority of the literature has only focused on the intervention applied to the plantar surface; no adequate attention paid toward other area of the foot such as dorsum surface. This study was to compare the effect of textured insoles on ankle proprioception and balance. 16 females, 14 males with the history of falling during the last year were recruited in this study. They were randomly tested in four different conditions: textured insole, textured collar and tongue, placebo insole, and no insole. Ankle joint position sense and balance tests including “forward reach test” and “timed up and go” were carried out by all participants. All data were recorded and analyzed using “repeated measure ANOVA”. Participants did the ankle joint position sense with smaller errors while using textured insole (P<0.01). The recorded time showed a significant reduction when textured insole used over the dorsal surface and around the ankle, in timed up and go test (P<0.01). It has been postulated that using the textured insole in different instep area of a shoe could improve the somatosensory sensation, functional balance and proprioception.

Older people enconter a reduced balance performance as they have lower sensory and motor abilities. Balance problem pomote the risk of falling and subsequent disabling injuries and even death among older people. These problems can impose an extensive chargers on healthcare systems. Insole and footwear are an interface between plantar surface and the ground and can regulate the sensory inputs from the foot. In the light of the given background، the role of footwear and insole can be given more attention to prevent falling problem in older people. This study was to review the effects of different types of shoes and insoles and their roles on balance in older people. A systematic search was carried out within electronic data-bases. Key words included all different synonyms of aging، balance، shoe، insoles and their combinations. There are three possible ways in which can affect balance using shoe and insole: First، by increasing sensory feedbacks as (e. g. vibrating insoles or textured insoles). Second، by making changes in plantar pressure (e. g. Arch support insoles). Third، by applying changes in alignment of ankle joint (e. g. different heel height in shoe). The finding of this review implied that reduction of sensory inputs from the foot in older people can cause a higher risk of balance instability and falling. Based on the research evidnces، using appropriate footwear and insole can effectively control the risk of balance instability and its complications in elder people.