Background: This essay reports a case about tissue defect of heel due to melanoma excision.

Patient history: The patient was a man 60 years old with a heel ulcer that had reported malignant melanoma in biopsy. Then the ulcer was done under wide local excision.

Materials and Methods: We should use flap for tissue defect coverage that tendon and heel bone are exposed from it. It seems using skin graft is not useful, because skin graft in persistent contact with shoes will get chronic ulcer. Among different flaps (sural flap or medial plantar flap), we decided to use medial plantar flap. The advantage of this flap is its sensority and low volume.

Conclusion: Conclusion with due attention the results, The meial planter flap, as an efficient method, is adviced to teconstruct heed specially after excision of melanoma.

Background: Determining the level of manual ability of children with cerebral palsy has significant role in scheduling care and providing supportive services by organizations such as the a social welfare office. Manual Ability Classification System (MACS) is responsible for this critical matter. In Mazandaran Province, the prediction of manual ability is intuitive and is done without tools. This study aimed to investigate the consistency between operational therapists prediction of future manual function of children with cerebral palsy and MACS scale.

Materials and Methods: This study was designed as a cross sectional trial. The study population consisted of 12 occupational therapists working in Mazandaran’s rehabilitation center under the social welfare office. Firstly, occupational therapists chose 100 children with cerebral palsy and classified their future manual ability into five levels according to their prediction. Then the researcher classified the children based on MACS scale. Finally, the amount of prediction consistency between therapists and researcher was statisticaly analyzed.

Results: The weighted kappa coefficients of MACS scale were 0.671 in first level and 0.747 in fifth level that show good agreement in these two levels. This coefficient was 0.417 in third level and 0.444 in forth level that shows fair agreement. The weighted kappa coefficient was 0.358 in second level that indicates slight agreement.

Conclusion: With prediction consistency between operational therapists and researcher, MACS is used as a suitable means for classifying the level of manual ability in children with cerebral palsy and predicting their needs to adaptive and auxiliary devices by occupational therapists in rehabilitation centers and social welfare offices.

Abstract

Background: With regards to importance of the role of parents in children's life, imbalance in the roles of parents can lead to serious mental, emotional and physical damages of the child. The purpose of this study was to determine how to do parenting role's tasks in parents of children with disability (physical- mental) younger than 7 years in the city of Arak in 2016.

Materials and Methods: In this study, the parenting role's tasks questionnaire for 120 parents of children with disability was completed. The effect of demographic characteristics on how to perform the role of parents was studied.

Results: Based on data collected and analyzed using Pearson correlation coefficient for the relationship between the parents and other factors, we have found no significant relationship between role of parents with the child's age. In disabled children, between parent's role and maternal age was significant difference which its correlation coefficient was -0.18, represented the inverse association between maternal age and the parent's role with disabled children. In comparison of parent's role based on child's gender, significant difference was not seen in any of cases. The impact of the seizure on performance of parenting role's tasks implied no relationship between history of seizure and performance of parenting role's tasks. Economic situation as well as on how to do tasks was ineffective.

Conclusion: Imbalance in performance of parenting role's tasks in primary care, education, leisure and cognition promotion showed that existence of a disabled child in the family had negative impact on the parenting role's tasks in different aspects, for example further focus on one of the domains lead to ignorance of other domains. Total score confirmed the negative impact of disabled children on efficient implementation of parenting role's tasks.