Razi Journal of Medical Sciences

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  “Acoustic Neuronoma” is a benign neoplasm situated in a critical place, so that one can say its behaviour looks like malignant tissues. Three frequent clinical symptoms are associated with tumor with different sensitivity and priority, including vertigo and imbalance, tinnitus and hearing loss. Presence of one or all of these symptoms does not make the definite diagnosis and differntial diagnosis possible with clinical and audiologic examinations, rather one should use more sophisticated methods for judgement about the origins of symptoms.

  In this article a case of 8th cranial nerve lesion is reported that was detected by ABR and MRI confirmed the diagnosis of acoustic tumor. Also, two cases of cochlear hearing loss with clinical and audiological similarity and different ABRs with the persented case will be described.

  The comparison will show the role of ABR as a low cost and high sensitivity test in differential diagnosis of 8th cranial never, conchlear and other peripheral lesions.

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    Background: Glomus jugulare tumors are encapsulated, slowly growing, highly vascular and locally invasive tumors. These tumors arise from para-ganglionic cells and they are histologically benign. The purpose of this study is to evaluate Gamma Knife Radiosurgery (GKRS) on the local tumor control.

Methods: This study is an observational cross-sectional research in which thirty-four patients with histologically confirmed Glomus jugulare tumor underwent GKRS either as primary or an adjuvant therapeutic option. In 83% of patients, GKRS was the only treatment and the rest of the cases had previously undergone microsurgery. The tumor volume ranged from 1.7 to 2.3 cm³, and the Gamma Knife Radiosurgery was performed through 13 to 23 Grays and marginal dose of radiation with irradiation coverage of 35 to 70%. The median follow-up period after surgery was 24 months. The results were analyzed with SPSS V.11.5 and variants have been described as percentage or mean, median and standard deviation.

Results: In the all patients the tumor size decreased or remained unchanged. No patient had a tumor growth after the prescribed treatment dose and the major reported complication was the peri-tumoral brain edema.

Conclusion: The findings of this study showed that GKRS is an important option for Glomus jugulare tumors either as primary or adjuvant treatment. However, longer follow-up period is necessary to further clarify the long-term outcomes.

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Background: In couple and family therapy, brief solution-focused treatment is a branch of the post-modern approach focusing on solutions to solve the problems. The current research was performed by the aim of studying the effect of brief solution- focused group couple therapy on improving marital quality in women.

 

Methods: The method of the research is semi-experimental the design is pretest-posttest and follow-up with control group. The population included all the women visiting Hamyaran Salamat Ravan (mental health helpers) institute in Bojnourd city in 2013. 30 women were selected using available sampling method, and they were replaced in two groups of experiment and control by random assignment method. The study tool was the Golombok-Rust Inventory of Marital State (GRIMS) that was completed by the participants in pretest, posttest and follow-up (one month) stages. The experiment group received the intervention for 7 sessions of 1.5-hour, but the control group did not receive any intervention. Data were analyzed using descriptive statistics and single variable covariance analyze through SPSS v.18.

 

Results: Results of the covariance analysis indicated that brief solution-focused group couple therapy leads to improvement of marital relationships quality among the women in the experiment group, and these results have been also consistent enough in the follow-up period.

Conclusion: Results suggest that brief solution-focused group couple therapy can be used as a treatment of choice for improvement and enhancement of marital relationship quality

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Background & Aims: The history of the evolution of human societies indicates the important and civilizing role of science and technology in the formation of economic, social, cultural, and political relations. Along with the increasing speed and development of science and technology, economic, social, cultural, and political concepts and approaches have also changed and played a more colorful role in the development of economic, social, cultural, and political relations between the governments of the world. The expansion of the process of globalization and the entanglement of global relations has led to the formation of programs, policies, and actions of governments in various fields of science, economics, and culture in the global space and, therefore, the field of politics. International became an important variable in shaping the development of domestic and foreign infrastructures of countries. At present, many countries have used all their power and capacity to advance their foreign policy goals in various forms of diplomacy, so that scientific relations are of special importance in foreign policy and this, by the way, the subject of science and technology has become a topic of discussion in scientific and political circles and has led to the formation of a new type of diplomacy called "science and technology diplomacy". One of the important functions of diplomacy is science and technology in the economic field. Economically, it is argued that science and technology diplomacy can flourish the national economies of countries and save them from the abyss of destruction; Because in the first step, it increases the speed of scientific development, and in the second step, it creates a multitude of economic experiences and connections, and in the third step, it creates trade, industry, science and gross national income as one of the economic resources. One of the key indicators of a resilient economy is the Index of Economic Complexity. It is clear that these economies will be better able to withstand external shocks and will have a more resilient structure. A look at the global statistics shows that according to the ranking of the countries complexity index in 2016, among 127 countries in the world, Japan, Switzerland, South Korea, Germany, Singapore are ranked first to fifth, respectively. And Iran was ranked 87th. This is while in 2011 Iran was ranked 114th. According to the latest global ranking conducted in 2018, Iran's ranking has changed to 101, which shows that it has not reached the desired position in terms of economic complexity index. It must be acknowledged that the resilience of the national economy requires a move towards economic complexity and the production and export of complex goods. This will not be achieved unless the production of knowledge-based products is on the agenda and priority of the country's products. The production of knowledge-based goods requires the interaction of different sciences together and the use of specialists in different sciences and the use of new and advanced technologies. Achieving advanced science and technology requires having successful diplomacy to establish effective interactions and exchanges with countries with new science and technology. Of course, it should not be overlooked that in realizing such a process, teamwork and strengthening the spirit of collectivism are also important. Given the current state of the country's troubled economy and the severe research vacuum regarding the use of an appropriate model to achieve "national economy resilience", the researcher seeks to present a model of science and technology diplomacy based on economic complexity to pay. Therefore, the main question of the present study is: What is the model of science and technology diplomacy, based on economic complexity, with the approach of the resilience of the national economy?
Methods: The present study is a qualitative research that was conducted by data theory. In this method, the researcher's goal is to produce a conceptual model or framework, especially when there is insufficient information about the phenomenon under study. This approach is a general methodology for theory development based on data collection and analysis and is developed and discussed during the research process. In this method, in order to reach the theory and extract it from the collected data, the concepts and categories must be extracted by converting the expressions into code. The present study was conducted with the participation of 6 experts from the Scientific Policy Research Center of the country and 2 university professors in this field who were selected by purposive sampling method. After the emergence of the first classes, the choice of the next participant depended on how much he could help to enlighten the emerging classes. This sampling process continued until data saturation. In this study, after 12 interviews, data saturation was obtained and primary classes were formed. The interviews were conducted individually in a secluded room and in a quiet environment with the coordination of the interviewee. The main method of data collection in this study was semi-structured interview with open-ended question. All interviews were conducted by the lead researcher. The initial questions of the interview were such that participants were encouraged to talk freely about their experiences.
Results: In the present study, the recorded interviews were carefully transcribed and their data were entered into Atlas TIA software. Then, by examining the text of the interviews line by line, coding, conceptualization and categorization the extracted codes were classified into 64 concepts and 17 categories. The process model of science and technology diplomacy based on economic complexity with the approach of resilience and health of the national economy indicates that "the need for economic development" and "the need for scientific development" are the main reasons for science and technology diplomacy based on economic complexity with the approach of resilience. And the health of the national economy is in the context of "production boom", "good and healthy governance" and "infrastructure". Strategies for achieving this phenomenon include: "conservation of specialized human resources", "territorial planning of development capacities", "knowledge management", "intelligent modeling of leading societies", and "benefiting from social capital". "International opportunities and threats" and "internal strengths and weaknesses" are intervening factors in the action/reaction between phenomena and strategies that can affect the speed of achieving strategies. Strengthen or weaken. The consequences of the phenomenon of science and technology diplomacy based on economic complexity with the approach of resilience and health of the national economy can be defined in two parts: national and transnational consequences.
Conclusion: The aim of this study was to present a model of science and technology diplomacy, based on economic complexity and the approach of resilience and health of the national economy. Findings showed that the causal conditions of the studied phenomenon consist of two categories: the need for economic development and the need for scientific development. Necessity of economic development with regard to conditions such as the need to exit the negative trade balance, the need to get rid of the monopoly economy and efforts to increase the resilience of the national economy and the need for scientific development due to the need to improve the scientific and technological position of the country, competitive Produced products and efforts to increase the complexity of manufactured products were identified and exploited. In general, the results of this study showed that the causal conditions of the studied phenomenon consist of two categories: the need for economic development and the need for scientific development. Necessity of economic development with regard to conditions such as the need to exit the negative trade balance, the need to get rid of the monopoly economy and efforts to increase the resilience of the national economy and the need for scientific development due to the need to improve the scientific and technological position of the country, competitive Produced products and efforts to increase the complexity of manufactured products were identified and exploited.
 

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Background and Aims: Low back pain is usually associated with psychological, social, and biological-physical problems. As pain becomes more chronic, the role of psychological and social factors becomes more prominent than biological factors. Following the failure of medical treatments for pain, specialists turned to non-sensory aspects of pain, including psychological factors. Therefore, the use of psychological therapies became part of new therapeutic lines. The aim of this study was to compare the effectiveness of autogenic education and emotion regulation training on pain intensity in women with chronic low back pain.
Musculoskeletal disorders are one of the most common chronic health problems, which is the second leading cause of physical disability in the world that is responsible for a significant portion of health care costs and leads to detrimental effects on personal health, quality of life, job satisfaction and wasted work days. One of the most common and costly disorders, especially among women, is chronic low back pain, which is defined as an unpleasant sensory and psychological experience associated with possible or actual tissue damage. While medical interventions play an important role in reducing pain, their unpleasant side effects have limited the widespread use of drug therapies. On the other hand, some chronic pain problems are difficult to diagnose and their drug treatment has limited effectiveness. Daily life with pain can cause excessive fatigue and thus impair the quality of life of the sufferer, so psychological interventions to reduce the problems caused by chronic pain, expanded. These interventions have many effects in the field of chronic diseases and can help to relieve the pain of patients with chronic pain in addition to medication, as well as alleviate their psychological symptoms that have also been the cause of pain. The two interventions ART and AT regulate the emotions of individuals, reduce cramps and muscle tensions in patients, create a feeling of physical and mental relaxation, and reduce the symptoms of the disease modifying the mind-body relationship. AT is a psychophysiological model of psychotherapy in which the individual uses passive focus and certain combinations of mental and physical stimuli, relying on the establishment of a mind-body relationship to treat the patient's low back pain. ART has also emerged from the integration of techniques from different approaches in a comprehensive training program consisting of 7 skills, which shows the effectiveness of clinical research and relies on the mind-body relationship to affect pain. Therefore, the present study compares the effectiveness of autogenic training and affect regulation training on pain intensity in women with chronic low back pain.
Methods: The present research was semi-experimental study which used a pre-test, post-test and control group design (two experiment and one control groups). The statistical population of this study, included all women with chronic low back pain referring to the Moradi pain clinic in Tehran, in the year 2018. The sample of present study included 33 women with chronic low back pain who were selected by available sampling method and were assigned to two experiment and one control groups (11 persons per groups) by random assignment method. The inclusion criteria of the research included: female gender, being in the age range of 20-50 years, having higher education than a diploma, diagnosis of chronic low back pain by a pain specialist, achieving a score higher than 34.52 in McGill Pain Questionnaire and continuing medication according the physician. The exclusion criteria of the research included: pregnancy or menopause, being in the age range of under 20 or upper 50 years, lack of diploma education, having any organ defect, co-occurrence with other chronic physical diseases such as diabetes, cardiovascular disease, etc. and absence of more than 1 session of group sessions. The data gathering tool was McGill Pain Questionnaire. Both experimental groups attended the sessions once a week for 12 sessions of 90 minutes, the control group did not receive any intervention from therapist. The data was analyzed by univariate analysis of variance (ANOVA), and multivariate analysis of variance (MANOVA), in SPSSv24.
Results: The mean and standard deviation of age for AT group were 40.27±11.49, for ART group were 43.55±8.05, and for control group were 41.45±7.64. Also the mean and standard deviation of sufferance duration for AT group were 1.91±1.30, for ART group were 1.36±0.80, and for control group were 1.45±0.82. In the field of education in AT group, %18.2 had diploma, %72.7 had bachelor degree, %9.1 upper bachelor degree, in ART group, %27.3 diploma, %18.2 bachelor degree, %54.5 upper bachelor degree and in control group, %45.5 diploma, %0 bachelor degree and %54.5 were upper than bachelor degree. Totally, 33 subjects with a mean age of 41 years and 9 months and 4 days and a standard deviation of 9 years and 4 months and 2 days participated in this study. The age range of the subjects has been extended from 25-50 years and the mean of the chronic low back pain sufferance duration was 1.58 year with a standard deviation of 0.708 year; the range of sufferance duration has been extended less than 1-2 years. The mean scores of pain perception and its subscales in the post-test have decreased compared to the pre-test in AT group of 22.09 scores and in ART group of 16.09 scores but in control group these amounts have increased slightly. Also, using MANOVA, the volume effect of the difference between the mean scores of pain perception subscales in the three groups of AT, ART and control in the two measurements in pre-test results of Pillais test showed significant changes in the collective effect of pain perception scores subscales in pre-test and post-test concerning to the AT, ART and control groups (p<0.05) and the effect size of this differences was %44.9. The results of ANOVA test showed significant changes in all 4 subscales of pain perception in both pre-test and post-test according to the groups of AT, ART and control (p<0.05). The effect size of these differences for sensory perception of pain was equal to 71.6%, for emotional perception of pain was equal to 67.1%, for measuring the pain was 67.8% and for various pains was 65.6%. The data show autogenic training and affect regulation training were affective on decreasing patients' pain.
Conclusion: Considering the effectiveness of the trainings, it can be said that ART intervention through techniques of emotion, muscular and respiratory relaxation, awareness without judgment, acceptance and tolerance of affects and AT intervention through autogenic relaxation using heat, weight and respiration exercises, advanced relaxation and autogenic meditation, have controlled negative emotions and closed the gate of pain by teaching cognitive strategies and led to a pain reduction in patients with chronic low back pain. Therefore, according to findings of present research, it is recommended that all specialists in health fields, apply these therapeutic models to relieve chronic pains, muscular tensions and mind-body relaxation.

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Background & Aims: Physical activity and a moderate level of fitness is a focal point in health benefits associated with lifestyle. Regular physical activity in adults can promote good health, improve cognitive function, and prevent disease. Abundant research from the health and exercise science literature also presents empirical evidence of positive “non-health effects” induced by physical activity or sports participation. Among the non-health effects, physical activity improves life satisfaction, happiness, subjective well-being, mental health, and interpersonal relations. Emotion regulation is a vital component of everyday life and inappropriate emotion regulation has been associated with a variety of psychiatric disorders and aggression. Broadly speaking, emotion regulation refers to a diverse set of processes by which “individuals influence which emotions they have, when they have them, and how they experience and express these emotions”. Although there are many different approaches people can use to regulate their emotions, two well-studied strategies are expressive suppression and emotional reappraisal. These two processes appear to differ in their effect on emotional experience and the associated psychophysiological processes, such as heart rate, skin conductance responses and neural activity. Whereas reappraisal is often capable of lowering emotional experience, reducing or altering psychophysiological activity, and improving social functioning, expressive suppression seems much less effective in these respects and might even have negative social consequences. Nevertheless, regulatory effects of suppression on neural responses have been observed, albeit later in time than was observed for reappraisal and which may reflect increased effort to continue inhibition or cognitive control when people are asked to suppress negative emotions. The effectiveness of regulation has been tested in various circumstances including the ability to increase and decrease positive emotions, the associated physiology and neural responses as induced by film clips and expectations of reward. However, the majority of studies to date are restricted to measuring the ability to regulate negative feelings induced by either the viewing of negatively-valenced images or by the anticipation of negative events, such as electric shocks. Nevertheless, the effectiveness of emotion regulation strategies is dependent to some degree on the specific type of stimulus and the emotion to be regulated. Regulation of emotion and social relationships are important factors related to participatory activities for students; Therefore, the purpose of this study was the role of teaching science and knowledge through physical activity on improving social relationships and emotional regulation.
Methods: In this quasi-experimental study, the statistical population included all female second and third grade elementary school students in Zahedan in the academic year 2010-2011. Due to the quasi-experimental study, 30 people were selected by purposive sampling. They were randomly assigned to experimental (n = 15) and control (n = 15) groups. Barton (1990) Social Relations Questionnaire and Gross and John (2003) Emotional Regulation Questionnaire were used to collect data. The method of physical activity intervention was 12 sessions and each session for one hour for experimental groups. Data analysis was performed using dependent t-test and independent t-test.
Results: The results of intra-group study showed that in the experimental group the level of social relations and re-evaluation increased significantly (P = 0.002 and P = 0.002, respectively), but the level of repression decreased (P = 0.001). On the other hand, the intergroup study showed that training through physical activity led to improved social relationships, re-evaluation and repression in the experimental group compared to the control group (P = 0.002, P = 0.001, P = 0.003, respectively).
Conclusion: Social support, a potential correlate of leisure time physical activity (LTPA), can broadly be defined as resources provided by other persons. It is a multidimensional concept; emotional support provides love and caring, whereas practical support provides tangible assistance with a task or goal. Lack of social support has repeatedly been associated with higher morbidity and mortality. It is possible that part of this relationship is attributable to the association between social support and LTPA, mental health being a plausible intermediary factor. For example, social ties and integration in social networks play a role in the maintenance of psychological well-being, which in turn might motivate self-care in individuals, including regular physical exercise. High levels of social support are also assumed to increase self-esteem, self-efficacy and perceptions of control over the environment, all of which can potentially help an individual to adopt a proactive lifestyle and to resist unhealthy behaviours, such as sedentariness. Furthermore, indirect evidence is consistent with a causal chain linking low social support to an increased risk of psychiatric morbidity and psychiatric morbidity to lower physical activity. On the other hand, it can also be argued that people with fewer social ties have more time to exercise. The mechanisms explaining these associations remain unclear. A positive role identity and feelings of being useful provided by nurturing close social relationships can lead to greater motivation to take care of oneself and maintain a physically active lifestyle. High social support may also indicate positive involvement and active influence of a close person, which can encourage the individual to maintain health-promoting behaviours, such as regular exercise. In addition, it is possible that higher social support is associated with better access to resources and may help to buffer the impact of daily stressors and life events and thereby reduce the likelihood of unhealthy coping behaviours such as discontinuing LTPA. A growing literature examines the outcomes associated with sports participation by using large-scale surveys. The literature can be grouped into three strands. First, many authors have studied the impact of sports participation among other activities as one of the ways social capital can be generated. Second, other studies have focused on the role of sports on children, that is, how sports activities favor the development of prosocial skills and attitudes. Finally, several authors have recently focused on the effects of social identity and a sense of belonging induced by team sports. Looking at the effects of sports participation on skills development in children, Felfe, Lechner, and Steinmayr (2016) find that cognitive and noncognitive skills are both affected by sports participation. They also find that children participating in sports have fewer problems with peers, and this fosters better relationship. In general, the results showed that in smart schools, physical activity interventions should be used for learners to improve the level of psychological factors.
 

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Background & Aims: Nowadays, imaging of the blood supply of the heart muscle by single photon emission computed tomography (SPECT: Single Photon Emission Computed Tomography) due to its non-invasive nature and providing information with physiological value and low cost compared to the valuable angiography method. It is highly diagnostic. But these images undergo changes and artifacts under the influence of factors, the result of which is the reduction of the diagnostic accuracy of the images and false positive cases. During the detection process, several physical effects such as attenuation, scattering, and collimator response function affect the frequency of emitted photons; this leads to the destruction of the contrast and as a result of reducing the quantitative and qualitative accuracy of the images. Attenuation, as the most destructive factor of SPECT images, reduces the quality of SPECT images of heart blood supply and reduces the sensitivity of tests related to the diagnosis of coronary artery diseases, and for non-uniform environments, especially in nuclear imaging of chest areas. And the heart is necessary to produce a map of patient attenuation coefficients. The existence of scattered photons is also one of the main factors of error in quantization; the detection of scattered events affects the contrast of the lesions and causes the lack of image resolution and signal-to-noise ratio. Therefore, to correct the attenuation and scattering of the rays in the heart images quantitatively and qualitatively, patterns are needed in SPECT systems. Due to the importance of the topic, various research groups around the world have presented their research and results on correcting the effect of scattering of rays and also correcting the effect of weakening the rays. If there was no limitation of energy resolution, it was easily possible to identify the scattered rays and prevent them from being recorded in the image. Because we know that scattered rays lose energy. Because gamma rays are single energy and their energy amount is completely known. Therefore, each photon with less energy will represent scattered rays, but due to the limited energy resolution of the gamma camera, a range is usually considered on the sides of the main energy, which is called the energy window. It is assumed that the photons recorded in this energy range are primary photons, but in fact, many photons scattered in the body are also recorded in this window. These scattered rays do not carry correct spatial information and lead to a decrease in image resolution and contrast and quantization errors in the image. In nuclear medicine, instead of researching and examining the patient or processing the image of the patient, simulated images can be examined. Simulators can provide information about each of the image destruction factors. The purpose of this research is to propose a new method for scattering correction, in this research, a combination of Monte Carlo and modeling is used for the rapid production of scattered views, and in the proposed method, the two-matrix method is used, this method At the stage of generating mathematical views, dispersion is added and this problem leads to the removal of scattered rays. As a result, an image is reconstructed that is free from the effects of attenuation and non-ideal dispersion and leads to an increase in contrast and improvement of power. Detecting waste, increasing the signal-to-noise ratio, and increasing the accuracy of quantification.
Methods: In this study, the effect of applying attenuation and dispersion correction using two energy windows (DEW) and three energy windows (TEW) methods in cardiac aspect imaging was investigated and evaluated, and to simulate cardiac aspect imaging, a special code similar to SAR Monte Carlo GATE was used as the SPECT imaging system and XCAT digital phantom with activity distribution and realistic attenuation map was used to model the human trunk.
Results: Comparison of image contrast improvement in different modes of attenuation and dispersion correction shows that the highest image contrast is obtained from the (TEW1+AC) method with an average increase of 25% and MSE in different modes of attenuation correction. And the dispersion compared to the reference image was reduced from 51.5% to 54.5%. Compared to the reference image, MSE decreased from 1.4 in Un_Cor to 1.15, 1.13, 1.12, and 1.14 in AC+TEW1, AC+DEW, AC, and AC+TEW2, respectively, and the signal-to-noise ratio (SNR) increased up to 71% in all methods of applying dispersion correction along with attenuation correction compared to applying attenuation correction (AC).
Conclusion: In this study, the effect of attenuation and dispersion correction in 5 non-correction modes, with attenuation correction, attenuation, and dispersion correction using two-window and three-window methods with triangular approximation and three-window with trapezoidal approximation on We evaluated XCAT phantom simulated images and heart muscle perfusion images by SPECT method and 4 different parameters were used to compare and evaluate the images, including profile, contrast, mean squared error (MSE) and signal to noise. According to the results of the quantification of reconstructed images, it is possible to apply dispersion correction along with attenuation correction.

 

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