Background: Carpal TUNNEL syndrome (CTS) is the most common upper extremity impingement neuropathy caused by median nerve compression within the carpal TUNNEL due to various conditions such as bone abnormalities, inflammation, trauma, neoplastic lesions and endocrinopathies. Increase in carpal TUNNEL pressure of more than 20 to 30 mmHg blocks the epineural blood flow; so, the nerve function is damaged. Carpal TUNNEL syndrome is primarily a clinical diagnosis supported by electrodiagnostic studies; in recent years, different imaging modalities, including magnetic resonance imaging (MRI) and ultrasound, are suggested for diagnosis of carpal TUNNEL syndrome.Methods: During November 2011 and May 2013, 84 patients clinically suspicious for carpal TUNNEL syndrome were enrolled in our study; the age of patients ranged from 19 to 66 with the average of 43 years and the sex ratio of women to men was 2.7: 1. All the patients underwent electerodiagnostic tests (EDT) as the gold standard diagnostic modality and the results of color Doppler sonography (CDS) were compared with electerodiagnostic findings.Findings: According to the ecterodiagnostic tests, patients with positive results of carpal TUNNEL syndrome were divided into three groups of severity including mild with 9 patients (11%), moderate with 14 cases (17%) and severe with 18 patients (21%). Sensitivity of color Doppler sonography for diagnosis of carpal TUNNEL syndrome was almost 83%, 71% and 55% in severe, moderate and mild groups of carpal TUNNEL syndrome, respectively.Specificity of this imaging modality was determined near to 81% in all three groups of the patients.Conclusion: In addition to electerodiagnostic tests, which are considered as the modality of choice for diagnosis of carpal TUNNEL syndrome, Doppler ultrasound can be a non-invasive imaging procedure for evaluation of patients that are clinically suspicious to this syndrome. Considering three groups of carpal TUNNEL syndrome based on severity of electerodiagnostic signs, results of color Doppler sonography is more reliable in patients with severe signs.

Background: Median neuropathy due to nerve compression in the wrist, or carpal TUNNEL syndrome (CTS), is the most common entrapment neuropathy. Incidence of CTS is high at an estimated value of 280.6 per 100, 000 patients per year. Accurate diagnosis of CTS is essential for treatment and preventing disability and morbidity.Methods: 64 patients with clinical diagnosis of CTS from the out-patient clinic of Alzahra Hospital, Isfahan, Iran were evaluated between January and March 2013. All the patients (54 women and 10 men) underwent nerve conduction study (NCS) and ultrasonography. The cross sectional area of the median nerve at the level of pisiform bone and 12cm proximal to that in elbow was estimated via ultrasonography which were used to calculate wrist/forearm ratio (WFR). The cut-off point value for WFR of median nerve was assessed and sensitivity and specificity of ultrasonography for CTS diagnosis was also determined.Findings: The optimal diagnostic cut-off values of CTS that we obtained by ROC curve was 2.07 and the areas under the ROC curve, was 0.8. This cut-off value had a sensitivity of 76%, specificity of 83%, positive predictive value (PPV) of 95% and negative predictive value (NPV) of 45%.Conclusion: The WFR is a new option in the ultra-sonographic diagnosis of CTS. This technique does not add significant time to routine ultra-sonographic examination.The use of a ratio also helps to omit the variability between populations and anatomic variation. Our initial findings suggest a high sensitivity for this method, but study of a larger population is needed for confirmation.

Background: Carpal TUNNEL syndrome is a common neurological disease with various risk factors involved in its onset. The present study aimed to compare the prevalence of risk factors in two groups with and without the syndrome.Methods: In a case-control study, 100 patients with carpal TUNNEL syndrome and 100 healthy people were selected and the prevalence of risk factors in carpal TUNNEL syndrome were evaluated and compared between the two groups.Findings: Of the known risk factors, prevalence of working with keyboard, powerful working, repetitive movements, working with vibrating tools, inflammatory diseases, obesity, and diabetes was significantly higher in the patient group.Conclusion: Today, the risk factors in carpal TUNNEL syndrome are changing, and computer users and people who work with vibrating tools are at more risk. Therefore, it is necessary to raise awareness in the community about the new disease risk factors, in order to improve the standard of industrial equipment and home appliances such as kitchen utensils as well.

Facilities built in areas affected by earthquake activity, such as TUNNELs, which have always been an integral part of human life, must withstand both dynamic and static loading. It has led to the need for practical studies on the effects of earthquakes on underground structures and the factors affecting their destruction. For this purpose, in this research, at first different patterns of TUNNEL’s excavation were investigated and by using Plaxis 2D software and based on Tabas earthquake in Iran, sensitivity analysis on geotechnical parameters of the soil surrounding TUNNEL such as cohesion, friction angle, unit weight and modulus of elasticity was carried out, and the parameters whose changes have the greatest and least effects on the bending moment changes on the TUNNEL lining are introduced. The results show that TUNNEL excavation patterns significantly affect the bending moment, axial forces, displacements, and surface settlement of the TUNNEL. Often, by dividing TUNNEL excavation area to small parts, the values of bending moment, axial forces, displacements, and surface settlement of the TUNNEL decreases in static analysis. Also, outputs of sensitivity analysis on geotechnical parameters of the soil surrounding TUNNEL showed that modulus of elasticity of the soil surrounding TUNNEL has the most effect and cohesion changes have the least effect on bending moment induced on TUNNEL lining..

Background: Tarsal TUNNEL syndrome is a relatively rare disorder .the physicians need to be cognizant of this problem in complex, vague foot complaints.Material and. Methods: Five cases with tarsal TUNNEL syndrome underwent surgical decompression during a three year period (1998-2001). These cases had all failed the conservative treatment-including local steroid injection. The 4 females and one male consisted of one case of rheumatoid disease one post ankle-fracture adhesion and three cases with unknown etiology.Results: Four patients had complete relief of their symptoms and were satisfied with the, surgical outcome. One patient had some improvement, but not a full recovery from all the symptoms.Conclusion: Surgical release of compressing fibrous sheath for tarsal TUNNEL syndrome is a good alternative for cases who do not respond to non-surgical treatment. The results are, however, variable and not always predictable.

Optimizing the positioning of minor drainage TUNNELs is a crucial strategy in mitigating groundwater inflow within main TUNNEL projects, a significant concern in civil engineering and infrastructure development. Groundwater inflow can lead to serious challenges, including TUNNEL instability, flooding, and increased construction costs. This makes effective management of water in underground projects paramount. The strategic placement of minor drainage TUNNELs facilitates the efficient collection and diversion of seepage water, thereby reducing the risks associated with groundwater inflows. This study employs numerical finite element modeling to examine the optimal positioning of drainage TUNNELs relative to main TUNNELs, considering various configurations and hydrogeological conditions. Results indicate that placing the drainage TUNNEL below the main TUNNEL significantly reduces groundwater inflow, especially as TUNNEL radii and groundwater head levels increase. These findings provide a practical framework for enhancing TUNNEL drainage efficiency, ensuring structural stability, and minimizing environmental impacts by introducing the final model in optimizing minor drainage TUNNEL position to mitigate groundwater inflow in main TUNNEL projects.

Nowadays ventilation of railway TUNNELs in Iran with regard to their age and the need for increasing the traffic lines, especially for the west part of the country, is of paramount importance. The most important factors affecting ventilation design of these TUNNELs are heat and the gases produced by fuel combustion in diesel engines. The heat produced by these engines may increase the temperature of the air in TUNNELs so that locomotive motors are not able to operate with a reasonable efficiency. Products resulting from fuel combustion may also cause problems for the TUNNEL users. Therefore, ventilation of the TUNNELs should be designed with respect to these two aspects. The method presented in this paper, which is the first scientific and practical step in this regard, is based on using present railway transportation facilities and approaching standardization of the appropriate required air inside the TUNNEL. Study in of different ventilation methods shows that excavation the galleries and connected shafts the air through which may be transferred, or installation of the equipment inside the TUNNEL are not technically and economically desirable due to lack of geotechnical surveys and therefore knowledge about the earth materials, elongation of the proposed galleries and shafts and finally lack of the clearance in TUNNEL. These considerations resulted in choosing the method of installing a powerful jet fan outside the TUNNEL and using the air-tight gates, one of the advantages of which is prevention of interference between the maintenance procedures with the train movement. In this paper the requirement for installation of ventilation facilities in the railway TUNNELs in Lorestan province in the west of Iran, with particular emphasis on the 102 Lorestan Railway TUNNEL has been discussed. First of all the possibility of applying the different methods of ventilation in this TUNNEL was studied and according to the geometric conditions of the TUNNEL and topographical situation of the area, the possibility of using the hand dollies and access TUNNELs was disregarded. The transverse and semi transverse ventilation systems was not preferred either, due to the complexity of these systems compared to longitudinal ventilation systems.Finally application of strong fans with 130m3/sand the 3 KPa pressure and an engine with 600 KW power along with utilization of ventilation gallery with 50 m length and 150 angle towards the main TUNNEL and airtight doors, has been selected as the optimal ventilation systems for this TUNNEL.