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Background. The present study evaluated the antimicrobial efficacy of composite resins containing nano-silver (NAg) particles used in fixed orthodontic retainers. Methods. Nano-composite resin samples with 1%, 2%, and 5% concentrations of NAg were prepared. The antimicrobial effectiveness of NAg was assessed against Streptococcus mutans, Streptococcus sanguis, and Lactobacillus acidophilus by the biofilm inhibition test (three-day-old biofilms), eluted components test (on days 3, 15, and 30), and disk-diffusion agar test after 48 hours. Measures of central tendency and index of dispersion were used to determine colony-forming units. Kruskal-Wallis test and Mann-Whitney U test were also used. Results. The biofilm inhibition test showed a significant decrease in the colonies of S. mutans (87.64%, 96.47%, and 99.76% decrease), S. sanguis (98.13%, 99.47%, and 99.93% decrease), and L. acidophilus (81.59%, 90.90%, and 99.61% decrease) at 1%, 2%, and 5% concentrations of Nag, respectively, compared to the control groups. The colony-forming unit (CFU)/mL of tested microorganisms continuously decreased with increased NAg concentration. In the eluted component test, no significant differences were noted in the 3rd, 15th, and 30th days between the different concentrations of Nag-containing composite resin disks and control samples. According to the disk-diffusion agar test, there was no growth inhibition zone for the composite resin disks containing 1% and 2% concentrations of Nag. However, the growth inhibition zone was seen with a 5% concentration, with a diameter of 9.5±0.71 mm for S. mutans, 8.5±0.71 mm for S. sanguis, and 8±1.41 for L. acidophilus. Conclusion. The incorporation of NAg into composite resins has antibacterial effects, possibly preventing dental caries around fixed orthodontic retainers.

Objective: In this meta-analysis and systematic review, we aimed to evaluate the effects of the TISADs to facilitates anchorage reinforcement. Methods: PubMed, Cochrane Library, Embase, ISI, Scopus, Web of Science, LILACS, BBO, OpenGrey, and Google Scholar, were used from the electronic databases until 2020 perform systematic literature. Two reviewers extracted data blindly and independently from various abstracts as well as full texts of articles they considered for data extraction. Using the Cochrane collaboration's tool, we evaluated the publications' quality. Then, we computed the mean difference of TISADs and conventional anchorage groups with a confidence interval (CI) of 95%, restricted maximum likelihood (REML), and random effect model of the mesial movement of molars and their tipping. Moreover, we employed Stata/MP 16 that has been considered the most rapid version of Stata for evaluating meta-analysis. Results: According to our electronic searches, 134 topics and abstracts with potential relevance were identified according to the research design. Finally, five publications matched the required inclusion criteria of the study. In addition, the Cochrane collaboration instrument exhibited all studies with low to moderate biases. Also, the mean difference of mesial molar movement showed less anchorage loss in the TISADs group vs. the controls, and a significant difference between these two groups (MD= -1.74 with a CI of 95%, -2.76, -0.71. P = 0.00). Conclusions: TISADs can reduce treatment time, and TISADs are more effective in enables the anchorage than other methods and higher tipping in the TISADs.

Background and Aim: Conventional post-operative rehabilitation programs focus on quadriceps strengthening and knee range of motion. However, hip muscle weakness is evident in patients with knee osteoarthritis. The present trial study aimed to investigate the effects of adding early hip muscle strengthening exercises to conventional rehabilitation programs on pain, Range of Motion (RoM), Quality of Life (QoL), and physical function in patients with unilateral Total Knee Arthroplasty (TKA). Methods & Materials: The intervention was initiated from the second day after surgery and continued for 10 sessions, 3 times a week on 24 participants in the control and intervention groups. Both research groups received Transcutaneous Electrical Neural Stimulation (TENS) and Infra-Red (IR), followed by exercises. The control group performed knee extensor and flexor strengthening and RoM exercises. The intervention group conducted hip-strengthening exercises in addition. Outcome measures included pain, knee flexion, and extension RoM, and QoL using the 36-Item Short Form Survey (SF-36), Timed Up and Go (TUG) test, Step Test, Six-Minute Walk Test (6MWT), and Hip and Knee Muscle Strength test. Ethical Considerations: This research was approved by the Research Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.1396.9511340012) and it was registered in the Clinical Trial Registration Center (Code: IRCT 20150314021459N6). Results: All outcome measures improved in both research groups. The improvement in the scores of pain (P=0.03), knee extension RoM (P=0.007), and TUG test (P=0.033) were significantly higher in the intervention group, compared to the control group. The strength of knee flexors (P=0.023), hip flexors (P=0.040), hip extensors (P=0.028), hip adductors (P=0.040), and hip external rotators (P=0.047) significantly improved higher in the intervention group. Conclusion: According to the present research results, both treatment approaches were effective on patients with unilateral total knee arthroplasty. Considering the better result of some of the outcome measures in the intervention group, the addition of hip strengthening exercises to knee exercises can be useful.

The aim of this study was to compare the fatigue effect on the viscoelastic behavior of the musculoskeletal system between the two sexes in a landing task. Stiffness and shock absorption capacity were studied from ground reaction force data using a mass-spring-damper model. A parametric simulation was also performed to demonstrate the effect of different values of model parameters on the vertical ground reaction force. Following fatigue, the shock absorption capacity reduced in men. According to the parametric simulation, this reduction can result in lower rate of force development which may make men less susceptible to impact injuries than women.

In recent years, thin silver nanowires (Ag NWs) with diameters smaller than 150 nm have been synthesized by implementation of NaCl or FeCl3 as reaction promoters and high molecular weight polyvinylpyrrolidone (PVP) as the capping agent. However, the yield of Ag NWs still remains low, mostly due to the insufficient aspect ratio (AR) of the synthesized nanostructures and the production of Ag nanoparticles, which is an undesirable by product. This study proposes a modified technique to alleviate the problem by using a mixture of FeCl3/CuCl2 as the reaction promoter and two different types of PVP with molecular weight of 360 k and 40 k as the capping agents. The appropriate mixtures of FeCl3/CuCl2 (molar ratio of 1.48:1.45) and PVP 360 k/40 k (molar ratio of 2:1) allow for the rapid synthesis of NWs with diameter of about 110 nm and length of up to 50 μm. It is revealed that the ARs of the synthesized NWs are much greater. The NWs are then used for the fabrication of transparent conductive films (TCFs). The obtained TCF prepared by a scalable, in-house, and cost-efficient spray apparatus possesses a transmittance of 91%, sheet resistance of 10 Ω/sq, and optical haze value of 6.6%. In fact, the AR of the NWs is increased as much as 1135%, and further the figure␣of merit of the TCFs is improved by as much as 2785%.

Objective: To compare the airway changes and risks of sleep apnea after the bimaxillary orthognathic surgery and mandibular setback surgery in the growing patients with skeletal Class III malocclusion . Material and Methods: MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar have been utilized as the electronic databases for performing systematic literature between 2010 to August 2020. The quality of the included studies has been assessed using MINORS. Meta-analysis was performed using Stata 16 software. Results: In electronic searches, a total of 218 potentially relevant abstracts and topics have been found. Finally, 23 papers met the criteria defined for inclusion in this systematic review. The mean difference of upper airway total volume changes between before and after surgery was (MD = 1.86 cm 3 95% CI 0.61 cm 3 -3.11 cm 3 ; p= 0.00) among 14 studies. This result showed that after Mandibular Setback Surgery, there was a statistically significant decrease in the upper airway volume . Conclusion: Class III Patients who undergo bimaxillary surgery show no other significant difference in airways volume after surgery than patients in Class III who undergo mandibular setback alone.

Objective: To determine the Dentists' practice in compliance with general and guidelines for handling Coronavirus Disease 2019 . Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles until September 2020. EndNote X9 was used to manage electronic resources as a resource. Joanna Briggs Institute reviewer's manual (JBI) tools was used to assess the quality of studies included in the current systematic and meta-analysis review. The 95% confidence interval (CI) effect size, the random effect model, and the Restricted maximum-likelihood (REML) methods have all been calculated. I 2 values of more than 50% indicated moderate-to-high heterogeneity. Stata/MP v.16 (the fastest version of Stata) statistical software was used to evaluate the Meta-analysis. Results: 39 articles were found in the initial keyword search. The full text of 16 studies was reviewed, and six studies were selected in the end. 72% of participants used a face mask during the dental procedure (72%, 95% CI; 40%-100%). 63% of participants measured fever when patients arrived during the COVID-19 pandemic (63%, 95% CI; 46%-79%). Moreover, 72% of participants used a face mask during the dental procedure (72%, 95% CI; 40%-100%). According to JBI tools, all studies had a moderate risk of bias . Conclusion: The results show that the performance of dental professionals in the conditions of the COVID-19 epidemic is not favorable. Training should be under the standards of treatment guidelines and further measures so that dental professionals can show proper practice by increasing their awareness of this virus and following up on its infection.

Objective: The GSTP1 gene, which is located on chromosome 11q13, consists of 7 exons and 6 introns. There are two polymorphisms in GSTP1 that have been exposed to a transposition for codon 105 (Ile/Val) and 114 (Ala/Val) in exons 5 and 6, which have been studied previously in relation to lung cancer. Since the level of GSTP1 expression in lung tissues and other human epithelial tissues is high, GSTP1Val-105 polymorphism is recognized as a sensitive factor for tobacco-related cancers, especially lung cancer. Methods: One hundred and twenty tissue block samples of patients with lung cancers and 120 peripheral blood samples of the control group were obtained from two referral cancer centers in Tehran, Iran, from 2011 to 2016. Genomic DNA was extracted from tissue blocks and buffy coat of study cases to detect SNP of GSTP1 gene using Tetra-primer ARMS-PCR. Results: There was a notable correlation between the incidence of lung cancer and variant Val105 (P-value=0.001; OR=2/6; 95% CI=1.49-4.53) and Ile105 (P-value=0.003; OR=0.41; 95% CI=0.23-0.73). The odds ratio for lung cancer in the homozygous Ile105/Ile105 genotype was 3.56 times higher than that of individual with heterozygous Ile105/Val105 (P-value

Background This study aimed to evaluate the responsiveness of Western Ontario Meniscal Evaluation Tool (WOMET) and specify its Minimal Clinically Important Difference (MCID) in patients undergoing physiotherapy intervention following undergoing a meniscal lesion or surgery. Our hypothesis was that the WOMET would have adequate responsiveness in patients with meniscal injury. method: 100 patients undergoing physiotherapy interventions filled the Persian version of the WOMET and a questionnaire of the Knee injury and Osteoarthritis Outcome Score (KOOS) at Session 1 and Session 10 (4 weeks later). They also filled the 7-point Global Rating of Change (GRC) scale at Session 10. Internal responsiveness was calculated using T test and effect sizes (standard response mean (SRM) and Cohen's d); and external responsiveness was calculated via receiver operating characteristic curve and correlation analysis. The inclusion criterion was the age of 18 to 70 years old for the patients who had the ability of filling the questionnaire. The exclusion criteria included ligaments injury, severe osteoarthritis, inability to complete the questionnaire due to the lack of sufficient knowledge, malignancy, infection, neuromusculoskeletal disorder, rheumatologic disease, knee surgeries for any other reasons, and dissatisfaction for being enrolled in the study. Results All the WOMET subscales (AUC = 0.7) had acceptable external responsiveness. SRM was Trivial, and the scores of Cohen’s d were moderate to large and t tests showed significant differences. Conclusion Our findings showed that all of the WOMET subscales had acceptable external responsiveness, and thus this questionnaire could be used to study the effects of physiotherapy interventions on patients undergoing a meniscal lesion or surgery.

Objective: T o evaluate the epidemiological evidence, symptoms, and transmission routes of Coronavirus Disease 19 for clinical dental care . Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles until October 2020. Therefore, EndNote X9 was used to manage electronic resources. A 95% confidence interval (CI) effect size, random effect model, and the REML method were evaluated. Forty-one articles were found. In the first step of selecting studies, 40 studies were selected to review the abstracts. Finally, six studies were selected. Results: The effect size of symptoms of COVID-19 was fever: 92% (ES = 0.92, 95% CI 0.79-1.06), cough: 73% (ES = 0.73, 95% CI 0.59-0.88), headache: 8% (ES = 0.8, 95% CI 0.06-0.22), myalgia 13% (ES = 0.13, 95% CI 0.01-0.27) and nasal congestion 22% (ES = 0.22, 95% CI 0.06-0.39). The following recommendations are appropriate during COVID-19 for dental emergency management: personal protective equipment and hand cleanliness practices, personal protective equipment (PPE), preprocedural mouth rinse, single-use (disposable), cone-beam computed tomography (CBCT) and periapical (PA) radiography, Rubber dam, sodium hypochlorite for root canal irrigation, disinfect inanimate surfaces, ultrasonic scaling instruments and airborne infection isolation . Conclusion: Fever should be used as the first sign in the diagnosis; dentists should measure the fever of all patients at the time of arrival and before any procedure and then ask about other symptoms.

Background: Craniosacral therapy (CST) and sensorimotor training (SMT) are two recommended interventions for nonspecific chronic low back pain (NCLBP). This study compares the effects of CST and SMT on pain, functional disability, depression and quality of life in patients with NCLBP. Methodology: A total of 31 patients with NCLBP were randomly assigned to the CST group (n=16) and SMT (n=15). The study patients received 10 sessions of interventions during 5 weeks. Visual analogue scale (VAS), Oswestry disability index (ODI), Beck depression inventory-II (BDI-II), and Short Form-36 (SF-36) questionnaires were used at baseline (before the treatment), after the treatment, and 2 months after the last intervention session. Results were compared and analyzed statistically. Results: Both groups showed significant improvement from baseline to after treatment (p < 0.05). In the CST group, this improvement continued during the follow-up period in all outcomes (p < 0.05), except role emotional domain of SF-36. In the SMT group, VAS, ODI and BDI-II increased during follow-up. Also, all domains of SF-36 decreased over this period. Results of group analysis indicate a significant difference between groups at the end of treatment phase (p < 0.05), except social functioning. Conclusions: Results of our research confirm that 10 sessions of craniosacral therapy (CST) or sensorimotor training (SMT) can significantly control pain, disability, depression, and quality of life in patients with NCLBP; but the efficacy of CST is significantly better than SMT. Key words: Craniosacral therapy; Sensorimotor training; Nonspecific chronic low back pain; Quality of life Citation: Ghasemi C, Amiri A, Sarrafzadeh J, Dadgoo M. Effects of craniosacral therapy and sensorimotor training on pain, disability, depression and quality of life of patients with nonspecific chronic low back pain: a randomized clinical trial. Anaesth. pain intensive care 2021;25(2):189-198. DOI: 10.35975/apic.v25i2.1458 Abbreviations: CST=Craniosacral therapy; SMT=Sensorimotor training; NCLBP=Nonspecific chronic low back pain; VAS=Visual analogue scale; ODI=Oswestry disability index, BDI-II=Beck depression inventory-II, and SF-36=Short Form-36; CSF=cerebral spinal fluid; CSS=craniosacral system; PRM=primary respiratory movements Received: 27 June 2020, Reviewed: 24 July 2020, Accepted: 27 July 2020

Objective: To evaluate the droplets and aerosols, posing potential risks of infection transmission of COVID-19 disease in dentistry . Material and Methods: PubMed, Embase, ISI, Scopus, Medicine have been used to search for articles between September 2019 to December 2020. Data extracted from the studies were included, study, study design, sample size, Sample collection time, Hallway Air Samples (copies/L of air), Personal Air Samples (copies/L of air). Effect size with 95% confidence interval (CI), fixed effect model, Inverse-variance methods were calculated. The Meta-analysis was evaluated with Stata/MP v.16 statistical software (The fastest version of Stata). Results: According to the purpose of the study, 64 articles were found; studies that did not meet the inclusion criteria were excluded from the study; the full text of 11 studies was reviewed. Finally, two studies were selected. The effect size of airborne COVID-19 concentrations of the hallway and personal air samples was 64% copies/L of air (ES, 0.64 95% CI=-1.45-2.73) and 100% copies/L air (ES, 1.00 95% CI=-1.77-3.76), respectively . Conclusion: Evidence of aerosol transmission of COVID-19 in observational studies of patients with COVID-19 was 64% copies/L of air and 100% copies/L of air in the hallway and personal air samples, respectively.

The main goal of the present work is to explore the three dimensional (3-D) atomic force microscopy (AFM) images of human teeth and investigating their micromorphology. For this purpose, 10 fresh and permanent canine teeth were selected from a group of 40-year-old men who were candidate for the experimental processes. Afterward, they were all applied for studying the morphology of their hard tissues. The tapping mode of AFM was used to characterize the surface micromorphology on the square areas of 1 μm × 1 μm (512 × 512 pts). AFM results and surface stereometric analysis indicate the relationships between the micromorphology of the surface and the structural properties of these tissues across the length scales. As can be seen, the surface of cementum has the most irregular topography (D = 2.87 ± 0.01) while the most regular topography (D = 2.43 ± 0.01) is found in dentin. Furthermore, the more and less regularity of the surface have been found in inner enamel (Sq = 26.26 nm) and dentin (Sq = 41.28 nm), respectively. Stereometric and fractal analyses give valuable information about human canine teeth via 3-D micromorphology.

Background and Objective: Owing to the high prevalence of injuries among female martial arts athletes, the effects of flexibility and muscular imbalance on lower limb injuries of female martial arts athletes during a competition season was studied. Methods: In this cross-sectional study, 66 professional female martial arts athletes of country (aged 15-40), prior to the season, were evaluated for muscle isometric strength and the flexibility assessment, in the ankle joints, knees and hips. During the training and holding of the tournament, the researcher followed up the created injuries and registered them by the physician or physiotherapist of the team. Paired t-test and SPSS 17 software were used to examine the relationship between the strength of the agonist / antagonist and flexibility in case of occurring injury. Results: The only significant difference between the flexibility in the right hip abductors (P = 0.02) and the evertor / invertor strength ratio in the right ankle (P= 0.007) was obtained with lower limb injury, and no significant statistical differences were found between the other parameters. Conclusion: The insufficiency of muscle force in hip joints and muscle strength imbalance in ankle joints can be important internal factors in incidence of injuries in female martial arts athletes.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders that plaques women today. One of the underlying factors associated with the development of PCOS is elevated inflammation. However, the application of available nutraceutical therapies remains relatively unknown and thus is the focus of the current study. In this manner, we evaluated the effects of probiotic supplement on clinical and immunological parameters of PCOS. Our randomized-control trial, four strains of Lactobacillus for a probiotic group and the equivalent dosage with maltodextrin was used as the placebo. To further understand the impacts of immunological parameters towards inflammation in PCOS, we measured interleukin (IL) 6, 10, TNF-α, hs-CRP and clinical manifestations before and after the trial. The probiotic supplementation resulted in a significant increase in IL-10 levels compared with the placebo, after the intervention. However, in both groups, there was a significant decrease in hs-CRP and IL-6 levels. Probiotic supplementation does not make any significant changes in the TNF-α levels. This study observed that Lactobacillus supplementation modulates inflammation in PCOS patients.

Farsi Background and Objective: Muscle strength deficits have usually been found after ACL reconstruction. Some studies have demonstrated a relationship between lower extremity muscle strength and the single-leg hop test in the ACL reconstructed knees. The aim of this study is to evaluate possible differences in lower limbs including function, muscle strength length and anterior knee pain, 6 months after anterior cruciate ligament (ACL) reconstruction between involved and uninvolved side. Method: Sixty patients who underwent anatomic double bundle ACL reconstruction were examined 6 - 36 months post-operatively. All subjects had undergone the same rehabilitation protocol after ACL reconstruction. Lower extremity isometric strength, muscle length and Triple Single-leg hop test were assessed. Measurements were performed 3 times within a 2-minute interval. The normal limb was tested before the operated limb. The peak strength value was normalized by the body weight. Results: In the Single-leg hop test there was statistically significant difference in the lower limbs comparing the involved with the uninvolved knee (P < 0.001). In the Tensor Fascia Lata-Ilio Tibial Band (ITB/TFL) length, there was statistically significant difference in the lower limbs (P < 0.001). In the isometric knee flexion strength there was statistically significant difference in the lower limbs at 90° (P < 0.001) and 105° (P < 0.001) knee flexion. In the isometric knee extension strength there was statistically significant difference in the lower limbs at 5° (P < 0.001), 45° (P = 0.025) and 90° (P = 0.003) knee flexion. In the isometric hip abduction, internal rotation and plantar flexion strengths there were statistically significant difference in the lower limbs (P < 0.001). There was statistically significant correlation between isometric muscle strength ratio (involved vs. uninvolved) and Single-leg hop test in hip abduction (r = 0.345, P < 0.001) , knee extension at 45° (r = 0.245, P = 0.05) and at 90° (r = 0.379, P = 0.002) knee flexion and between isometric muscle strength ratio and anterior knee pain in hip abduction (r = 0.345, P = 0.03) , knee extension at 90° (r = 0.311, P = 0.009) and at 5° (r = 0.272, P = 0.023) knee flexion. Conclusion: Our study shows that after ACL reconstruction, lower limb function and strength deficit remained despite the completion of rehabilitation. These deficits were found at knee, hip and ankle joints. The present results can be used for re-planning rehabilitation protocol.

Objective Tuberculosis (TB) is caused by infection of Mycobacterium tuberculosis. Host genetic variability is an important determinant of the risk of developing TB in humans. Although the association between MBL polymorphisms and TB has been studied in various populations, the results are controversial. The aim of this study was to investigate mannose-binding lectin ( MBL ) gene polymorphisms with susceptibility to pulmonary tuberculosis (PTB) in a Lur population of Iran. Methods In this case-control study, four functional MBL gene polymorphisms ( HL , XY , PQ and AB ) were genotyped by using PCR Single Strand Conformation Polymorphism (SSCP) technique in a Lur population living in Lorestan Province, consisting of 100 patients with pulmonary tuberculosis (PTB) age and sex matched 100 healthy controls (HCs). Association analyses were performed with the SPSS 21 statistical software. Results We found that MBL ( HH ) genotype polymorphism significantly was associated with increased susceptibility to TB (35% in patients vs. 22% in controls, P = 0.0417, OR = 1.909, %95 CI = 1.020–3.573). Additionally, H allele showed a significant association with increased risk of TB (56.5% in patients vs. 46% in controls, P = 0.0357, OR = 1.525, %95 CI = 1.028–2.262). Also, the distribution of L allele in patients was significantly lower frequency in TB patients compared to controls (43.5% vs. 54%, P = 0.0357, OR = 0.656, %95 CI = 0.442–0.973). However, the allelic and genotypic frequencies of AB , XY and PQ polymorphisms were not significantly different between the patients and the controls. We couldn't detect any significant differences between haplotypes among TB patients and healthy controls. Conclusions Our findings demonstrated that HH genotype and H allele may increase the susceptibility to pulmonary TB in the Lur population of Iran, although L allele may decrease the susceptibility to pulmonary TB in this population. We suggest that it is necessary to further more studies with larger sample size and other ethnic population.

Background: Employee examination is one of the requirements of the occupational health care system. The present study aimed to evaluate the current health status of the staff working in an Iranian gas company to prevent, follow-up, and treat the disease. Methods: This cross-sectional descriptive-analytical study was conducted on the data collected from health screening of 94 service personnel in one of the gas companies in Iran. Data were collected by the 4-sheet forms of occupational examinations containing the following information: demographic data, general health status (blood pressure, smoking, allergy history, surgery, occupational accidents, body mass index), cardiovascular system, musculoskeletal, liver, kidney, gastrointestinal, clinical examination, paraclinical evaluations of the internal gland, cholesterol, triglycerides, liver enzymes, and hematopoietic system (CBC). Data were analyzed using SPSS 25. Results: All participants were male with an average (Standard Deviation) age and BMI of 42.96 ± 8.00 and26.83 ± 4.08, respectively. The participantschr('39') body mass index indicated that 45 staff (48.38%) were overweight and 15 individuals (16.12%) were in the range of obesity. The participants had history of smoking (22.3%), cholesterol above 200 (27.7%), and triglycerides above 300 (8/5%). The rate of hypermetropia, musculoskeletal disease, hypertension, high blood concentration and low blood platelets, hyperglycemia, cardiovascular disease, and kidney disease were 25.80%, 24.5%, 9.6%, 56.4%, 7.4%, 1.1%, and 12.8%, respectively. Conclusion: Although the studied company has a yearly occupational medical examination, the workers have not been provided with a comprehensive report and appropriate feedback. Therefore, it is essential to follow up the health reports and examinations and refer the patients to the related physicians.

Children, including pediatric and adolescent patients, cannot be viewed as simply small adults. Anatomical and physiological differences can offer fundamental challenges in diagnosis and surgical treatment of many conditions. Use of appropriate instruments and equipment, well suited for younger patients, can help make insertion easier as well as facilitate closure. In this chapter, the authors provide an overview of current instrumentation and related technologies for treating these younger, smaller patients.

Background The aim of the study is comparison of the effects of soft tissue manipulation and rest on the knee extensor muscle fatigue after maximal isokinetic contractions. Methods Fifteen healthy females aged 20-30 years selected for research. This study implemented a semi-experimental test-retest measurement method. Each of the volunteers was evaluated three sessions. The first session was to familiarize the volunteers with the test and isokinetics. For the main test, each of the volunteers was evaluated twice with a one-week interval between evaluations. In each session, after warm-up, perceived fatigue using a visual analog scale (VAS), average of peak torque (APT), and average power (AP) for maximal concentric isokinetic output of the quadriceps was measured at a velocity of 60 degrees per second. Then¸ in order to apply the fatigue protocol, the subjects were asked to perform successive maximal quadriceps contractions until three consecutive quadriceps torque outputs reached below 50 percent maximal torque output. Afterwards, for remeasurement, the average of peak torque and average power were calculated. The extent of perceived fatigue was evaluated as before. Subjects then either rested or received soft tissue manipulation on the knee extensors for a 15-minute duration. After intervention (soft tissue manipulation or rest) parameters were evaluated for third time. Results The stability of average peak torque¸ average power, and visual analog scale before performing fatigue protocol was 85%, 83%, and 31.9%, respectively. The stability after fatigue was 43%, 50%, and 93%, respectively. After maximal fatigue and a decrease in torque output to below 50 percent maximal torque, 15 minutes of soft tissue manipulation could change the APT after fatigue from a mean of 58.3 (nm) to 91.5 (nm), the AP from 39.4 to 63.6 (nm/s), and the VAS from 90.0 to 12 (mm). But 15 minutes of rest could change the APT from 52.5 to 68.1 (nm), the AP from 37.6 to 48 (nm/s) and the VAS from 90.0 to 27.3 (mm). Conclusion The study showed that soft tissue manipulation was more effective than rest as a strategy to return muscles to a normal state and caused more relief in perceived fatigue.

Aim: Alzheimer's disease (AD) is characterized by oxidative stress, neuroinflammation and progressive cognitive decline. Abscisic acid (ABA) is produced in a variety of mammalian tissues, i...

Background: Lumbar motion analysis is used as a clinical method in the diagnosis and treatment of low back pain (LBP). So far, no studies have shown if manipulating the sacroiliac joint (SIJ) will change spinal kinematics. Objective: The main objectives of this study were to investigate the effects of SIJ manipulation on the lumbar kinematics in subjects with innominate rotation and to compare lumbar kinematics among experiment and control groups. Material and Methods: This study was a quasi-experiment-control trial study. 21 LBP patients with anterior or posterior innominate rotations in experiment group and 22 asymptomatic subjects in control group were evaluated. Lumbar kinematic variables (LKV) include lumbar range of motion (ROM) and speed, lumbar lateral flexion and rotation asymmetry were evaluated using Qualysis Track Manager (QTM) twice within two days in control group, and these parameters with pelvic asymmetry and disability were tested before and after intervention in the experiment group. Results: While pre-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.0001), rotation (p=0.008) ROM and lower lateral flexion speed (p=0.014), post-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.01) ROM in comparison with control group. Pelvic asymmetry (p=0.049) and disability (p=0.01) significantly decreased in the experiment group after manipulation, but LKV did not change significantly after the intervention (p˃0.05). Conclusion: Experiment groups had different lumbar kinematics in comparison with control group before and after SIJ manipulation. Despite the changes in pelvic asymmetry and disability, intervention had no effect on lumbar kinematics. Citation: Zamanlou M, Akbari M, Jamshidi A. A, Amiri A, Nabiyouni I. Manipulation Effect on Lumbar Kinematics in Patients with Uni- lateral Innominate Rotation and Comparison with Asymptomatic Subjects. J Biomed Phys Eng. 2019;9(3):295-302. https://doi.org/10.31661/ jbpe.v0i0.760

Aim: The present systematic review and meta-analysis aimed to evaluate the clinical effectiveness of miniscrews in Class I and II Malocclusion Patients. Methods: From electronic databases, between 2010 and 2020, PubMed, Embase, Cochrane Library, ISI were used to conduct systematic literature. Two reviewers extracted data blindly and independently from the abstract and full text of the studies they used for data extraction. The mean differences between the two groups (miniscrews vs. conventional anchorage) with a 95 % confidence interval (CI), the Inverse-variance method, and the fixed-effect model were calculated. The Meta-analysis was evaluated using the statistical software Stata/MP v.16 (The fastest version of Stata). Results: A total of 186 potentially relevant titles and abstracts were found during the electronic and manual search. Finally, the inclusion criteria required for this systematic review were met by a total of seven publications. The mean difference of molar mesiodistal movement among seven studies and heterogeneity was -0.53 mm (MD, -0.53 95 % CI -0.69, -0.38. P= 0.00) (I2 = 96.52 %). This result showed maximum reinforcement in miniscrews with fewer mesial movements. Conclusion: The result of the current systematic review and meta-analysis shows that miniscrews in patients with class II and I malocclusion help maintain better anchorage preservation than traditional anchorage devices.

Background The methods to standardize the test items used for classification of patients with knee pain based on the movement system impairment (MSI) approach have been established. To our knowledge, no study has concentrated on establishing reliability for proposed classification for knee pain problems. Objective The aim of the study was to assess intra- and intertester reliability of the knee MSI classification in patients with knee pain. Design A cross-sectional methodological study. Setting Rasul Akram Hospital. Participants Ninety-six subjects with knee pain aged 18–65 years. Methods In order to examine intertester reliability, all three testers assessed the symptoms, signs and the MSI diagnosis of subjects with knee pain simultaneously. In order to assess intratester reliability, the procedure was exactly repeated after a one-week intersession period. Kappa values and percentages of agreement were calculated to analyze the reliability level. Results The kappa values for intra- and intertester reliability of the symptom items ranged from 0.83 to 1.00 and 0.00 to 0.83, respectively. For the sign items, the kappa values ranged from 0.18 to 1.00 and 0.00 to 0.82, respectively. Finally, the kappa values of intra- and intertester reliability for patients' classification judgments ranged from 0.66 to 0.71, and 0.48 to 0.58, respectively. Conclusion The results of the present study indicate that intertester reliability for the symptoms, signs and classification judgments of patients with knee pain based on the MSI approach seemed generally acceptable. However, for intratester reliability, lower levels of the system were observed, probably due to different pain levels or pain behavior between test and retest sessions.

Pericardial tuberculosis (TB) is rare, but has particularly severe complications and a high mortality rate when not treated. Prompt treatment of pericardial TB is important and can be life-saving. We report a 13-year-old girl with massive pericardial effusion and negative workup for TB, who was empirically treated with an excellent response.

Background Categorizing patients with knee pain problems based on pathoanatomical sources has not proved to be the most effective method for directing physical therapy interventions. Movement system impairment (MSI) classification system may be an alternative in the assessment, diagnosis, and management of patients with knee pain. No previous study has been conducted to validate the proposed system in these patients. Objective To assess construct validity of the MSI classification system in patients with knee pain. Design A cross-sectional methodological study. Setting Rasul Akram Hospital. Participants One hundred eighty subjects with knee pain aged 18–65 years. Methods The MSI classification recognizes seven categories of knee pain problems based on the findings from the symptoms and signs assessment. Three physical therapists examined subjects with knee pain. A principal component analysis (PCA) was used to derive proposed categories. Eigenvalues and a scree plot were also used to determine the factor retention. Results Four factors related to three proposed categories were extracted from the PCA. Two factors were related to tibiofemoral rotation (TFR) category. The other two factors were related to proposed categories patellar lateral glide (PLG) and tibiofemoral hypomobility (TFHypo). Conclusion The results provided evidence for the construct validity of three (TFR, PLG, and TFHypo) of the seven categories proposed by MSI classification. In addition TFR was subcategorized into two groups which were named as tibial lateral rotation (TLR) and femoral adduction/medial rotation (FAdd/MR) in the present study.

Aim: One of the main factors that play a pivotal role in the transmission of COVID-19 from human to human is saliva;according to the subject's importance, the present study aimed to evaluate the potential of transmission via the saliva of coronavirus disease Methods: PubMed, ISI, Embase, Scopus, Medicine have been used until September 2020 to search for articles Therefore, EndNote X9 used to manage electronic resources A 95% confidence interval (CI) effect size, fixed effect model, Inverse-variance methods have been calculated The positive rate of SARS-CoV2 assessed with meta analysis To deal with potential heterogeneity, random effects were used, and I2 showed heterogeneity I2 values above 50% signified moderate-to-high heterogeneity The Meta-analysis has been evaluated with Stata/MP v 16 (the fastest version of Stata) statistical software Results: According to the study's purpose, in the initial search with keywords, 19 articles were found, the full text of 3 studies was reviewed, and finally, three studies were selected The positive rate of SARS-CoV2 was 86% (86%;95% CI 67 %-100%) Conclusion: saliva can be a non-invasive specimen type for diagnosis of COVID-19 Dentists should be aware that saliva plays a major role in the transmission of COVID-19 from human to human, and failure to follow prevention protocols can contaminate them © 2021 All Rights Reserved

Purpose: To develop a novel in vitro method of evaluating coronary artery ischemia using a combination of noninvasive coronary CT angiograms (CCTA) and 3D printing. Materials and Methods: Five patients with varying degrees of coronary artery disease who underwent non-invasive CCTA scans and invasive fractional flow reserve (FFR) of their left anterior descending coronary artery (LAD) were included in this study. The LAD artery was segmented and reconstructed using Mimics (Materialise). The segmented models were then 3D printed using a Carbon (Carbon Inc.,) and Objet260 Connex (Stratasys) printers with urethane methacrylate (UMA) family of rigid resins and Veroclear, respectively. An in vitro flow circulation system representative of invasive measurements in a cardiac catheterization laboratory was developed to experimentally evaluate the hemodynamic parameters of pressure and flow. Physiological coronary circulation was modelled in vitro as flow‐dependent stenosis resistance in series with variable downstream resistance. A range of physiological flow rates was applied by a peristaltic steady flow pump and titrated by a flow sensor. The pressure drop and the pressure ratio (Pd/Pa) were assessed for patient-specific aortic pressure and differing flow rates to evaluate FFR in vitro. Results: For these five models, there was a good positive correlation (r = 0.78) between the in vitro and invasive FFR. The mean differences, as assessed by Bland-Altman analysis, between in vitro and invasively measured FFR was at 0.01±0.1 (95% limit of agreement -0.1169 to 0.1369). Conclusions: 3D printed patient-specific models can be used in a non-invasive in vitro environment to quantify coronary artery ischemia as assessed by invasive FFR.

The primary mode of visualization during transcatheter procedures for structrural heart disease is fluoroscopy, which suffers from low contrast and lacks any depth perception, thus limiting the ability of an interventionalist to position a catheter accurately. This paper describes a new image guidance system by utilizing augmented reality to provide a 3D visual environment and quantitative feedback of the catheter's position within the heart of the patient. The real-time 3D position of the catheter is acquired via two fluoroscopic images taken at different angles, and a patient-specific 3D heart rendering is produced pre-operatively from a CT scan. The spine acts as a fiduciary land marker, allowing the position and orientation of the catheter within the heart to be fully registered. The automated registration method is based on Fourier transformation, and has a high success rate (100%), low registration error (0.42 mm), and clinically acceptable computational cost (1.22 second). The 3D renderings are displayed and updated on the augmented reality device (i.e., Microsoft HoloLens), which can provide pre-set views of various angles of the heart using voice-command. This new image-guidance system with augmented reality provides a better visualization to interventionalists and potentially assists them in understanding of complicated cases. Furthermore, this system coupled with the developed 3D printed models can serve as a training tool for the next generation of cardiac interventionalists.

Objective This study evaluated the effectiveness of ergonomic latex pillows in terms of clinical and biomechanical (cervical range of motion) outcome measures in patients with cervical spondylosis. Design This parallel-group randomized controlled trial randomly assigned 42 patients with cervical spondylosis to the experimental and control groups. Both groups received 12 sessions of routine physical therapy for 4 wks. While the experimental group received an ergonomic latex pillow, the control group slept on their own usual pillow during the mentioned 4-wk period. Pain intensity, functional disability, medication use, and cervical range of motion were measured before and after 4 wks of intervention. Results After 4 wks of intervention, the experimental group showed pain relief, decreased disability, and significantly increased range of motion in all directions. The simultaneous use of an ergonomic latex pillow and physical therapy could more successfully decrease pain intensity compared with routine physical therapy alone. In addition, extension and right lateral flexion variables significantly increased in the experimental group compared with the control group. Conclusions The administration of an ergonomic latex pillow can ameliorate treatment outcome in patients with cervical spondylosis.