---

The brachial plexus is the plexus of nerves that supply the upper limb. Anomalies in the formation of lateral cord of brachial plexus and communication between its branches are commonly observed but the variation of the course of lateral cord is very rare. We observed that lateral cord of brachial plexus and its branch had a different configuration in dissecting room in Bandar Abbas medical school. Here, the lateral cord pierced the coracobrachialis muscle and then divided into the musculocutaneus and the lateral root of median nerve. After a distance , the lateral root of median nerve joined the medial root of median nerve, and median nerve formed anterior to brachial artery. The rest of the course of the median nerve and the musculocutaneous was normal in arm region.

---

Background and Objective: The human anthropometric characteristics are surveyed in anthropology. Anthropology is used in archeology, physiotherapy, rehabilitation and legal medicine. This study was carried out to evaluate the anthropometric characteristics of upper limb in Iranian and Pakistani subjects. Method: This descriptive - analytic study was performed on 300 resident’s adult subjects (180 males and 120 females) in Qazvin, Iran and 356 residents (181 males and 175 females) in Dera Ghazi Khan, Pakistan. Anthropometric characteristics of upper limb were measured in an anatomical position. Results: The mean±SD of arm length was 36.8±2.37 CM and 28.1±2.44 CM, in Pakistani and Iranian males, respectively, this difference was significant (P<0.05). The Mean of forearm length, hand length and hand width in Iranian men and women were non-significantly more than Pakistani subjects. Conclusion: Anthropometric characteristics of upper limb of Iranian are higher than Pakistani subjects, but this difference only in arm length of men was significant.

---

Background and Objective: The growing evidence suggest on the association between dietary patterns and obesity. This study was done to determine the relation between pattern of nutrient intake and obesity in Isfahanian adults.

Methods: In this descriptive - analytical study, dietary data were collected using a semi-quantitative food frequency questionnaire in 8,691 subjects aged 18-55 years. Complete data of 6,724 and 5,203 adults were available for general and abdominal obesity, respectively. Daily intakes of 38 nutrients and bioactive compounds were calculated for each participant. Factor analysis was applied to derive major nutrient patterns.

Results: Three major nutrient patterns were identified: 1) pattern high in fatty acids, cholesterol, vitamin B12, vitamin E, zinc, choline, protein, pyridoxine, phosphorus, and pantothenic acid; 2) high in thiamine, betaine, starch, folate, iron, selenium, niacin, calcium, and manganese; and 3) high in glucose, fructose, sucrose, vitamin C, potassium, dietary fiber, copper and vitamin K. Men in the highest quintile of the second pattern were less likely to be generally obese in the fully adjusted model (95% CI: 0.20-0.76, OR: 0.39, P<0.05). After adjustment for potential confounders, a significant positive association was observed between the third pattern and general obesity among men (95% CI: 1.04-3.04, OR: 1.77, P<0.05), but it was not in women (95% CI: 0.74-1.88, OR: 1.18, P>0.05).

Conclusion: Nutrient patterns were significantly associated with general, but not abdominal obesity in the male Iranians participating in SEPAHAN study.

---

Background and Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiologic data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms and gastro-esophageal reflux disease (GERD) in a large group of Iranian adults.

Methods: This descriptive -analytic study was conducted on 3363 Iranian adults (19-70 yr), whom were working in 50 health centers across Isfahan province in Iran during 2012. We used easy non-random sampling to select participants. The “healthy lifestyle score” for each participant was calculated by summing up the binary score given for five lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. A validated Persian version of ROME III questionnaire was used, to assess functional gastrointestinal disorders.

Results: The prevalence of FD and GERD among study participants was 14.5 and 23.6%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (95% CI: 0.05-0.92, OR: 0.21, P=0.03) and GERD (95% CI: 0.09-0.69, OR: 0.26, P=0.01), respectively, compared with those with the lowest score. They were also less likely to have early satiation (95% CI: 0.11-0.73, OR: 0.28, P=0.001), postprandial fullness (95% CI: 0.09-0.50, OR: 0.22, P<0.001) and epigastric pain (95% CI: 0.21-0.92, OR: 0.44, P=0.03). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits and non-smoking were separately associated with FGIDs (P<0.05).

Conclusion: This study showed that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults. Individual lifestyle-related factors were also associated with these conditions.

---

Background and Objective: Irrational beliefs underlie a wide range of cognitive impairments. This study was performed to compare the effect of cognitive-behavioral therapy and acceptance and commitment therapy on irrational beliefs of medical students.
Methods: In this quasi-experimental study, 45 medical students of Golestan University of Medical Sciences in north of Iran were non-randomly divided into control, cognitive-behavioral therapy (first intervention) and acceptance, commitment therapy (second intervention) groups. All three groups completed the pre-test, but the control group did not receive any therapy. The intervention groups were received 8 sessions of therapy. The data were collected through Jones's 1969 (IBQ-40) irrational beliefs questionnaire.
Results: The total score of irrational beliefs in the both intervention groups were reduced in comparison with control group (P<0.05). The mean score of the problem-based avoidance subscale (35.26±6.32) was significantly reduced in the second intervention group compared to the first intervention group (30.53±9.47) (P<0.05). Also, the mean scores of emotional impulsivity in the first intervention group (22.73±9.49) were significantly increased compared to the second intervention group (29.93±1.75) (P<0.05).
Conclusion: Two methods of cognitive-behavioral therapy and acceptance and commitment therapy reduce the irrational beliefs of medical students.

---

Background and Objective: Neuropathic pain is a large and difficult group of peripheral nerve diseases, which are complicated to treat. This study was designed to determine the effectiveness of acceptance and commitment therapy (ACT) on psychological well-being and pain perception among patients with chronic neuropathic pain.
Methods: This clinical trial was performed on 30 patients with chronic neuropathic pain who were referred to the Rohani Hospital and private clinic of a neurologist in Babol (Iran) in 2022. The patients were randomly divided into an interventional and a control group. The patients completed the psychological well-being scale (Ryff) and pain belief and perception inventory (Williams and Thorn) in the pretest. Then, ACT (120 minutes) was performed for the interventional group, 8 sessions a week. The patients completed the scales after the treatment course and 2 months after the posttest.
Results: In the first follow-up, there were significant differences between the two groups in terms of total score of psychological well-being (P<0.05), the subscales of self-acceptance (P<0.05), positive relationships with others (P<0.05), autonomy (P<0.05), environmental mastery (P<0.05), purpose in life (P<0.05), personal growth (P<0.05), the total score of pain perception (P<0.05), the subscales of belief in the stability of pain in the present (P<0.05) and belief in the mysteriousness of pain (P<0.05). The treatment results were maintained in the second follow-up phase. In the first follow-up, the subscales of belief in the continuation of pain in the future and belief in self-blame did not differ significantly between the two groups, but in the second follow-up, the subscales of belief in the continuation of pain in the future (P<0.05) and belief in self–blame (P<0.05) differed significantly between the two groups. In addition, the average psychological well-being in the intervention group was higher than that in the control group, and the average pain perception in the intervention group was lower than that in the control group.
Conclusion: This study shows the ACT could be an effective intervention for improving psychological well-being and pain perception among patients with chronic neuropathic pain.
 

---

Background and Objective: Intermittent exotropia is the most common form of exotropia in children. Non-surgical treatments include refractive error correction, occasional patching of the normal eye in young children, prism therapy, and orthoptic exercises. This study aimed to compare the effects of wearing overminus spectacles versus patch therapy in 3- to 8-year-old children with intermittent exotropia.
Methods: This clinical trial was conducted on 30 children (9 boys and 21 girls) with intermittent exotropia aged 3 to 8 years with no previous treatment history referring to the strabismus clinic of Khatam-al-Anbia Hospital in Mashhad. Patients were randomly assigned to two groups: Patch therapy (n=20) and overminus (n=10). In the patch therapy group, the patient’s healthy eye was patched for 2 to 4 hours a day for 6 months. Overminus spectacles were selected based on cycloplegic refraction between 2 and 4 diopters. Astigmatism was fully prescribed. Patient follow-up time was 3 months and then 6 months. Finally, data, including the size of the deviation and the degree of deviation control, were collected and analyzed.
Results: The median spherical error of patients before intervention in the overminus group was +1 diopter in the right eye and +0.75 diopter in the left eye, and in the patch therapy group, +0.75 diopter in both the right and left eyes. Six months after the intervention, the median spherical error in the overminus group was +0.62 diopters in both the right and left eyes, and in the patch therapy group, +0.75 diopters and +0.62 diopters in the right and left eyes, respectively. No significant statistical difference was found between the study groups. The median deviation size of patients in the overminus group before intervention was +25 prism in distance vision and +25 prism in near vision, and 6 months after intervention, it was +22.5 prism in distance vision and +20 prism in near vision. Also, the median deviation size of patients in the patch therapy group before intervention was +25 prism in distance vision and +25 prism in near vision, and 6 months after intervention, it was +25 prism in distance vision and +25 prism in near vision. No significant statistical difference was found between the study groups. The median deviation control based on the Newcastle Scale Score (NSS) of patients before intervention was 3.5 in the overminus group and 4 in the patch therapy group, which was 1.5 in the overminus group and 3 in the patch therapy group 6 months after the intervention. Although there was a greater improvement in control based on the NSS in the overminus group compared to the patch therapy group.
Conclusion: Both overminus and patch therapy are effective in treating patients with intermittent exotropia. In patients using the overminus method, deviation control is higher compared to the patch therapy method.