Background: It has been suggested that weakness and asymmetry of core stabilizing muscles have an important role in the development of scoliosis and its complications, especially low back pain. However there is insufficient data comparing symmetry and function of these muscles in scoliotic patients with the normal population. Also there are only a few studies assessing the relationship between the degree of spinal deviation and asymmetry of core stabilizing muscles. This study evaluates the thickness, symmetry, and activation of the external oblique (EO), the internal oblique (IO) and the transversus abdominis (TrA) muscles of patients with AIS and compares these data with a group of normal adolescents. Objectives: The objective of this observational study was to know the asymmetry pattern of lateral abdominal muscles at rest and during the abdominal drawing-in maneuver (ADiM) in adolescents with idiopathic scoliosis and to compare it with a group of healthy adolescents. Methods: Twenty healthy adolescents and twenty patients with AIS, aged 10 to 18 years, were included. The thickness of lateral abdominal muscles was measured, using ultrasound, at the end of normal exhalation at rest and during the abdominal drawing-in maneuver (ADiM). Muscular activity was represented as absolute difference and percentage change in the muscle thickness during the ADiM compared with rest. Results: There was no side to side asymmetry in muscle thickness at rest and also during ADiM in two groups. Thickness of right EO [0.39 (0.09) in the AIS group compared to 0.51 (0.12) in the normal group] and left EO [0.38(0.10) in the AIS group compared to 0.50 (0.11) in the normal group] at rest was higher in the normal group (P < 0.05). The activity of right and left EO was higher in AIS group (P < 0.05). There was a positive correlation between the lumbar Cobb's angle with the right and the right-to-left difference of TrA thickness during the ADiM (P < 0.05). In other words, the more the lumbar Cobb's angle to the right, the thicker the right TrA relative to the left TrA during the ADiM. Conclusions: The EO muscle was thinner and had higher activity during ADiM in the AIS group. Analysis of our data showed that in the AIS group the higher the lumbar spinal curve to the right, the thicker the right TrA compared to the left TrA.

Endocarditis is a rare focal complication of brucellosis but the most common cause of mortality. The diagnosis of the complications of endemic diseases is therefore important. We evaluated Brucella endocarditis cases in a teaching hospital in Iran between April 1998 and March 2006. Nine patients with a median age of 38.11 years were recorded, of whom seven (77.7%) were male. Underlying cardiopathy was present in three patients (33.3%). The median duration of the symptoms prior to diagnosis was 5.33 months. Endocarditis involved the aortic valve in six cases (66.6%), the mitral valve in two cases (22.2%) and the aortic valve plus the mitral valve in one case (11.1%). Serologic tests were positive in eight (88.8%) and blood culture was positive in two (22.2%). Aortic valve replacement surgery was undertaken for five patients (55.5%). One patient died due to arrhythmia. A high degree of suspicion is therefore necessary in order to ameliorate the course of Brucella endocarditis.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) impairs patients` quality of life and clinical outcomes. Pulmonary rehabilitation (PR) program can improve the functional capacity in patients with chronic lung disease. Thus, the study aimed to evaluate the effect of the PR program on the quality of life, anxiety, depression, and pulmonary function of patients with COPD. Materials and Methods: In this single-group before-and-after clinical trial, adult patients with COPD and recent history of exacerbation were recruited. The intervention was a PR program, including training of breathing exercises at home and aerobic exercise program, twice a week about 30 to 60 min for 8 weeks. The program was prepared according to the patient’s tolerance by a sports medicine specialist in a pulmonary rehabilitation clinic. The primary outcome was quality of life measured by the St. George’s Respiratory Questionnaire (SGRQ). Secondary outcomes were assessing anxiety, depression, pulmonary function, COPD status, the ability to walk, and shortness of breathing. All outcomes were measured before and one week after the program. Results: Twenty-two eligible patients of both genders (68% male and 32% female) with a Mean±SD age of 65.09±9.72 years finished the program. Quality of life was improved significantly following the intervention (51.49 [16.68] vs 4275 [15.63]; P<0.001]. Anxiety and depression (P<0.001), pulmonary function parameters, such as forced expiratory volume in 1 second (FEV1) (P<0.001) and FEV1/ forced vital capacity (FVC) ratio (P=0.015), COPD status (P=0.001), the ability of walk1ing (P<0.05), and shortness of breath (P=0.001) were improved significantly after the intervention. Conclusion: The PR program resulted in clinical improvement in patients with COPD. Thus, we recommend that it be used besides medical management.