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Background and Aim: Freiberg’s disease is osteochondrosis or a vascular necrosis of metatarsal head. In many cases treatment is no operative. In patients who fail no operative treatment, surgical treatment may be offered. In this article, we studied surgical treatment with resection arthroplasty of metatarsophalyngeal joint in patients with unsuccessful no operative treatment. Materials and Methods: Resection arthroplasties of metatarsophalyngeal joint were performed in 16 patients with Freiberg’s disease and unsuccessful no operative treatment between 2001 and 2007. In all patients, second metatarsophalyngeal joint involved. The average of follow up was 34 months (12-56). Results: There were 12 female (75%) and 4 male (25%) patients with an average age of 25 years (range 18-40). There were excellent outcome in 12 (75%), good in 2 (12.5%) and moderate in 2 (12.5%) cases. Conclusion: Surgical treatment with metatarsophalyngeal joint resection arthroplasty has very good result in patients with Freiberg’s disease that conservative treatments have failed.

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Abstract Background and Aim: Calculating per capita performance is a logical and reasonable basis for the diagnosis of staff’s competency and merits and for achieving organizational objectives. This study aimed at analyzing the costs and determining the per‌ capita performance of the personnel working in the hygiene sectors of Shahroud University of Medical Sciences. Materials and Methods: In this descriptive cross-sectional study, all the costs of the sectors affiliated with the Health Deputy of Shahroud University of Medical Sciences were extracted in 2009. The services and activities were standardized and the time required for the performance of each activity was determined through using service provider comments. The primary health cares were provided based on the methods recommended in the reviewing and program evaluation techniques. The data were collected through over 75‌ forms and were fed into Excel and the cost‌ analysis software. After analyzing the data, the results were displayed in frequency distribution tables and charts. Results: 44.4% of the participants were males. Useful work time per capita in health houses were 270 minutes per day, in rural health centers it was 214‌ minutes, in urban health centers it was 203 minutes, in urban boarding health centers it was 343 minutes, and in health posts, it was 168 minutes. The useful work time per capita for the whole city employees was 225 minutes per day. The available workforce received 459 Rials for each minute of required work and 854‌ Rials for each minute of useful work. Conclusion: Only half of the temporal capacity of rural health workers, health technicians, administrative staff, and the diagnostic and therapeutic personnel were efficiently used, while for the temporary capacity and delivery and labor facilities of health posts, this figure stood at less than one third. Professional enrichment, clarifying work processes and workforce adjustment can play an important role in increasing productivity.

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Aims: Effects of fasting on diabetic patients has been considered more in recent years. This study was done to investigate the changes in body weight, blood pressure and biochemical parameters in fasting people. Methods: In July and August (Ramadan) 2012, 75 diabetic patients from Kenareh village, Iran, were selected by census method and finally the results of 60 patients were enrolled. 15 days before Ramadan, triglyceride, fasting blood glucose, systolic and diastolic blood pressure in the sitting position, weight, height, body mass index and age of samples were calculated and recorded. At this stage, all samples in terms of the occurrence of any possible complications related to the fasting i.e. hypoglycemia, hyperglycemia and diabetic ketoacidosis were also examined. Correlation of each parameter was evaluated with age using Pearson correlation test and with gender using two-sample T-test. Results: During Ramadan, weight, systolic blood pressure, triglycerides, blood sugar and body mass index of samples were significantly decreased but diastolic blood pressure did not have significant decrease. After Ramadan, 4.9% of subjects suffered from hypoglycemia, 23.8% from hyperglycemia and 1.9% from diabetic ketoacidosis. Conclusion: Changes in serum biochemical parameters in patients with type II diabetes as a result of fasting, reduces diabetes risk factors i.e. serum glucose concentration, triglyceride, and BMI.

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Aims: Magnetic resonance venography based on susceptibility weighted imaging (SWI) utilizes deoxygenated hemoglobin in veins as an intrinsic contrast medium. Magnetic susceptibility difference between deoxygenated hemoglobin, oxygenated hemoglobin and parenchyma lead to an excellent venous contrast. The purpose of this study was to evaluate the different magnetic resonance imaging sequences and susceptibility weighted imaging in the visualization of sinus venous thrombosis.

 

Materials & Methods: This cross-sectional study was performed in Shafa Medical Imaging Center in Isfahan City, Iran, from August 2013 to September 2014 and 12 patients with sinus venous thrombosis were analyzed using MRI, SWI, and Phase contrast-magnetic resonance venography (PC-MRV). 

 

Findings: In all patients, sub-acute superior sagittal sinus, transverse and sigmoid sinuses thrombosis was most successfully detected during the susceptibility weighted imaging. In only one case, the sub-acute left transverse and sigmoid sinuses and left jugular vein of thrombosis was discernible with T1W. In 6 patients, sinus venous thrombosis was discernible with T2W in the sub-acute stage. PC-MRV showed the acute and sub-acute sinus venous thrombosis in all patients.

 

Conclusion: Susceptibility weighted imaging has a high diagnostic value for detecting sub-acute superior sagittal sinus, transverse and sigmoid sinuses thrombosis.

 

 

 

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Aims: Obsessive-Compulsive Disorder (OCD) is one of the severe psychological health problems imposing considerable social and economic costs on society. OCD debilitating symptoms can disrupt interpersonal relations, job performance, and life quality. The purpose of this study is to investigate the mediating role of alexithymia in the relationship between coping strategies and personality traits with OCD.
Methods & Materials: This is a descriptive correlational study. The study population consists of all people with OCD referred to psychiatric clinics in Kerman City, Iran, during 2018-2019. Of this population, 200 patients were selected using a convenience sampling method. Research instruments included the ways of coping questionnaire, NEO five-factor personality inventory, Toronto alexithymia scale, and Maudsley obsessive-compulsive test. The obtained data were analyzed using the Pearson correlation test and simultaneous and hierarchical regression in SPSS v. 23.
Findings: Personality traits had a negative significant correlation with alexithymia (r=0.523, P<0.000) and OCD (r=0.253, P<0.000). Alexithymia had a significant positive correlation with OCD (r=0.272, P<0.000). There was no correlation between problem-focused coping and alexithymia (r=-0.045, P<0.531). There was a positive correlation between emotion-focused coping and OCD (r=0.198, P<0.000). The fit indices indicated a good fit of the proposed model (P<0.005).
Conclusion: Alexithymia, as a mediator of the relationship between coping styles and personality traits with OCD, plays an essential role in improving the psychological health of people with OCD.

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Aims: Stress is one of the significant factors contributing to the onset, exacerbation, and recurrence of Multiple Sclerosis (MS) that imposes high costs on society and people. The present study aims to assess the role of spiritual intelligence, sense of coherence, and cognitive flexibility (internal resources) in predicting perceived stress in patients with MS.
Methods & Materials: In this descriptive/correlational study, 156 patients with MS were selected as samples using a convenience sampling method. The participants completed the Perceived Stress Scale (PSS), Spiritual Intelligence Self-Report Inventory (SISRI), Sense of Coherence Scale (SOC), and Cognitive Flexibility Inventory (CFI). The collected data were analyzed using descriptive and inferential statistics (stepwise regression analysis) in SPSS v. 24.
Findings: Transcendental awareness (a component of SISRI), meaningfulness (a component of SOC), and perception of controls and alternatives (components of CFI) predicted perceived stress in MS patients.
Conclusion: In stress management program, internal resources education can help reduce perceived stress in patients with MS.

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Aims Programmed cell death protein-1 (PD-1) is a membrane receptor expressed on the surface of T and B lymphocytes, monocytes, natural killers, and dendritic cells. In cancer, the PD-1/PD-L1 system prevents the proliferation of T lymphocytes and causes the release of cytokines and cytotoxicity, which leads to the apoptosis of tumor-specific T cells, thereby preventing the immune response to cancer cells. 
Methods & Materials In this study, the extracellular part of the humanized PD-1 protein was cloned and expressed, and the protein was injected as an antigen into a camel (Camelus dromedarius) to obtain a camel polyclonal antibody against PD-1 protein. 
Findings The obtained results indicate the proper expression of the protein in the prokaryotic system. Also, using various tests, such as ELISA and western blot, it was confirmed that the polyclonal antibody obtained from camel can identify PD-1 protein. 
Conclusion This study showed that because of the advantages, such as the ability to bind multiple epitopes, camel polyclonal antibodies can be used in antibody-based research for effective and strong molecular applications to detect PD-1 receptors.