Introduction: One of the common undesirable postural abnormalities that poor mobility has brought to humans due to the significant growth of technology and widespread use of tools and communication devices is the excessive increase of the back arch (hyperkyphosis) and forward head deformity. Therefore, the aim of this research is to review the effects of rehabilitation exercises on people with kyphosis and forward head posture. Methods: The current study was a systematic review, searching for articles in Persian and Latin from the beginning of December 2005 to the beginning of April 2023, using the Wos, SID, Magiran, Scopus, ISC, PubMed and Google Scholar databases. Results: A number of seven articles in the field of rehabilitation exercises reported that corrective exercises improve forward head and kyphosis, as well as posture. One article indicated that the use of braces reduced trapezius muscle electrical activity in patients with kyphosis, which may delay fatigue onset. Conclusions: : The current review study showed that exercise protocols improve kyphosis and forward head complications, as well as improve pain and maintain proper posture in affected individuals.
Introduction: Thyroid nodules are highly prevalent. The role of insulin resistance in thyroid nodule formation has recently gained attention. While several studies have explored the relationship between metformin and insulin resistance, limited research has assessed the effect of metformin therapy on thyroid nodule volume and number. This study investigated the effect of metformin on the size and number of thyroid nodules. Methods: A total of 240 euthyroid women with thyroid nodules were divided into four groups. Group 1 received levothyroxine 100 μg/day, Group 2 received metformin 500 mg twice daily, Group 3 received a combination of both drugs for three months, and Group 4 served as the control group with no treatment. Thyroid ultrasound was performed at baseline and after three months. Statistical analyses included the Kruskall–Wallis, Wilcoxon, and Chi-square tests, examined the differences of the size of thyroid nodules and the mean of thyroid hormones levels between groups, for Each group included 60 people and to compare the percentage of differences between the groups, respectively. Also P value less than 0.05 was considered meaningful. Results: Results showed no statistically significant differences in thyroid hormone levels after treatment among the three groups except the levothyroxine group. Additionally, only the levothyroxine group showed a significant post-treatment decrease in TSH and increase in T4. Thyroid nodule size significantly decreased in the levothyroxine group and the levothyroxine-metformin combination group compared to the metformin-alone and control groups. Conclusions: This study indicates that metformin does not reduce the size of thyroid nodules, contradicting studies suggesting its potential antineoplastic effects on the thyroid. However, the study duration may be insufficient for definitive conclusions, necessitating further high-quality studies with larger sample sizes and longer follow-up periods.
Introduction: Hallux valgus is a common foot deformity causing lateral deviation of the first toe and progressive subluxation of the first metatarsophalangeal joint. The purpose of this study was to investigate the effect of kinesiotype and ankle strengthening exercises with a bosu ball on pain, balance and big toe angle in women with hallux valgus. Methods: This clinical trial study used a pre-test and post-test design. First, forty-five women with hallux valgus and flat feet were selected via convenience sampling and randomly assigned to three groups: a kinesiotape group (four weeks, three sessions/week, 24-hour tape application per session), a kinesiotape with Bosu ball ankle strengthening exercises (four weeks, three sessions/week, 30 minutes of exercises and 24-hour tape application per session), and a control group (no intervention). Pain, balance, and hallux valgus angle were measured using the Visual Analogue Scale (VAS), stork test, and goniometer, respectively. Data were analyzed using one-way ANOVA at a significance level (P ≥ 0.05). Results: After performing the exercises, comparing the data between the two groups before and after 4 weeks revealed a significant difference in pain, balance, and hallux valgus angle in the two groups of kinesiotape and kinesiotape along with the strengthening exercises of Boussou bathop compared to The control group showed (P = 0.001). Conclusions: A combined program of kinesiotape and Bosu ball ankle strengthening exercises may improve pain, balance, and hallux valgus alignment in women.
Introduction: Multiple sclerosis (MS) is the most common neurological disorder in young adults and balance problems due to MS may result in disturbances in upright posture, limitations in walking and turning, and ultimately falls in patients. The aim of this study was to investigate the effects of a combined physical exercises and cognitive-behavioral stress management intervention program on static, dynamic balance and balance confidence in PwMS. Methods: The statistical population included MS patients (aged 20–60 years with Expanded Disability Status Scale [EDSS] scores of 2–4) referred to the Arak MS Association. Thirty participants were selected via convenience sampling and randomly assigned to experimental and control groups. Participants underwent pretests using the Timed Up and Go (TUG) test, single-leg stance test, and the Activities-Specific Balance Confidence (ABC) Scale. Then, they participated in the combined motor and cognitive intervention program, and finally performed a post – test. Data were analyzed by Independent and Paired Student T-tests. Results: According to the results, the mean score of the experimental group in the TUG test (P ≤ 0.002), and standing on one-foot tests increased significantly in the post-test (P ≤ 0.001). There were no significant differences in mean ABC scores between the experimental and control groups on the post-test (P ≤ 0.153). Conclusions: The findings suggest that a combined motor and cognitive intervention program can effectively improve agility, dynamic and static balance in people with MS. Improving balance confidence may require a longer duration of training due to its subjective nature.
Introduction: Good governance, as one of the fundamental concepts in healthcare system management, plays a key role in enhancing the efficiency, effectiveness, and equity of healthcare services. This concept, Emphasizing principles such as transparency, accountability, participation, and legality, has been considered as a framework for improving policymaking and management in Iran's healthcare system. This study conducted in 2024 aimed to design and present a model of good governance in the healthcare system using a mixed approach of thematic analysis and Partial Least Squares (PLS) method. Methods: The research method included both qualitative and quantitative components. The qualitative phase, involved managers, health policy experts, specialists from the Ministry of Health and Medical Education, and academic scholars. Sampling was done using purposive and snowball sampling methods, with 17 participants selected until theoretical saturation was reached. In the quantitative phase, the Partial Least Squares (PLS) method was used for model fitting. The statistical population for this section included all experts and managers in Iran's healthcare sector, with a minimum sample size of 384 determined based on Cochran's formula. Results: The results of thematic analysis of the qualitative data and model fitting showed that the final good governance model in the healthcare system consists of seven main dimensions: effectiveness, efficiency, equity, transparency and accountability, participation, legality, and leadership. Each dimension comprised specific components, and the importance of each was confirmed in strengthening good governance. Conclusions: This study presents a comprehensive good governance model for the healthcare system, offering a framework for improving policymaking, management, and performance in this sector. The proposed model can be used as a strategic decision-making tool and improving management structures.
