Correlation between Radiologic Sign of Lumbar Lordosis and Functional Status in Patients with Chronic Mechanical Low Back Pain

Alireza Ashraf,Siamak Farahangiz,Bita Pakniat Jahromi,Nazanin Setayeshpour,Mahshid Naseri,Ali Nasseri 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.5

Study Design: A cross-sectional study. Purpose: To describe the correlation between lumbar lordosis angle and functional status of patients with chronic mechanical low back pain (CMLBP). Overview of Literature: There are different and conflicting opinions regarding the relationship between the degree of lumbar lordosis and functional status of patients with low back pain. Nonetheless, the severity of lordosis is still one of the routine physical exams considered in rehabilitation clinics. Methods: The degree of lumbar lordosis of 150 patients with CMLBP was measured by means of Cobb’s method using sagittal standing spinal radiographs. Subjects with probable secondary causes of low back pain (trauma, congenital anomaly, spinal infection, rheumatologic problems and history of spinal surgery) were excluded. Besides recording demographic data, their score of functional disability was estimated using Oswestry Disability Questionnaire, one of the most useful and reliable questionnaires. Comparison between these data was made regarding different age and gender groups. Results: In this study, 119 subjects were female and 31 male, with an age range of 19–85 years. The average degree of lumbar lordosis was 44.69±11.43 and that of Oswestry disability index (ODI) 30.52%. Although we found a significant direct relationship between age and degree of lumbar lordosis (Pearson’s correlation coefficient, p =0.016, r =0.197), while insignificant correlation was seen between the degree of lumbar lordosis and ODI (p =0.129). Conclusions: There was no significant correlation between the degree of lumbar lordosis and the score of functional disability with regards to different age groups and gender.

The Efficacy of Intramuscular Calcitonin Injection in the Management of Lumbar Spinal Stenosis

Alireza Ashraf,Mehdi Khodadadi,Amin Sadraei,Mahshid Naseri,Ali Nasseri 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1

Study Design: A prospective, cross-sectional, non-randomized study. Purpose: To assess the effectiveness of intramuscular calcitonin injection in the treatment of lumbar spinal stenosis (LSS). Overview of Literature: LSS, manifesting as chronic low back pain and neurogenic claudication, is a chronic condition with an increasing incidence in the elderly population having inadequate effective conservative treatment options. Methods: In this study, 36 patients with LSS who were diagnosed based on the clinical findings and magnetic resonance imaging were included. Patients received 100 IU of calcitonin per week for one month and were evaluated before and after treatment using the Oswestry disability index (ODI) questionnaire and visual analogue scale (VAS). Before treatment, the patients were divided into two subgroups based on their ODI results: patients with mild to moderate low back pain (disability, 0%–40%) and patients with severe or very severe low back pain (disability, 40%–100%). Results: In patients with mild to moderate low back pain, there were no significant changes in the ODI and VAS after calcitonin injection. But in patients with severe or very severe low back pain, pain severity, personal functions, ability to lift and carry objects, time interval between standing and initiation of pain, social life, disability percentage, and VAS were significantly improved after treatment with calcitonin. Conclusions: It seems that an intramuscular injection of low dose of calcitonin may have some beneficial effects on the pain due to LSS, especially in patients who suffer from severe or very severe low back pain.

Efficacy of Acupuncture versus Local Methylprednisolone Acetate Injection in De Quervain's Tenosynovitis: A Randomized Controlled Trial

Maryamsadat Fakheri,Alireza Ashraf,Maryamsadat Fakheri,Aref Nasiri 사단법인약침학회 2014 Journal of Acupuncture & Meridian Studies Vol.7 No.3

There is no consensus on the management of De Quervain’s tenosynovitis, but local corti- costeroid injection is considered the mainstay of treatment. However, some patients are reluctant to take steroid injections. This study was performed to compare the efficacy of acupuncture versus corticosteroid injection for the treatment of this disease. Thirty pa- tients were consequently treated in two groups. The acupuncture group received five acupuncture sessions of 30 minutes duration on classic points of LI-5, LU-7, and LU-9 and on ahshi points. The injection group received one methylprednisolone acetate injec- tion in the first dorsal compartment of the wrist. The degree of disability and pain was evaluated by using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) scale and the Visual Analogue Scale (VAS) at baseline and at 2 weeks and 6 weeks after the start of treatment. The baseline means of the Q-DASH and the VAS scores were 62.8 and 6.9, respectively. At the last follow-up, the mean Q-DASH scores were 9.8 versus 6.2 in the acupuncture and injection groups, respectively, and the mean VAS scores were 2 versus 1.2. We demonstrated short-term improvement of pain and function in both groups. Although the success rate was somewhat higher with corticosteroid injection, acupuncture can be considered as an alternative option for treatment of De Quervain’s tenosynovitis.

A Novel Cell Disruption Approach: Effectiveness of Laser-induced Cell Lysis of Pichia pastoris in the Continuous System

Maryam Gazor,Seyed Siamak Ashraf Talesh,Alireza kavianpour,Maryam Khatami,Amin Javidanbardan,Seyed Nezamedin Hosseini 한국생물공학회 2018 Biotechnology and Bioprocess Engineering Vol.23 No.1

In biotechnological processes, often cell disruption has been an inevitable step as current host cells express most of the desired products intracellularly. Thus, an appropriate cell disruption technique must be selected considering different factors including the target product, process scale, and cell wall structure. In the current study, as a novel method, the efficacy of cell disruption via laser was tested qualitatively and quantitatively in batch and continuous systems, respectively. Laser-induced cell lysis can be a clean, rapid and convenient alternative to the other conventional disruption techniques. Our investigations in the continuous system with a flow rate of 800 μL/sec proved efficient (~ 90%) Pichia pastoris cell disruption at the wavenumber 1,064 nm with the energy input of 284 mW after four complete rounds of circulation. The main mechanism of cell disruption is assumed to be thermolysis via instant heat increase in the laser-treated spot. The results of the current study showed that continuous laser system could be applied in laboratory and industry scale for cell disruption.

Sympathetic Skin Response in Patients with Vascular Erectile Dysfunction

Mostafa Jazayeri,Behrooz Kazemi,Alireza Aminsharifi,Alireza Ashraf,Mahshid Naseri,Ali Nasseri,Amirhooshang Vahedi 대한남성과학회 2014 The World Journal of Men's Health Vol.32 No.1

Purpose: We aimed to investigate the utility of sympathetic skin response (SSR) test for evaluating vasculogenic erectile dysfunction (ED) which is the most common type of impotence. Materials and Methods: Men in the age group of 28 to 60 years and suffering from vasculogenic ED, as confirmed by a papaverin test and color Doppler sonography, at least for 6 months referred from our university urology department were included. We used the International Index of Erectile Function (IIEF-5) for grading severity of dysfunction and recorded the SSR of every patient from the median, tibial, and dorsal nerves of the penis. One-way analysis of variance (ANOVA), independent t-test and Pearson’s correlation coefficient were used for comparing quantitative variables, and Fisher's Exact test was used for comparing qualitative variables. The Mann-Whitney U Test and the Kruskal-Wallis test were performed for analysis of data that were not normally distributed. A p value of less than 0.05 was considered significant. Results: Forty-two patients were recruited for the study. We found a strong statistical relationship between the IIEF score and the pathologic SSR registered from every mentioned nerve. Patients with abnormal SSR had more severe ED according to IIEF score (p<0.001). In addition, the IIEF score had a significantcorrelation with diabetes mellitus and cardiovascular disease (t-test; p<0.05). Conclusions: Our results confirmed the presence of autonomic dysfunction in patients with vasculogenic impotence via an SSR test. We suggest evaluating the efficacy of the SSR test in patients with vascular impotence for treatment response monitoring in future studies.

Effect of Motor Imagery on the F-Wave Parameters in Hemiparetic Stroke Survivors

Mahshid Naseri,Peyman Petramfar,Alireza Ashraf 대한재활의학회 2015 Annals of Rehabilitation Medicine Vol.39 No.3

Objective To assess the effect of motor imagery, as a rehabilitation method in stroke, on F-wave parameters that undergo changes during upper motor neuron involvement. Methods Twenty-one fully conscious hemiparetic stroke survivors with a completely plegic hand (power 0/5) and a minimum interval of 72 hours since stroke were recruited into this study. The mean F-wave latency, amplitude, and persistence in the median and ulnar nerves were measured in both the affected and non-affected sides at rest and in the paretic hand during a mental task. Comparison was made between data from the affected hand and the non-affected hand as well as between data from the affected hand at baseline and during motor imagery. Results Patients had significantly different F-wave persistence between the affected and non-affected sides (paired t-test, p<0.001). Motor imagery could improve F-wave persistence in both the investigated nerves (paired t-test, p=0.01 for ulnar nerve and p<0.001 for median nerve) and F-response amplitude in the median nerve (paired t-test, p=0.01) of the affected limb. Conclusion The amplitude and persistence of F-wave were improved during motor imagery, representing F-wave facilitation. This result suggests that motor imagery can restore motor neuron excitability, which is depressed after stroke.

The anatomical variations of median nerve in Shiraz, Iran

Zia Moasses,Arefeh Aryan,Ashraf Hassanpour-Dehnavi,Mohammad Zarenezhad,Alireza Dorodchi 대한해부학회 2024 Anatomy & Cell Biology Vol.57 No.1

The origin and distribution of median nerve varies among the different individuals. The median nerve variations in axillary region were reported by many authors previously. Understanding of these variations is especially necessary for clinicians to prevent iatrogenic nerve damage. The current work aimed to evaluate the possible anatomical variations of median nerve in the axillary region in a sample of the Iranian cadavers (Shiraz, Fars). We dissected 26 upper limbs from 13 male cadavers to investigate the different variations of median and musculocutaneous nerves according to Venieratos and Anagnostopoulou classification. In 23.07% of specimens (n=6), the medial root united with 2 lateral roots and formed the median nerve proximal to the coracobrachialis muscle. In one case, a communicating branch separated from the musculocutaneous nerve distal to the coracobrachialis and connected to the median nerve in upper arm. Our results suggest that there are anatomical variations of the median nerve in terms of its origin and its communication with the musculocutaneous nerve in the population of southern Iran. The anatomical knowledge of the median nerve variations is important for clinicians to improve patient health outcome. Theses variations of the median nerve should be considered during surgical procedures of the axillary region and nerve block of the infra clavicular part of the brachial plexus.

Anesthetic efficacy of supplemental buccal infiltration versus intraligamentary injection in mandibular first and second molars with irreversible pulpitis: a prospective randomized clinical trial

Nazanin Zargar,Shiva Shojaeian,Mohammadreza Vatankhah,Shirin Heidaryan,Hengameh Ashraf,Alireza Akbarzadeh Baghban,Omid Dianat 대한치과마취과학회 2022 Journal of Dental Anesthesia and Pain Medicine Vol.22 No.5

Background: To compare the anesthetic efficacy of supplemental buccal infiltration (BI) (1.7 ml) versus intraligamentary (IL) injection containing 0.4 ml of 4% articaine with 1:100.000 epinephrine after an inferior alveolar nerve block (IANB) with 1.7 ml 2% lidocaine in the first and second mandibular molars diagnosed with irreversible pulpitis (IP). Methods: One hundred subjects diagnosed with IP of either the mandibular first (n = 50) or second molars (n = 50) and failed profound anesthesia following an IANB were selected. They randomly received either the IL or BI techniques of anesthesia. Pain scores on a 170 mm Heft-Parker visual analog scale were recorded initially, before, and during supplemental injections. Furthermore, pulse rate was measured before and after each supplemental injection. During the access cavity preparation and initial filing, no or mild pain was assumed to indicate anesthetic success. The chi-square test, Mann-Whitney U test, and independent samples t-test were used for the analyses. Results: The overall success rates were 80% in the IL group and 74% in the BI group, with no significant difference (P = 0.63). In the first molars, there was no significant difference between the two techniques (P = 0.088). In the second molars, IL injection resulted in a significantly higher success rate (P = 0.017) than BI. IL injection was statistically more successful (P = 0.034) in the second molars (92%) than in the first molars (68%). However, BI was significantly more successful (P = 0.047) in the first molars (88%) than in the second molars (64%). The mean pulse rate increase was significantly higher in the IL group than in the BI group (P < 0.001). Conclusions: Both the IL and BI techniques were advantageous when used as supplemental injections. However, more favorable outcomes were observed when the second molars received IL injection and the first molars received BI.

Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome

( Azam Mohammadi ),( Mahshid Naseri ),( Hamid Namazi ),( Mohammad Javad Ashraf ),( Alireza Ashraf ) 대한폐경학회 2016 대한폐경학회지 Vol.22 No.2

Objectives: To investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score. Methods: Biopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients’ function. Results: ER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score. Conclusions: Sex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes. (J Menopausal Med 2016;22:80-86)