seyed morteza kazemi

The medial collateral ligament (MCL) injury is one of the possible complications of primary total knee arthroplasty (TKA), which can lead to coronal-plane instability that requires surgical revision. Injured MCL can result in joint instability and polyethylene wear. Different strategies have been proposed for MCL reconstruction based on the location of the injury. However, there is a lack of clarity regarding the optimal method for handling an iatrogenic MCL injury throughout a TKA.

A PRISMA flow diagram was used to guide the systematic literature review. An extensive search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar. Newcastle Ottawa scale checklist was used to assess the methodological quality of the articles.

A total of 19 qualitative studies, including non-cadaveric patients with MCL injury during TKA, were identified after analyzing the full text of the articles. All included studies were either retrospective, observational cohort or case series. A total of 486 patients were studied to gather information on the methods used to repair the MCL and their results. Most injuries arose in the tibial attachment, which surgeons mostly realized during the final stages of surgery. Used techniques can be categorized into three main groups: Primary repair, Repair with augmentation, and changing prosthesis characteristics.

This systematic review demonstrated that the most popular management of iatrogenic MCL injury was using suture anchors, staples, screws and washers, and more constrained prostheses. The proper method should be decided considering the site of the MCL injury. Level of evidence: I

 Following an anterior cruciate ligament (ACL) rupture, proprioceptive deficiency may be responsible for functional balance defects and joint instability. Recently, using transcranial direct current stimulation (tDCS) or biofeedback has been recommended for athletes with ACL rupture.

 This study aimed to evaluate the effects of tDCS and biofeedback modalities while performing contraction exercises in athlete with an ACL rupture.

 Thirty-three athletes with ACL rupture were randomly divided into three groups of tDCS, biofeedback, and control, with 11 people in each group. All groups underwent a ten-session training of intermittent contractions of the lower extremity muscles in a standing position at different knee angles, including 30, 45, and 90 degrees of knee flexion during four weeks. The control group received no tDCS or biofeedback modalities except the contraction exercises. All subjects were evaluated both before and at the end of interventions. The proprioception measured as rate of absolute error in the knee joint reconstruction was assessed by the digital photography technique at knee flexion angles of 30, 45, and 90 degrees. The functional balance was assessed by the star excursion balance test in eight different directions. All measurements were carried out on the injured limb.

 The results showed no significant difference among three groups regarding all variables related to the proprioception and functional balance (P > 0.05). Intra-group comparison (before and after intervention) indicated that biofeedback significantly improved both the functional balance in all directions and the proprioception of the injured knee at three knee flexion angles (P < 0.05). Moreover, tDCS significantly improved the functional balance in six directions, except anterior-lateral and posterior, and also improved the proprioception at all angles of knee flexion.

 Although the results did not show a large difference among groups, both tDCS and biofeedback modalities, along with intermittent isometric exercises, may have reduced knee absolute error at the knee flexion angles of 30, 45, and 90 degrees as well as improved the functional balance. Therefore, it was recommended that these modalities should be included in rehabilitation program targeting ACL-deficient knee subjects.

Iran and Afghanistan share deep historical, cultural and civilizational ties. Iran is one of Afghanistan’s largest trading partners. However, economic sanctions have disrupted bilateral trade between these two neighboring countries through various channels. This paper presents an empirical analysis of the impact of economic sanctions on trade between Iran and Afghanistan in the period 2004-2018 by applying the Gravity Model, while the estimation is performed using fully modified least-squares technique. Findings of the research indicate that the imposition of any strong economic sanctions, in the long run, not only during the sanctions period but also in the post-sanctions period, has increased trade between Iran and Afghanistan. On the other hand, weak sanctions during the sanctions period have reduced trade; nevertheless, weak sanctions in the post-sanctions period have increased bilateral trade. Development of trade cooperation between the two countries, facilitation of trade affairs and expansion of joint regional and international cooperation should be on the agenda of economic policymakers in Iran and Afghanistan.

In the present era, due to the development of transportation system and communication technology, the economies and trade of countries are intertwined. This highlights the vital importance of foreign trade as the main lever for economic growth and development. Meanwhile, trade between Iran and Afghanistan due to its proximity and high potential for trade and economic cooperation doubles the importance of the issue. But the imposition of economic sanctions on Iran poses a variety of obstacles and restrictions on trade between the two countries. Therefore, in this study, the effect of economic sanctions on trade between Iran and Afghanistan during the years (2001-2009) has been studied and analyzed by Eviews10, using a Fully Modified Ordinary Least Square method. Economic sanctions have entered the model in the form of a dummy variable. The findings show that the imposition of any economic sanctions has led to an increase in long-term trade between Iran and Afghanistan. Therefore, the two countries should consider the necessary strategies to reduce the effect of sanctions.

osteotomy around the knee is one of the most common corrective surgeries for lower limb deformities. The exact relationship between the effects of these surgeries on the ankle joint is unclear.This study aimed to investigate the effect of HTO on the subtalar joint in patients with genu varum. In the case series study33 patients including 27.2% men and 72.7% womenwith an average age of 41.9, with genu varum who underwent corrective surgery of open wedge high tibial osteotomy were studied. the heel alignment angle was determined before and after surgery in 10-months follow-up based on Saltzman view in conventional radiography. The data were then compared. Average genu varum correction angle was 11.9±1.3°. Heel alignment degree was 5.9±1.3° before HTO surgery, and after the surgery,in final follow-up,it was to 3.4±1.2° valgus, this value was statisticallysignificant(p=0.04). Moreover, there was a significant statistical relationship between average correction of Varus deformity and heel alignment anglechanges (P=0.02, r=0.3). Correcting Varus knee deformity can be effectiveon heel alignment angle in patients undergoing HTO surgery with genu varum. The angle of the subtalar valgus decreases as a result. Level of evidence: III

Nowadays, with the advancement of the building industry, new structural systems are introduced by researchers. Despite the fact that modern systems have many advantages, they suffer from a common problem that is the lack of sufficient knowledge and experience for designers and executors in how to design and implement them as well as the need for new materials and skilled labors. In the present study, a new structural form was proposed that has both the benefits of modern systems and does not require much new technical knowledge. The system (LBF) consists of hot-rolled box section columns that are arranged at short distances from each other to which square beams are connected. All sections are hot rolled and joints are made by welding so that the implementation problems are rare and the need for skilled labors is obviated. In this paper, had been introduced the components of this construction form. Then, behavior of this connection evaluated with using the Abaqus software and experimental under monotonic loads. The obtained results indicate that this construction form has the potential to be used in regions with low hazard of earthquakes and with low-rise buildings.
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There are limited studies regarding the effects of high tibial osteotomy (HTO) on other areas of lower extremity. In current study, we investigated the changes of tibiotalar joint following HTO.
A total of 39 patients with genu varum requiring HTO were enrolled in this before and after study. The genu varus, joint diversion (JDA), lateral distal tibial (LDTA) and lateral distal tibial-ground surface (LDT-GSA) angles were measured before the operation and compared with 6 months after the surgery.
Twenty threeout of39 patients (59%) were females. The genu varus angle decreased significantly (130±1.70versus 0.60±10). No significant changes were seen in JDA (P=0.45) and LDTA (P=0.071). LDT-GSA changed significantly (P=0.011) from 8.10±10 in varus to -0.30±0.50 in valgus.
Although HTO did not change the JDA and LDTA, however, significant change in LDT-GSAindicates that HTO can significantly decrease the shearing forces exerted on the ankle joint.

Chronic regional pain syndrome (CRPS) is one of the most important and worst types of peripheral nervous system, especially in upper extremity. The aim of this study was determination of the effect of a combined rehabilitation program in the treatment of patients with CRPS type I. In this quasi-experimental and before-after study, 20 patients with chronic regional pain syndrome were selected simply and their pain, range of motion, edema and muscular strength were examined and recorded before intervention. Then, patients under went a combined treatment programs included some modalities from physical and occupation therapy. Patients attended at clinic for 20 therapeutic sessions with one day intervals. Finally, data were analyzed using paired–t test. Post operatively, pain and edema were decreased and range of motion and grip strength was increased significantly (P > 0.05). Current study demonstrated that early and combined physical and occupational therapy efficient in the treatment of patients suffering from CRPS type I. This combined program can relieve pain and edema and increase ROM and grip strength.