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Introduction: Irritable bowel syndrome is a type of digestive dysfunction characterized by chronic abdominal pain and changes in bowel movements and is somehow related to psychological factors. Therefore, the present study aimed to assess the effectiveness of emotional-focused therapy in the difficulty of emotional regulation and the severity of symptoms in patients with irritable bowel syndrome (IBS).. Material & Methods: in this study, a pretest-post-test, quasi-experimental method with a control group was used. The statistical population of the present study was all patients with IBS referred to specialized and subspecialty centers of hospitals and clinics in Arak in the spring of 2023, of whom 30 eligible people volunteered to participate in the research. They were selected by purposeful sampling. The participants in the research completed the difficulty of emotion regulation questionnaire and the symptoms of irritable bowel. Results:The results demonstrated that emotional therapy has an effect on the difficulty of emotion regulation and the severity of symptoms in patients with IBS. Discussion & Conclusion: Traditional medical management is often unsatisfactory and does not address critical issues. Results suggest that it is essential that psychological treatments target IBS-specific factors for change, including emotion regulation. Therefore, one of the effective treatments for IBS can be emotional therapy. [ABSTRACT FROM AUTHOR]

Iatrogenic colonic perforation (ICP) is a rare but serious complication of colonoscopy, with an incidence ranging from 0.016% to 8% depending on the type and purpose of the procedure. Several patient-related, endoscopist-related, and procedure-related factors increase the risk of ICP, which most commonly occurs in the sigmoid colon. Following specific guidelines for colonoscopy performance and quality can help prevent ICP. Early diagnosis is essential, and imaging modalities such as radiography or CT scan may be needed to evaluate the extent of damage. The management of ICP depends on the size and location of the perforation, the presence of peritonitis or sepsis, the underlying colon pathology, and the patient's general condition. Endoscopic, surgical, or conservative methods may be used, but surgical consultation should always be sought urgently. Surgery is usually indicated for large perforations, signs of peritonitis, inadequate bowel preparation, severe comorbidity, failure of conservative treatment, underlying colon disease requiring surgery, transplant recipients, or immunocompromised patients. Laparoscopic-assisted exploration is the preferred surgical technique for ICP. The timing of a follow-up colonoscopy depends on the indication for the initial colonoscopy that led to ICP. [ABSTRACT FROM AUTHOR]

Introduction: Patients with COVID-19 can have various and complex coagulation disorders that cause hypercoagulable conditions. Investigating the role of anticoagulants with different doses in the outcome of patients with COVID-19 seems to be needed. Therefore, the present study was conducted with the aim of predicting factors of severe disease, including the number of lymphocytes, LDH, and the recovery status of patients. Methods: A cross-sectional study was conducted in patients with COVID-19 hospitalized in Hazrat Rasool Akram (PBUH) Hospital. Study entry includes acute respiratory symptoms caused by COVID-19 disease (uncontrollable cough, dyspnea, prolonged medicine and blood saturation drop) along with lung involvement in chest spiral CT scan without injection, SARS RT-PCR–CO virus test was positive and transfer to intensive care unit (ICU) was indicated. Anticoagulant starting time, type and dose of anticoagulant received and duration of use were recorded. Two groups of prophylaxis dose, higher dose than prophylaxis (medium dose and therapeutic dose) were divided. Results: Out of the total number of patients referred to Rasul Akram Hospital, 90 people (43 women (47.8%) and 47 men (52.22%)) participated in this study. The average hospitalization in the ICU was 13.50 ± 12.39 days and 17.18 ± 13.36 days in the hospital. Also, the duration of coagulant therapy was 17.13 ± 13.38 days. 53 patients (58.9%) received a prophylactic dose, 28 patients (31.1%) received a therapeutic dose, and 9 patients (10%) received a moderate dose of anticoagulant. Anticoagulant in 74 patients (82.2%) was unfractionated heparin (UFH) and in 16 cases (17.8%) low molecular weight heparin (LMWH). The changes of LDH, number of lymphocytes, dimer, fibrinogen, ferritin and FDP according to the dose of anticoagulant assessed in the three groups of prophylaxis, treatment and no statistically significant difference. The mean of ICU admission days according to different doses of anticoagulant did not show a statistically significant difference. Conclusions: Finally, the findings obtained from the study showed that the use of different doses of anticoagulant does not cause a difference in the level of LDH, number of lymphocytes, ferritin and FDP at different measurement times. Also, the length of stay in the hospital and the time of hospitalization in the intensive care unit did not differ between the groups receiving prophylactic anticoagulant, medium dose and therapeutic dose. [ABSTRACT FROM AUTHOR]

Background and Objectives Corona is caused by a viral infection called acute respiratory syndrome corona virus 2 which spreads rapidly, causing irreparable damage and death. In order to predict and develop treatment algorithms, the study of biomarkers is important in determining the severity of the disease. Therefore, we investigated the correlation of Interleukin 6 IL-6, Lactate dehydrogenase LDH, C reactive protein CRP and disease severity in COVID-19 patients. Materials and Methods In this descriptive and analytical cross-sectional study, the information of 365 coronavirus hospitalized patients randomly selected in Sina Hamadan hospital during 2019 was entered into SPSS 26. The severity of the disease was also measured according to the defined reference and clinical symptoms and classified into two levels. The data were analyzed with gamma correlation instability test, Somers' D at significance level of p value <0.05. Results It was found that IL-6 with a correlation coefficient of 0.506, LDH with a correlation coefficient of 0.291 and CRP with a correlation coefficient of 0.23, all at the level of 0.01 (p value = 0.01), have a positive effect on the severity of Corona disease and the amount of this positive effect is based on Somers' effect coefficient d 0.839, 0.458 and 0.358, respectively. Conclusions Patients with severe COVID-19 have significantly higher serum levels of CRP, LDH and IL-6. Baseline levels of IL-6, CRP, and LDH were closely related to the severity of COVID-19 disease. These laboratory markers can be used as clinical indicators of disease exacerbation and prognosis of COVID-19. [ABSTRACT FROM AUTHOR]

Background. Iron deposits impair neurons and cause cognitive disorders through different pathways. Today, with the help of quantitative susceptibility mapping (QSM), iron accumulations in different brain areas can be evaluated and measured. This research aims to identify the changes of iron deposits in the brain nuclei in different stages of cognitive disorders using the QSM technique and introduces biomarkers for the early diagnosis of these disorders. Methods. The data of thirty-five participants with normal cognitive conditions and forty six patients with cognitive disorders, classified into four different groups based on the severity of the disorder, were downloaded from the ADNI database. After determining the regions (ROIs) with the FSL automatic segmentation tool, the mean QSM values of twelve brain nuclei were determined with the help of Slicer software, and SPSS software was used for statistical analysis. Results. There was an inverse correlation in the left putamen nucleus of LMCI group (P=0.041). Direct correlation between age variable and QSM values of the left putamen nucleus (P=0.000078) and right putamen nucleus (P=0.000017) of the control group were reported. Conclusion. As the severity of disorders increases in the LMCI group, the number of paramagnetic deposits, such as iron, in the left putamen nucleus increases. Therefore, the QSM values of the left putamen nucleus can be used as an indicator of the severity of the disorder in the advanced stages of cognitive disorders. Practical Implications. Iron deposits cause damage to neurons and cause cognitive disorders through various pathways. Today, with the help of the quantitative susceptibility mapping technique, the numeral of iron accumulations in different brain areas can be evaluated and measured. This research aims to identify the changes of iron deposits in the brain nuclei in different stages of cognitive disorders by using the Quantitative susceptibility mapping (QSM) technique to introduce biomarkers for early diagnosis of these disorders. [ABSTRACT FROM AUTHOR]

Background & Aims: Personality disorder is a type of mental disorder in which a rigid and unhealthy pattern of thought, performance, and behavior is observed in a person. A person with a personality disorder has difficulty in understanding and communicating with situations and people. This causes significant problems and limitations in relationships, social activities, and understanding of diseases. The presence of personality disorders in sick people leads to the development of the disease and increases the level of stress and depression in patients. Among the diseases observed in patients suffering from personality disorders such as dual personality, the presence of stress, depression, harming themselves, scratching the skin, and causing self-inflicted wounds are mentioned. Personality disorders usually start in adolescence or early adulthood. There are different types of personality disorders. Some types may become less apparent during middle age. Types of personality disorders are classified into three clusters based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one other personality disorder. To diagnose a disorder, showing all signs and symptoms is unnecessary. Cluster A personality disorders are characterized by abnormal and unusual thinking or behavior. They include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder. Cluster B personality disorders are characterized by dramatic, overly emotional, or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder, and obsessivecompulsive personality disorder. There is increasing evidence about the negative impact of personality disorders on various physical, mental, and emotional aspects of healthy and sick people. Psychotherapy can help a person understand the effects of their behavior on others, learn to manage or cope with symptoms and reduce behaviors that cause problems in functioning and relationships. The type of treatment depends on the specific personality disorder, its severity, and the individual's condition. If personality disorders are not treated in people, the level of many diseases such as depression, cardiovascular diseases, and skin diseases will increase. Skin diseases are conditions that affect the skin. These diseases may cause rashes, inflammation, itching, or other skin changes. Some skin diseases may be genetic, while lifestyle and psychological factors such as severe obsessions and personality disorders may cause others. Both the skin and the central nervous system are derived from the ectoderm during embryogenesis. Their anatomicalfunctional relationship has been known for a long time. However, many aspects of this relationship are not fully understood. There are several studies that confirm the link between Dermatosis and mental illness. The findings of studies conducted in the field of psychiatry show that infectious-parasitic Dermatoses are the most common skin diseases in more than 70% of patients with mental disorders. The general explanation for this complication is that the physical condition of many mental patients decreases, which is associated with a decrease in immune defense and, as a result, an increase in sensitivity to skin infections. Considering the importance of skin diseases and the effect of personality disorders on this type of disease and the explanations provided, the question raised here is the relationship between personality disorders and skin diseases in various studies in the field of psychiatry. What results have been obtained and what requirements have been recommended regarding the reduction of this disease through psychotherapy? Methods: The current study is a review study that includes papers published in domestic and foreign journals available in SID, PubMed, Google Scholar, Magiran, Springer, Wiley, Web of Science (ISI), Scopus, Science direct, and ProQuest databases. The range of years 2020 to 2022 was used. Papers were searched using the keywords "acute skin diseases, skin diseases, personality disorders, mental disorders" and their English equivalents. As a result of the initial search of papers, there were 156 articles, of which 74 apapers remained in the screening stage, and at the end, 12 papers were subjected to content analysis. Results: This review study showed that personality and mental disorders have an effect on the development of skin diseases and controlling these disorders is considered as a solution to reduce the complications of skin diseases. Conclusion: In general, it can be concluded that in order to reduce the complications of skin diseases, paying attention to the personality and mental disorders of people can increase the patient's understanding of the disease and reduce the level of complications of this disease. Psychotherapy of the last century uses biological, psychological, and social factors at different levels significantly in the pathogenesis of each disease, through complex interactions in the treatment of diseases. There are many ontogenetic, anatomical, and functional connections between the skin, the psyche, and the immune system. These connections are the reason that Neuro-immunological mechanisms are often involved in the pathogenesis of Dermatoses. This is why skin diseases are classified as "paradigm" psychosomatic diseases. The skin is the only organ that is completely visible, and therefore the patient can always observe it closely. Patients are free to act on their ideas about pathogenic mechanisms. This means that, as mentioned above, clinicians, especially in the field of dermatology, must examine (and respect) patient disease models. However, skin lesions are visible not only to the patients themselves but often to other people as well. For example, patients with Dermatosis are often exposed to stigma: skin diseases may cause hatred or fear of contagion. Therefore, feelings such as embarrassment about one's illness, or disgust expressed by other people, may affect the patient's outlook on life. Some patients actually anticipate and experience imaginary stigma even in the case of minimal skin lesions. The fact that skin is very visible has also contributed to psychoanalytic theories and interpretations of psychoanalysts interested in psychosomatic medicine for skin diseases. [ABSTRACT FROM AUTHOR]

Background & Aims: Aging is a period that is associated with gradual, progressive and spontaneous erosive changes in most organs and physiological functions of the body. In fact, human beings have many problems that affect their lives as they enter old age. Common physical problems among the elderly that occur as a result of certain diseases or as a result of the aging process include loss of balance, postural control, difficulty in gait and gait control, muscle atrophy, weakness and dysfunction, and decreased strength (1). Balance is a complex motor skill that describes the body's postural dynamics in preventing falls. With the onset of old age, changes in the function of the musculoskeletal system, vestibular system, sensory system and visual system occur as physiological systems involved in balance, and the elderly are exposed to serious injuries due to imbalance, including bone fractures and Places long disabilities (1, 2). It is one of the effective factors in improving the balance of athletic performance, but older people have problems in performing these exercises due to movement restrictions due to chronic pain, low level of physical fitness, as well as fear of imbalance and falling. Research has shown that water has a beneficial role in rehabilitation in injured people due to its special properties such as buoyancy, relaxing role on muscles and reducing tension, reducing pain caused by environmental stresses such as weight pressure on the lower extremities, as well as People with special disabilities, such as the elderly (9). According to the above, the aim of this study was to investigate the effect of exercises and sports activities in water on the balance of injured elderly athletes. Methods: In this quasi-experimental study, 30 retired athletes with knee and ankle injuries were selected by purposive sampling and randomly divided into two groups of control and water exercise. Dynamic balance and static balance of subjects were measured before and after the exercise intervention. The star excursion balance test (7) was used to measure static balance and the star balance test (11) was used to measure the dynamic balance of the subjects. The intervention included 8 weeks of water balance exercises. SPSS version 26 was used for data analysis software. Results: The results showed that in the static equilibrium index, the main effect of test sessions (F1,28= 184.90, P= .001, η² = 0.738) and group (F1,28= 19.84, P= .001, η2 = 0.524) was significant. In the dynamic equilibrium index, the main effect of the test sessions(F1,28= 317.40, P= .001, η² = 0.689) and the group (F1,28= 55.33, P= .001, η² = 0.511) was significant. Conclusion: The results of this study showed that selected water sports exercises improved static and dynamic balance of elderly athletes with a history of knee and ankle injuries. The results of the present study are in line with the results of previous research, including the research of Guillamón et al. (2019), Askari et al. (2018), Padua et al. (2018), Mousavi and Ghazalian (2020) and Dokht Abdiyan et al. (2016), all of which have beneficial effects of exercise in water mentioned (8, 12-15) was consistent. Retired Athletes are a group of seniors who, in addition to the problems that arise in the normal course of old age, are also involved in chronic injuries during their professional sports career. In some cases, the presence of such chronic sports injuries can increase the problems many times over. Exercise in water can improve the motor function (9, 10) of the elderly by developing the capabilities of the central nervous system as well as motor coordination. One of the limiting factors of motor function in injured people is chronic pain caused by injury (16). It has also been shown that these individuals are limited in their daily activities due to chronic pain and excitatory stress-induced stress (17, 18); On the other hand, to prevent age-related complications that include the destructive process of the nervous system as well as skeletal muscles, and exercise can be a preventive and therapeutic process (18). The use of the aquatic environment due to its properties can reduce the fear of falling in the elderly with the buoyancy it creates (9, 10); Therefore, the elderly can easily exercise and enjoy the benefits of exercise. On the other hand, due to the fact that body weight on land causes pressure on the lower limbs and thus increases stress on nerve endings and as a result increases pain in injured limbs, they usually have problems for training on land; Therefore, according to the characteristics of aquatic environments, these people can benefit from the benefits of rehabilitation exercises as well as physical activities by adjusting their weight due to the special conditions of water (19, 20). In general, it can be said that exercising in water by increasing neuromuscular function improves balance in elderly athletes with a history of lower limb injuries. Balance and gait problems and maintaining a proper walking pattern are complications of aging that are much more severe in the elderly with a history of severe sports injuries to the knee and ankle. Exercise has its limitations due to the physiological problems of the aging process, especially those suffering from diseases such as osteoarthritis, chronic joint injuries, and mobility disabilities. Therefore, despite the benefits of physical exercise, it should be considered that doing this type of exercise on land due to some psychological and physical problems of old age, especially in people who suffer from diseases and injuries such as joint pain and have limitations. They are, it is difficult.Therefore, due to the low risk nature of water, water exercises can be used to improve balance and gait indicators. The results of the present study showed that participation in 8 weeks of selected water sports exercises led to improved gate parameters such as stride length, step frequency, walking speed and endurance as well as static and dynamic balance in elderly athletes with a history of severe knee and ankle injuries This exercise method can be used to prevent the complications of old age, especially in the elderly who have a strong sports history and have suffered severe ankle and knee injuries during their professional sports. [ABSTRACT FROM AUTHOR]

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome. Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS). Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005). Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05). Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment. [ABSTRACT FROM AUTHOR]

Introduction: Despite the negative consequences of the Covid-19 pandemic on mental health, our knowledge of the changes in the severity of symptoms of psychological disorders during the pandemic is insufficient. Aim: The purpose of this study was to investigate the changes in the symptoms of anxiety, depression, obsessive-compulsive disorder, social anxiety, and generalized anxiety in the student population during the covid-19 pandemic. Method: This study is a longitudinal descriptive study in terms of data collection. A sample of 376 people was selected with the convenience sampling method from the Zanjan University of Medical Sciences and Zanjan National University undergraduate students using an online research platform (Porsal). The sample was evaluated in 4 stages at 6-month intervals from April 2020 to September 2021. BDI-II, BAI, GAD-7, OCI-R, and SPIN were used for data collection. The data were analyzed by repeated measure ANOVA using SPSS version 26, and R software. Results: During the Covid-19 pandemic, the intensity of symptoms of anxiety (p=0.008), obsessive-compulsive (p=0.023) and generalized anxiety (p=0.052) had an increasing trend, and with the subsidence of the pandemic conditions, the intensity of these symptoms has also been reduced. However, the intensity of depression was continuously increasing (p=0.001), and the intensity of social anxiety also had slight changes (p=0.964). Conclusion: Covid-19 pandemic has caused a significant increase in the severity of the symptoms of psychological disorders; therefore, it is necessary to investigate the underlying factors of these changes and other psychological consequences of the Covid-19 pandemic by conducting more extensive studies. [ABSTRACT FROM AUTHOR]

Background & Aims: Throughout human history, there have been structured games among all cultures. Playing can be enjoyable, fun, and relaxing and can be used as a way to escape from everyday life (1). In addition to being a fun pastime, gaming is a social activity in which people with common interests interact with each other. With the popularity of computers, tablets, and smartphones and the use of the Internet in recent years, playing online and offline games has become a common activity, especially for young people, and increasingly, as an important part of recreational activities (3). Numerous studies show that in parallel with the spread of the Internet, overuse of it can lead to problems such as addiction and dependence, so that even Internet addiction is defined as a 21st-century epidemic (4, 5).Online games are a type of Internet games that have become widespread due to increasing people's familiarity with the Internet, especially the youth, increasing the speed of the Internet, as well as the existence of highspeed and wireless connections (6). Addiction to online games is considered obsessive, extreme, uncontrollable, and physically and mentally destructive. Therefore, addiction to these games can be defined as: Extreme and impulsive use of online games, in a way that leads to social and emotional problems, and despite these problems, a person can not control his extreme use of the game Slowly Internet addiction is an impulse control disorder characterized by overuse of the Internet, which is associated with significant functional impairment, anxiety, depression, and other symptoms of psychiatric pathology (7). Internet addiction is sometimes associated with suicide, even after modulating potentially disturbing variables such as depression. Attention-Deficit/Hyperactivity Disorder (ADHD) is a developmental neurological disorder that has three main characteristics: Attention Deficit Hyperactivity Disorder, Hyperactivity Disorder, and Impulsivity. People with ADHD have abnormalities in parts of themselves (9). Some psychologists report about the related between depression, anxiety and symptoms of ADHD with Addiction to online games (10). Also relation is between internet addiction with d reducing of academic hope and sleep quality (20, 21). Acceptance and Commitment Therapy: This follows a pattern of health, not illness, and assumes that human psychological problems are related to unhappiness and emotional disorders caused by language, thus helping human beings cope with Cognitive and emotional problems mainly work on language (26). The effectiveness of treatment based on acceptance and commitment on sleep quality, academic hope and anxiety in students with internet game disorder, with and without comorbidity of ADHD in Khorramabad in 2020 became necessary. Methods: The statistical population was students with internet game disorder in Khorramabad city. The sample size was 42 people (14 people for each of the experimental and control groups) so that each group consisted of an equal number of students with internet game disorder with and without comorbidity of attention-deficit/hyperactivity disorder. Therapeutic intervention sessions were performed in 9 sessions of two hours and one session per week. To measure the research variables, questionnaires of Internet Gambling Disorder -20 test, mental health assessment of children and adolescents aged 6 to 14 years (CSI-4), Petersburg quality of sleep (PSQI), academic hope scale (date and waist), and Beck anxiety (1988) and an acceptance and commitment-based treatment package were used. Data analysis was performed using analysis of covariance in SPSS22 and Smart PLS. Results: The results show that the univariate test is significant for each of the dependent variables in both post-test and follow-up stages (P <0.01). Also, the univariate test is significant only for dependent variables of academic achievement (P <0.05). And is not significant for other variables (P <0.05). Conclusion: The effectiveness of acceptance and commitment-based therapy on sleep quality, academic hope and anxiety of students with internet gambling disorder has an effect and this effect persists over time. In explaining the present study, it can be said that the results of this study are consistent with the mentioned studies, meaning that the ACT treatment approach has an effect on the dependent variables and this effectiveness has continued and shows that the treatment is based It is an effective treatment approach for acceptance and commitment for different types of behavioral, psychological, mental, mood disorders, etc. Obviously, it is moderated by the individual's relationship to these experiences. Therefore, these people are taught that to the extent that they can accept and tolerate their experiences, they can act independently of the experiences. According to the results of the present study, it can be said that acceptance and commitment-based therapeutic education can reduce the symptoms of Internet gambling disorder and reduce the severity of dependence and thus the desire for treatment in a positive way., Be effective. Therefore, by teaching these ACT skills, an effective step can be taken to treat students with internet game disorder with and without co-occurrence with ADHD. Acceptance and commitment therapy affect the quality of sleep and this effect persists over time. In the explanation of the present study, it should be said that according to Table 4-12, the treatment based on acceptance and commitment on the quality of sleep of students with internet game disorder is effective and this effectiveness has continued in a one-month follow-up period. Explaining the results of the present study, it should be said that the therapeutic approach based on acceptance and commitment of ACT is effective on students' academic achievement with internet gambling disorder and this effectiveness has continued in a one-month follow-up period. Acceptance and commitment therapy has an effect on anxiety and this effect has persisted over time. According to the results of the present study, it can be said that therapeutic training based on acceptance and commitment can be effective in reducing the symptoms of internet gaming disorder and reducing the severity of mental disorders. Therefore, by teaching these treatment skills based on acceptance and commitment, an effective step can be taken in the direction of treating students with internet gaming disorder with and without comorbidity with attention deficit hyperactivity disorder. [ABSTRACT FROM AUTHOR]

Introduction: Allergen exposure and sensitivity, asthma progression, and increased airway hyperresponsiveness (AHR) are interconnected. The relationship between mite sensitivity and lung function is still unclear. Therefore, this study aimed to investigate the relationship between mite allergy and pulmonary function decline in patients with asthma referred to Deziani Allergy Clinic in 2017. Material & Methods: This descriptive cross-sectional study was performed on patients referred to Deziani Allergy Clinic in Gorgan in 2017. The patients were included in the study based on the clinical criteria for asthma. Mite antigen skin test was performed for all patients, and they were divided into two groups: sensitive and non-sensitive. A pulmonologist, allergist, and clinical immunologist performed a pulmonary function test (PFT) and bronchial stimulation test to confirm and evaluate the severity of asthma. Pulmonary function data were statistically compared between the two groups. (Ethic Code: IR.GOUMS.REC.1396.240) Findings: In total, 382 patients with a mean age of 42.75±16.50, including 146 (38.2%) males and 236 (61.8%) females, were included in the study. Moreover, 144 (37.7%), 101 (26.4%), and 137 (35.9%) patients had mild, moderate, and severe asthma, respectively. In addition, 173 (45.3%) cases were sensitive to mites. The FVC, FEV1, and FEF 25-75 values were significantly lower in patients with sensitivity, compared to the group without mite sensitivity (P<0.05). PFT results in females sensitive to mites were significantly lower in all cases, except for FEV1/FVC (P<0.050). The use of bronchodilators was significantly associated with improved pulmonary function in those who were over the age of 45 years (P=0.05). Discussion & Conclusion: Patients with mite allergy have poorer pulmonary function, and it plays an obvious role in the severity of asthma symptoms. Pulmonary specialists can help better control and reduce these patients' symptoms by adopting appropriate treatment programs, including improving the living environment and presenting the necessary guidelines to reduce contact with this allergen. [ABSTRACT FROM AUTHOR]

Introduction: There is inconsistent data regarding COVID-19 prognosis in patients with background hypothyroid disorder. The present study aimed to evaluate the severity of symptoms and blood parameters in COVID-19 patients with hypothyroidism. Material & Methods: This study investigated 100 COVID-19 patients (50 individuals with a history of hypothyroidism and 50 patients without thyroid disorder [euthyroid]). Demographic and clinical characteristics were collected from the COVID-19 registry database in Shahid Mustafa Khomeini Hospital. All patients were admitted and treated between March and December 2020. Hospitalization duration, the ICU admissions rate, and blood laboratory tests were evaluated in this study. Findings: Hospitalization period was significantly longer in the hypothyroid group, compared to the euthyroid group (P=0.009). The number of red blood cells (RBCs), hemoglobin level, and hematocrit percentage were lower in the hypothyroid group (P=0.001, P=0.003, and P=0.003, respectively). Nevertheless, the number of white blood cells (WBCs) and inflammatory indicators, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were the same in both groups. (Ethic code: IR.MEDILAM.REC.1401.186) Discussion & Conclusion: Although background hypothyroidism had no significant effect on inflammation severity caused by COVID-19; however; it extended hospital stay in these patients. Anemia, a common problem in hypothyroidism, may explain longer hospitalization in hypothyroid COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background and Aim: One of the major challenges in feeding intensive care patients is the appropriate time to start gastrointestinal nutrition. This study aimed to compare the consequences of early and late gastric nutrition in trauma patients under mechanical ventilation in the intensive care unit. Methods: This prospective cohort study was conducted in Zanjan in 2020-2021. In this research, 78 mechanically ventilated trauma patients were selected by convenience sampling. Patients were divided into early and late gastrointestinal nutrition groups according to their feeding time. In these patients, outcome variables, residual gastric volume (within five days), aspiration pneumonia (first, third, and fifth days), and laboratory nutritional indices (first, third, fifth, and tenth) were assessed. Data were analyzed by SPSS v.22 software at the significance level of 0.05. Results: The results of repeated measures ANOVA showed that the gastric residual volume in the early gastrointestinal nutrition group (0) was significantly lower than in the late gastrointestinal nutrition group (11.42 ± 32.28; P<0.001). The pneumonia aspiration with Cochran's Q test did not show a statistically significant difference between the two groups (P<0.05). In addition, comparing the laboratory indicators with repeated measures ANOVA showed that total protein and calcium in the late gastrointestinal nutrition group showed a statistically significant increase. As well, phosphorus, magnesium, and lymphocyte showed a statistically significant increase in the early gastrointestinal nutrition group (P<0.05). However, these indicators did not show clinically significant differences between the two groups. The stepwise multiple regression model results showed the role of disease severity in predicting the laboratory indicators of total protein, calcium, lymphocyte, and phosphorus. Furthermore, consciousness level played a role in predicting the magnesium index. Conclusion: Regarding the effect of early feeding on the remaining volume of the stomach, it is recommended to start early feeding in trauma patients. [ABSTRACT FROM AUTHOR]

Background and Aim: The military structure of military occupations in comparison with civilian occupations puts employees in a variety of stressful situations related to the work, family, and organizational environment. The aim of this study was to investigate the prevalence and stressful sources of militarism in a group of military personnel. Methods: The present research method was descriptive with a cross-sectional design. The sample studied in this study was 300 active military personnel who were selected by the available sampling method. The instrument used in this study was the scale of Azad and Nedaei's (2020) Military Stress Factors Scale. The research questions were answered through statistical methods of frequency distribution, mean and standard deviation, and t-test. Results: The results showed that 61.3% of employees are moderately stressed and 19% of them are exposed to severe stress. Also, the result of the t-test indicates a significant difference between the mean stress of the sample group and the mean of the population. Conclusion: Significant military stressors are ongoing among employees that endanger their mental health. Systematic interventions should be provided to prevent the aggravation of stressors and reduce stress among employees. [ABSTRACT FROM AUTHOR]

Background and aim: It is suggested that hearing impaired children with hearing aids and cochlear implant, showed poor pragmatic abilities. Pragmatic is the most related language component to social interaction. Further, it has effect on personality development and self-esteem. The main aim of the present study is investigating the relationship between pragmatic abilities and self-esteem in hearing impaired children. Materials and methods: sixty hearing impaired children with hearing aids or cochlear implant were included into this study according to inclusion and exclusion criteria. Then parents or other caregivers were asked to fulfill Children’s Communication Checklist (CCC) and self-esteem questionnaire. The participants were divided into three groups based on hearing impairment severity, including: severe, moderate and mild. The relationship between pragmatic ability and self-esteem was examined in three groups and without considering categorization, by Pearson correlation coefficient, significant level was 0.05. Ethical considerations: This project is approved in Arak university of medical sciences with ethical registration code IR.ARAKMU.REC.1399.150. All parents gave written informed consent form. findings: the results illustrated that there is significant relationship between pragmatic abilities and self-esteem in all hearing impairment children without considering categorization (p<0.05). By considering categorization, significant relationship was showed in self-esteem and pragmatic abilities in moderate and mild groups (p<0.05). Conclusion: according to our analysis, pragmatic abilities and self-esteem are related. This relationship is more obvious in low severity impairment. [ABSTRACT FROM AUTHOR]

Background Keratoconus (KCN) is a bilateral, progressive, and non-inflammatory disorder in the cornea, which results in thinning and protrusion of the cornea. Objective This study aims to determine the effectiveness of using pachymetric progression indices (PPIs) in grading the severity of KCN disease. Methods In this study, 76 patients with different stages of KCN were enrolled. The severity of KCN was graded according to maximum keratometry, cornea thickness, and spherical equivalent. The PPIs measured by Pentacam and the demographic characteristics were recorded and their correlation with the severity of KCN was assessed. Results In terms of KCN severity, 18% of patients were at grade 1, 31% at grade 2, 42% at grade 3, and 7% at grade 4. The power of PPIs in predicting KCN grade 4, grade 3 and grade 2 based on the area under the curve ranged from 0.722 to 0.993. Conclusion The PPIs (Minimum, Maximum, Average) can predict the severity of KCN disease with good sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background and Aims: Chronic periodontitis is an inflammatory disease that results from the accumulation of plaque and mass around the gingival tissue. Hypertension is one of the main causes of fertility in the world. The present study aimed to compare periodontal parameters’ means in people with normal blood pressure and hypertension. Material and Methods: This cross-sectional descriptive-analytic study was conducted on patients referred to the Dental School of Golestan University of Medical Sciences. The participants were selected from patients referred to the dental school by convenience sampling method. Firstly, the periodontal parameters including periodontal pocket depth (PPD), clinical attachment loss (CAL), gingival index (GI), and plaque index (PI), were assessed in all of the participants. Then, the patient's blood pressure was measured. Results: Participants in this study were 280 subjects including 102 male and 178 female between the ages of 20 to 50 years with a mean age of 33 ± 7.5. However, the increased means of plaque index, gingival index, and periodontal pocket depth in people with high blood pressure (both systolic and diastolic) compared to normal blood pressure were not statistically significant. Still, the mean of clinical attachment loss was significantly higher in people with high blood pressure (0.79 ± 0.78) than in people with normal blood pressure (0.53 ± 0.57) (P = 0.03). Conclusion: Considering the changes in periodontal parameters in people with high and normal blood pressure and the possibility of a possible relationship between periodontal tissue loss and high blood pressure as a clinical event, the joint efforts of physicians and dentists can be played an effective role in improving community general health. Background and Aims: Chronic periodontitis is an inflammatory disease that results from the accumulation of plaque and mass around the gingival tissue. Hypertension is one of the main causes of fertility in the world. The present study aimed to compare periodontal parameters’ means in people with normal blood pressure and hypertension. Material and Methods: This cross-sectional descriptive-analytic study was conducted on patients referred to the Dental School of Golestan University of Medical Sciences. The participants were selected from patients referred to the dental school by convenience sampling method. Firstly, the periodontal parameters including periodontal pocket depth (PPD), clinical attachment loss (CAL), gingival index (GI), and plaque index (PI), were assessed in all of the participants. Then, the patient's blood pressure was measured. Results: Participants in this study were 280 subjects including 102 male and 178 female between the ages of 20 to 50 years with a mean age of 33 ± 7.5. However, the increased means of plaque index, gingival index, and periodontal pocket depth in people with high blood pressure (both systolic and diastolic) compared to normal blood pressure were not statistically significant. Still, the mean of clinical attachment loss was significantly higher in people with high blood pressure (0.79 ± 0.78) than in people with normal blood pressure (0.53 ± 0.57) (P = 0.03). Conclusion: Considering the changes in periodontal parameters in people with high and normal blood pressure and the possibility of a possible relationship between periodontal tissue loss and high blood pressure as a clinical event, the joint efforts of physicians and dentists can be played an effective role in improving community general health. [ABSTRACT FROM AUTHOR]

Background and Objectives The clinical manifestations of bleeding diseases is very important in terms of proper management and prevention strategies. The aim of this study was to determine the frequency of early clinical manifestations of bleeding diseases in Hamadan. Materials and Methods In this cross-sectional study, 76 patients with hemorrhagic diseases with medical records in Besat Hospital during 2020-2021 in terms of age, sex, type of hemorrhagic disease, the primary clinical manifestations, coagulation factor level, family history of hemophilia, number of blood product injections, receiving way of blood products and illness severity were evaluated. Data were analyzed using chi-square test and SPSS software version 23 Results The mean age of patients was 24.60 ± 15.56 years; 82.92% were male and 17.08% were female. Hematoma (18.42%), petechiae and ecchymosis (18.42%), bleeding after circumcision (18.42%), and nosebleeds(10.50%) were the most common initial manifestations. Hemophilia type A with 67.1% which was severe (66.77%), moderate (14.4%) and mild (18.83%). No significant difference between the severity of hemophilia with the initial manifestations of the disease and the type of product was observed and neither between girls and boys in terms of initial clinical manifestations. Conclusions In this study, the most common BDs in hemophilia occurred within the ages of 1-2 years with Glanzman syndrome the most frequent. Hematoma, petechiae, ecchymosis, and bleeding were the most common occurrences in hemophiliacs. Most of them had a severe form of the disease and in terms of type, severity, and first clinical manifestations of hemophilia the findings were almost similar to the results of other studies. [ABSTRACT FROM AUTHOR]

Background and Aims : Considering the fact that insufficient study has been done on the effect of malocclusion on the quality of life and confidence among Iranian children and the high prevalence of malocclusion in the Iranian population, the purpose of this study was to determine the effect of malocclusion on Oral Health Related Quality of life(OHRQoL) in children aged 8-11 in Tabriz in 2020. Materials and Methods: Five hundred children aged 8-11 participated in this study. Dental Aesthetic Index (DAI) was used to assess the participants’ malocclusion. Furthermore, the participants answered a standardized questionnaire namely child perception questionnaire to determine their social and emotional well-being in relation to the malocclusion. Clinical examinations were performed by the same researcher. One way Anova with LSD follow up tests under SPSS18 software for Windows 10 were utilized for analysis of data. P< 0.05 were considered significant. Results: The study sample consisted of two groups of 216 boys and 284 girls. The results showed that malocclusion had a statistically significant effect on quality of life related to oral health and emotional health of children.(Pvalue<0.05). However, malocclusion did not affect the social health of these children.(p value>0.05) Conclusion: In the present study, the effect of malocclusion on Oral Health Related Quality of Life (OHRQoL) in children aged 8-11 in Tabriz in 2020 was assessed. The results of this study showed malocclusion and its severity has a significant effect on quality of life. It also had an effect on a person's emotional health, but no significant relationship was found between a person's social health and malocclusion. Therefore, in general, it seems that malocclusion had a significant effect on the quality of life and emotional health of individuals, but the social health of children is not affected by malocclusion. [ABSTRACT FROM AUTHOR]

Background & Aims: Sleep and epilepsy are complex interactions and are completely interdependent, so that some patients experience seizures while asleep or deprived of sleep or when waking up, and for some they occur during the day or night (1). The American Psychiatric Association defines sleepiness as symptoms of excessive quantity of sleep (e.g., extended nocturnal sleep or involuntary daytime sleep), deteriorated quality of wakefulness (i.e., sleep propensity during wakefulness as shown by difficulty awakening or inability to remain awake when required), and sleep inertia (i.e., a period of impaired performance and reduced vigilance following awakening from the regular sleep episode or from a nap) (2). Its prevalence is higher in seizures than in the control group (3, 4) and in different groups seizures have been reported between 31 to 60% (5-7). According to common clinical beliefs, sleep disruption can have a significant effect on memory, as REM sleep or slow-wave sleep is essential for optimal cognitive function (3), and excessive daily sleepiness can increase seizures (8, 9) and pain (10) in patients; However, the exact function of sleep remains unclear, and the findings have not always been consistent. These discrepancies require the conduct of research in which, through a comprehensive look, a large number of parameters related to sleepiness are present in seizures. In other words, the heterogeneity of the previous findings highlights the variability of the course of the disease as a result of the interaction of sleepiness and seizures, which makes it necessary to conduct more research to better understand the problems of patients. Therefore, the aim of the present study was to investigate the comorbidity effect of sleepiness and epilepsy on cognitive functions, quality and severity of pain and disease severity markers in patients with epilepsy. Methods: The present research was conducted as a case-control study in 2020 in Shiraz Namazi Hospital. The statistical population of this study included all patients with focal epileptic seizures (temporal lobe epilepsy) (n = 30) and generalized (idiopathic generalized epilepsy) (n = 21) and psychogenic non-epileptic seizures (n = 17) in Shiraz. Through their follow-up treatment process, they referred to the epilepsy and seizure ward of Shiraz Namazi Hospital, from which 68 patients with inclusion criteria were selected through purposive sampling method. According to the inclusion and exclusion criteria, each patient completed a comprehensive list of demographic and clinical variables, the Stanford Sleepiness Scale, the Montreal Cognitive Assessment, the McGill Pain Questionnaire, and the Visual Analogue Scale under the supervision of an on-site clinical psychology PhD student. After collecting research data, patients with seizures were divided into two groups with sleepiness (n = 45) and no sleepiness (n = 23) through a cut score equal to or greater than 3 on the Stanford Sleepiness Scale. Data were analyzed using parametric and non-parametric tests in version 24 of SPSS software. Results: Preliminary findings showed that there was a significant difference between the two groups of patients with epilepsy with and without sleepiness in terms of mean age and frequency of antiepileptic drugs (P <0.05); While there was no difference between the two groups in terms of type of seizure, education, gender, marital status and employment status. In order to investigate the effect of sleepiness on cognitive function and components related to pain quality, multivariate and univariate analysis of covariance was used to control age variables and use antiepileptic drugs. The results showed that patients with sleepiness in functions of language, Abstraction, delayed recall, as well as achieving the overall Montreal Cognitive Assessment score performed worse. These patients had higher sensory perception of pain experience, rated their pain higher, scored higher in pain quality, and chose more words to describe their pain (P<0.05). Evaluations of disease severity markers through nonparametric tests also showed that compared to patients without sleepiness, patients with epilepsy with sleepiness have experienced more pain, more seizures, a higher incidence of comorbid physical diseases, a longer history of psychiatric diagnoses, and they have more concomitant use of antiepileptic and psychiatric drugs (P<0.05). Conclusion: The results showed that patients with epilepsy with sleepiness had lower mean scores on some cognitive subscales than their counterparts without sleepiness; However, the two groups did not differ in terms of spatial visual function, naming, attention, and orientation. Using a methodology similar to this study, Vascouto et al. Found that there was no difference between the two groups of patients with seizures with and without sleepiness in most cognitive components such as attention and spatial visual skills; Only from the point of view of the total score of auditory verbal learning, there is a significant difference (11) that is relatively consistent with the present study. Although more research is needed to draw more detailed discussions, the discrepancies in some findings can be explained by differences in the type of patient samples in the two studies and the reduction in attention and performance resulting from sleepiness. The results also showed that patients with epilepsy with sleepiness compared to their counterparts, evaluated the qualitative dimensions of their pain higher and experienced more severe pain. Consistent with these findings, Gutter et al. Found that sleepiness comorbidity in epileptic seizures leads to increased chronic pain in patients (10) and Jaussent et al. Also reported that chronic pain is a significant predictor of sleepiness (12). In this regard, potential underlying mechanisms such as structural and functional changes in the prefrontal cortex (13), anterior cingulate cortex (14), hippocampus (15), amygdala (16), insula (17), subcortical regions (17) and shock spinal cord passages (18); Neural-glial interactions; Abnormalities in autonomic function and hypothalamic-pituitary-adrenal axis and other biological factors may contribute to the relationship between sleepiness and pain. Finally, the results showed that the frequency of seizures, the presence of comorbidities of physical disease, the history of psychiatric diagnoses and the simultaneous use of antiepileptic and psychiatric drugs in patients with epilepsy with sleepiness were higher than their counterparts. In this regard, Pizzatto et al. (19) and Xu et al. (20) evaluated patients with epileptic seizures and did not find a relationship between daily sleepiness scores and the frequency of seizures. But Lee et al. Showed that the presence of psychiatric symptoms is an independent predictor of sleepiness in patients (21). It seems that sleepiness reduces the ability to control seizures in patients (22) and contributes to their recurrence and worsening of the disease. Disruption of patients' circadian rhythms can also be involved as a consequence of sleepiness; Because circadian rhythms affect the frequency of seizures depending on the epileptogenic region (23,24). According to the findings, measuring sleep habits, sleep hygiene and comorbidity of sleepiness is an unavoidable necessity. In particular, early diagnosis and treatment of comorbid sleepiness and seizures can improve the prognosis and reduce the negative health consequences in patients (25). Lack of objective measurements of sleepiness and self-reported nature of the data are the limitations of the present study. Future studies can complement these findings by using objective measures of sleepiness. Patients with epilepsy with sleepiness have a poorer cognitive and clinical status than their counterparts. [ABSTRACT FROM AUTHOR]

Background & Aims: The new coronavirus, known as severe coronavirus syndrome (SARS-CoV2), is a viral pneumonia caused by an emerging virus that causes Coronavirus Disease 2019 (COVID-19) (1). The etiology and pathology of the disease are not known exactly, but it has been reported to enter host cells by the angiotensin-converting enzyme (ACE2). (2) The range of clinical symptoms of the disease varies from asymptomatic to respiratory failure, which requires mechanical ventilation. These symptoms have been more severe in patients with diabetes and hypertension (1). Detection of COVID-19 is based on RT-PCR (real-time reverse transcription polymerase chain reaction) test of the pharyngeal sample. It has been found that chest CT scans can be useful in diagnosing interstitial pneumonia in patients with suspected COVID-19 (7, 8). Bilateral peripheral GGO involvement is the most common finding on chest CT scan in COVID-19 patients. The appearance of GGO alone or with consolidative opacities was also a common finding in chest CT. Chest CT scan and pathological changes are more severe in patients with diabetes. Diabetes is one of the most common diseases in Iran and the world. This disease is considered as a risk factor in patients with 19-COVID. The risk of severe symptoms and death in diabetic patients with COVID-19 is higher than others. This study aimed to evaluate the differences in the severity of lung involvement in chest CT scan of diabetic and non-diabetic patients with Covid-19. Methods: The present study is a retrospective cross-sectional study that was performed on 148 patients with Covid-19 including 74 diabetic patients and 74 non-diabetic patients admitted to Kosar Hospital in Semnan and Firoozabadi Hospital in Tehran in 2016. Inclusion criteria were confirmation of coronary heart disease, confirmation of diagnosis of diabetes from 5 years ago and use of diabetic drugs in the case group. Demographic information, signs and symptoms, chest CT scan findings and RT-PCR were extracted from patients' medical records. Statistical analysis was performed using SPSS software and the significance level of P was less than 0.05. Results: There was a statistically significant difference between the age of patients with COVID-19 in the two groups of diabetic and non-diabetic patients (p = 0.002). Chest CT scan in diabetic and non-diabetic patients with COVID-19 was 21.44 and 20.04, respectively. There was no statistically significant difference between the chest CT scores of patients with diabetic and non-diabetic groups by sex and age. Conclusion: In the present study, the rate of lung involvement by chest CT scan in 74 diabetic patients with Covid-19 was compared with 74 non-diabetic patients. There was a statistically significant difference between the ages of patients with COVID-19 in both diabetic and non-diabetic patients, so that the mean age of diabetic patients was higher than non-diabetic patients. There was no statistically significant difference between the sex and chest CT scan score of patients with COVID-19 in the two groups of diabetic and non-diabetic patients. The results of the present study showed that the mean age of diabetic patients was higher than non-diabetic patients. The rate of pulmonary involvement in diabetic and non-diabetic patients with COVID-19 was not different and the score of lung CT scan was similar in both groups; In addition, age and gender had no effect on CT scan score. This finding is the most important result of the present study. Pulmonary infiltration may be due to the body's immune response to the virus, and overproduction of inflammatory cytokines, known as cytokine storms, can cause lung damage (15). People with diabetes are affected by low-grade chronic inflammation that may facilitate the cytokine storm, which in turn appears to be the cause of severe cases of COVID-19 (19). IL-6 is the most common marker of inflammation in diabetes mellitus with COVID-19. (20). From these cases, it can be concluded that in diabetic patients, due to the higher level of inflammatory cytokines, lung damage is also expected to increase. Another cause of severe COVID-19 9 and more lung involvement in diabetic patients can be a disorder in the innate immune system of these patients, which increases the risk of infection. Another mechanism in the disorder of the immune system in diabetic patients is the increased adhesion of microorganisms to the cells of diabetic patients; In addition, some Firoozabadi hospital clinical research development unit(FHCRDU),patients with COVID-19 is higher than non-diabetic patients, this difference is not statistically significant. [ABSTRACT FROM AUTHOR]

Background The parents of children with autism spectrum disorder have special challenges and problems with their children’s disorder, so they have more stress in parenting than other parents, also having psychological disorders is very common in these parents. The aim of this study is to evaluate the effect of psychological disorders and parental stress on children with autism spectrum disorder and digestive problems. Materials and Methods: This study was a descriptive-analytical one with a correlation method. Based on the purpose of the study, the statistical population was all parents with children with autism spectrum disorder who were referred to special need schools in Isfahan. 30 participants were chosen using the available sampling method. In this study, SPSS version 22 was used to analyze the data. Results : The results showed that parental stress had no significant effect on gastrointestinal disorders in children with autism and the results showed a positive and significant effect of parental psychological disorders on the severity of gastrointestinal disorders in children with autism. The results showed the effect of psychological disorders of parents that need to be considered as an effective factor in the treatment process of this disease. Conclusion: Factors may contribute to gastrointestinal problems in autistic children, including a variety of gastrointestinal bacteria and gene expression patterns, as well as inadequate dietary fiber, which acts as a natural anti-constipation agent. [ABSTRACT FROM AUTHOR]

Background Anxiety and stress are important risk factors for psycho-somatic disorders like gastrointestinal disorders. The main purpose of this study is to investigate the relationship between anxiety and stress with functional gastrointestinal disorders (FGID). Materials and Methods: This study was a descriptive-analytical one with a correlation method. In this study, 82 patients with FGID who were referred to Noor Hospital of Isfahan in 2019 were selected and evaluated with anxiety and stress scale (HASS) and severity of gastrointestinal symptoms scale. Data were analyzed with descriptive statistics, Pearson correlation, and multivariate regression. Results: The results showed that there was a significant positive relationship between anxiety and stress with the severity of gastrointestinal symptoms in these patients, and anxiety could predict changes in the severity of gastrointestinal symptoms very well. Conclusion: According to the findings of the study on the correlation between anxiety and stress with the severity of gastrointestinal symptoms in patients with functional disorders, in the treatment of these patients should pay attention to the areas of anxiety and stress and minimize these aggravating factors with psychological measures.es. [ABSTRACT FROM AUTHOR]

Background and Aim: Chronic urticaria is a dermal disease with continuous rash, itching or angioedema, papules and inflammatory plaques, which under conditions transformed from the acute phase to the chronic phase, causing depression and anxiety for many years in patients. Chronic urticaria has a significant impact on the quality of life of the patient. The aim of this study was to examined the quality of life and related factors of patients with chronic urticaria in Kurdistan Province. Materials and Methods: This descriptive study was performed on 228 patients referred to the Allergy Clinic of Besat Hospital in 2016 Census sampling method was used for selecting patient/ Information was gathered by using DQLI questionnaire. Then describe the data by frequency and percentage descriptive and quantitative data were calculated with Chi 2 and Spearman correlation, by using SPSS 15. Results: The mean age of participants was 34.81 ± 10.55 years. Data analysis showed that there was a significant correlation between quality of life and gender (p 0.05). Conclusion: The results showed that chronic urticaria has significant effect on patients' quality life. It seems that these patients were psychologically involved and their level of satisfaction of quality life was reduced.

Background Considering the high prevalence of Coronavirus Disease 2019 (COVID-19) and the medical resource constraints, a better understanding of the characteristics of the disease and identifying the factors indicating the severity of the disease can help decide on the allocation of important and limited resources. The current study aimed to investigate the demographic, clinical, laboratory characteristics, and imaging features of critically-ill patients with COVID-19 who were admitted to the Intensive Care Unit )ICU) of 3 hospitals in Rash City, Iran. Objective This retrospective study was performed on 138 patients with COVID-19 who were admitted to the ICU. The study patients’ data, including demographic characteristics, underlying disease, laboratory, imaging findings, and disease outcome were extracted from their records. Methods This retrospective study was performed on 138 patients with COVID-19 who were admitted to ICU. Patient data, including demographic characteristics, underlying disease, laboratory and imaging findings, and disease outcomes, were extracted from patient records. Results In this study, the majority of patients were male and in the age range of 55-69 years. Diabetes mellitus, hypertension, and chronic heart disease were the most common underlying diseases; shortness of breath, fever, and cough were the most common symptoms. Ground glass opacities were the most common sign in lung Computer Tomography (CT) scan and an increase in the level of LDH, ESR, CRP, neutrophil percentage, and lymphopenia were the most common laboratory findings in the study subjects. The mortality rate was equal to 90.58%. Conclusion This study revealed that most patients with severe manifestations of the disease were older, had a history of underlying disease, symptoms of shortness of breath, cough, and fever, and extensive lung involvement in imaging and changes in laboratory results. Mortality remained high despite medical therapy and mechanical ventilation. [ABSTRACT FROM AUTHOR]

Introduction: Parents problems can not only lead to the occurrence or aggravation of their childrens disorders, but also affect their childrens psychological problems. Aim: The purpose of this study was to compare personality disorder symptom in parents of children with autism disorders, attention deficit hyperactivity disorder (ADHD) and normal control. Method: This is a cross-sectional study. The population of this study included all parents of children with autism and ADHD from Tabriz City in year 2020. 130 parents of children with autism, 170 parents of children with ADHD were selected available sampling method and were mached with 273 parents of normal control. All the clinical assessment of autism, ADHD and comorbidities were conducted by child and adolescent psychiatrists. The severity of personality disorder symptom were assessed by Millon Clinical Multiaxial Inventory (MCMI-III). KruskalWallis test using SPSS version 26 software was used for data analysis. Results: According to results of Kruskal-Wallis test, the mean ranking of personality disorders in the three groups respectively were parents of children with autism> parents of children with ADHD> control parents were (p<0.01). Conclusion: Parents of children with autism suffer from higher vulnerability than symptoms of personality disorders compared to parents of children with ADHD. Additional studies are needed to make clinical interventions in parents appropriate to childrens mental disorders. [ABSTRACT FROM AUTHOR]

Introduction: Major depression disorder is one of the most common psychological disorders that is often characterized by anhedonia, low mood, lethargy, distraction, changes in sleep and appetite and suicidal ideation. Aim: The aim of this study was to evaluate the effectiveness of emotional schema therapy on the severity of depression, emotional dysregulation and emotional schemes of patients with major depressive disorder. Method: The present study was an experimental study with a pretest-posttest design with a control group. The study population was patients with depression who referred to health centers in Khoy in 2020. 30 of them were randomly selected and assigned to experimental and control groups. The experimental group underwent 9 one-hour treatment sessions. Data were collected using Beck Depression Questionnaire (BDI-II), Emotional Regulation Questionnaire (ERQ) and Leahy Emotional Schemas Questionnaire (LESS-II). Data collection was analyzed using multivariate analysis of covariance in SPSS-26 software. Results: The results of post-test scores of depression intensity, suppression, reappresial and adaptive and non-adaptive emotional schema showed that there was a significant difference between the experimental and control groups (p<0.001). The effect size of emotional schema therapy was to reduce the severity of depression (0.86), repression (0.63), re-evaluation (0.69), adaptive emotional schemas (0.74) and non-adaptive emotional schemas (0.78). Conclusion: Emotional schema therapy as an emerging emotion-focused therapy can be used as an effective and efficient treatment to reduce depression, emotional dysregulation, and correct emotional schemas. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosis of borderline personality disorder and its severity has always been one of the problems of clinical psychologists and psychiatrists, which is a significant problem for patients with this disorder due to its prevalence and treatment measures. Aim: This study aims to standardize and normalize “Shortened Scale of Borderline Personality Disorder Symptoms List” for the Iranian community to use diagnostic for the severity of borderline personality disorder symptoms and determine its reliability and validity. Method: The design of the present study was content analysis. The statistical population consisted of 214 students of the academic year 2018-2019 of the University of Kurdistan and 25 patients with borderline personality disorder hospitalized from December to February 2018 in Quds Psychiatric Hospital by available sampling method, who responded to a Shortened Scale of Borderline Personality Disorder Symptoms List (Bohas et al., 2007). Data analysis was performed using SPSS-24 software and Cronbach's alpha calculation, confirmatory and exploratory factor analysis. Results: In the exploratory factor analysis, three factors were extracted that in total, these three factors were able to explain 62% of the variance of 23 questions of this questionnaire. The internal consistency of the scale category was also obtained with Cronbach's 0.96 and with the retest method of 0.73, which is desirable. The Varimax wheel matrix showed that all questions could be used. Conclusion: The abbreviated scale of borderline personality disorder symptoms list can be used as a helpful tool in clinical and non-clinical research to diagnose and severity of borderline personality disorder symptoms in Iranian society. [ABSTRACT FROM AUTHOR]

Background: Recognition of influential factors is necessary for predicting the severity of cholecystectomy. We aimed to evaluate the diagnostic power of the proposed scoring system for predicting the severity of laparoscopic cholecystectomy. Materials and Methods: In this cross-sectional study, there were 122 patients who underwent cholecystectomy in Shahid Beheshti Hospital during 2018. Prior to surgery, accurate history, and clinical, laboratory, and ultrasound information were recorded and scored on a checklist. Finally, the difficulty of cholecystectomy was divided into three categories of easy (less than 60 minutes, uncomplicated) and difficult (between 60 and 90 minutes, divided into controllable) and very difficult (between 90 and 120 minutes with uncontrollable complications or open surgery). Data were analyzed in SPSS software, version 22, and the indicators were calculated for the purpose of the study. Results: There were 28 (22.4%) men and 97 (77.6%) women. The mean ± SD ages of the patients in easy and difficult operations were 44.71 ± 13.56 and 44.52. 14.56 years, respectively (p = 0.939). The patients’ sex and history of acute cholecystitis attacks did not have a significant relationship with the difficulty of laparoscopic cholecystectomy (p ≥ 0.05). However, between the palpable gallbladder (p < 0.0001), impacted stone (p < 0.0001), gallbladder wall thickness (p < 0.0001), and body mass index above 30 (p < 0.0001) there was a statistically significant relationship between the difficulty of operation. There was also a significant relationship between AST (p = 0.034), T Bill (p = 0.008) WBC (p < 0.0001), and the difficulty of laparoscopic cholecystectomy, but between ALT (p =0.065), the severity of cholecystectomy was not significantly related. Sensitivity (86%), specificity (58%), positive predictive value (44%) and negative predictive value (91%) were calculated for the scoring system for the difficulty of laparoscopic cholecystectomy. Conclusion: To predict the difficulty of laparoscopic cholecystectomy, we strongly recommend the preoperative scoring system. It is also recommended to conduct further studies on the use of the scoring system during surgery. [ABSTRACT FROM AUTHOR]

Background and Aim: Ankyloglossia is a developmental anomaly of the tongue that restricts the movement of the tongue. The incidence of ankyloglossia ranging from 0.02% to 4.4% in different communities. The present study was performed to determine the prevalence of ankyloglossia in children aged 3-5 years in Sari. Material and Methods: In this study the prevalence of ankyloglossia in 975 children aged 3 to 5 years was investigated. A simple examination was done and the diagnosis of ankyloglossia was based on the presence of a short lingual frenum and Kotlow criteria. Also, the length of the free tongue was measured by a ruler, and based on the measurements, values of 16 mm and above were considered normal and values less than 3 mm were considered severe. The prevalence and severity of ankyloglossia were compared by sex with chi-square or Fisher exact test and normal distribution of quantitative variables was analyzed by the Shapiro-Wilk test. Result: The results showed that the prevalence of ankyloglossia in children aged 3 to 5 years in Sari was 3.6%, of which the prevalence was 2% in girls and 1.6% in boys, and only 0.7% of them had a severe form of this anomaly. Gender and age of children and also the age of the mother at delivery had no significant relationship with the prevalence of ankyloglossia.(P=0.73) and there is no significant different between mother age and ankyloglossia .(P=0.8) Conclusion: As a result of this study, the prevalence of ankyloglossia in children aged 3 to 5 years in Sari was 3.6%, which was higher among girls than boys. [ABSTRACT FROM AUTHOR]

Background: Recently, the prevalence of metabolic syndrome in societies is increasing. In this study, we investigated the association between metabolic syndrome and the severity of chronic obstructive pulmonary disease (COPD) based on the Global Initiative for Chronic Obstructive Lung Disease 2017 (GOLD 2017) criteria for outpatients. Methods: In this cross-sectional study, 96 patients with COPD to Alzahra hospital in Isfahan, Iran, during the years 2016 and 2018 were enrolled. The severity of COPD in patients was determined based on the GOLD 2017 criteria, as well as the frequency of metabolic syndrome. Other factors such as lipid profiles, anthropometric characteristics were evaluated, and the association between severity of COPD and metabolic syndrome with other variables were studied. Findings: The frequency of metabolic syndrome in patients with COPD was 86.5%. The mean of waist circumference, fasting blood sugar (FBS), systolic (SBP) and diastolic blood pressure (DBP), body mass index (BMI), and triglyceride in patients with metabolic syndrome and COPD were significantly higher than patients with COPD without metabolic syndrome (P < 0.050). Moreover, there was no significant relationship between COPD severity and metabolic syndrome (P > 0.050). Conclusion: Metabolic syndrome was not associated with severity of COPD based on our findings, and further studies are needed.

Background and Objectives Vitamin K-dependent clotting factor deficiency (VKCFD) is usually an acquired problem due to liver disease, malabsorption, and overdose of warfarin. In the present paper the significance and role of vitamin K-dependent coagulation factors in menorrhagia were evaluated. Case We present a rare case of 43 year woman with acquired vitamin K deficiency and severe menorrhagia without any gynecological problem. The level of all Vitamin-K dependent coagulation factors, Fctor II, Factor VII, Factor IX, and Factor X decreased. Furthermore, even after multiple administration of Vitamin K and its oral consumption, still the level of coagulation factors and menorrhagia did not ameliorate. Conclusions Acquired VKCFD is one of the rare situations that can be life-threatening. [ABSTRACT FROM AUTHOR]

Background: Sepsis, which is a common inflammatory response to severe infection, is one of the major causes of mortality in hospitalized patients. Sepsis, severe sepsis or sepsis syndrome, and eventually septic shock, may be seen in the development of infection. The aim of this study was to evaluate the short-term and long-term mortality in patients with severe sepsis and septic shock in centers with low antibiotic resistance. Methods: In this cross-sectional study, blood culture samples and peripheral blood samples were taken from all patients for para-clinical tests. The severity of severe sepsis and septic shock was assessed by the APACHE II and SOFA clinical criteria. Sepsis risk factors and primary causes of sepsis were recorded. Results: From 100 patients, 55% had severe sepsis and 45% had septic shock. SOFA24h and SOFA96h scores were significantly higher in patients with septic shock. The most common primary cause of sepsis was related to abdominal infections with a frequency of 42%. The frequency of confirmed positive blood culture was 53%. The most commonly isolated pathogen was E.coli with a frequency of 66%. Short-term mortality was 29% and longterm mortality was 28.2%. Conclusion: The main risk factors affecting the mortality of patients were age-related septic shock, cardiovascular disease; hypertension, immunosuppression, and SOFA score. [ABSTRACT FROM AUTHOR]

Background and purpose: Preeclampsia is a serious condition in pregnancy. Previous studies have shown that NT-pro BNP level is higher in preeclamptic patients than that in pregnant women with normal blood pressure. Severity of preeclampsia is one of the critical factors in managing patients, so, this study aimed at investigating the relationship between the level of NT-pro BNP and severity of preeclampsia. Materials and methods: In this descriptive study, three groups of pregnant women with normal blood pressure (n= 29), non-severe preeclampsia (n= 30), and severe preeclampsia (n=31) were included. Diagnostic criteria and classification of preeclampsia were based on the guideline for hypertension in pregnancy by the American College of Obstetricians and Gynecologists, 2013. The level of NT-pro BNP was measured by ELISA. Data analysis was done applying t-test, fisher test, Kruskal Wallis, and Mann Whitney. Results: The levels of NT-pro BNP were 40±26, 55±33, and 74±37 pg/ml in pregnant women with normal blood pressure, non-severe preeclampsia, and severe preeclampsia, respectively. Significant differences were found between the cases with normal blood pressure and those with severe preeclampsia in the level of NT-pro BNP (P= 0.003). Conclusion: The level of NT-pro BNP in preeclamptic women was higher than that of the pregnant women with normal blood pressure which was correlated with the severity of preeclampsia too. It seems that the level of NT-pro BNP could be used to differentiate severe preeclampsia from non-severe cases.

Background and Aims: Periodontal diseases are prevalent and are not only a threat to oral and dental health of patients and community, but also affect the quality of life associated with oral health. Therefore, the present study aimed to evaluate the effects of non-surgical periodontal therapy on the quality of life associated with oral health in patients with periodontitis and gingivitis. Materials and Methods: 47 patients with gingivitis and moderate to severe chronic periodontitis referred to the periodontology department of Yazd Dental School in 2019 were studied. OHIP-14 validated questionnaire was used to assess the quality of life related to oral health. At the beginning of the study, both groups completed the questionnaire. Then scaling and root planning for periodontitis group and scaling for gingivitis group were done. Patients completed the questionnaires again 9-12 weeks after periodontal treatment. Data were analyzed by SPSS software version 22 using independent T-test, Chi-square, Mann-Whitney and Wilcoxon tests. Results: The mean score of quality of life in patients with gingivitis was 19.18±11.68 before the treatment and 13.26 ±11.41 after treatment. The mean score of quality of life in patients with periodontitis was 23.29±9.80 before treatment and 13.95±9.68 after treatment. All the differences between groups before and after treatment were statistically significant (showing better quality of life after the treatment) (P<0.05). There was no statistically significant difference between the mean score of quality of life related to oral health in the studied patients according to the age and sex (P>0.05). Conclusion: According to the results of this study, treatment of periodontal diseases improves quality of life related to oral health in patients with gingivitis and moderate to severe chronic periodontitis. [ABSTRACT FROM AUTHOR]

Background: Shivering after anesthesia is a common complication that can lead to problems such as increased intraocular and cranial pressure and postoperative pain with increasing oxygen consumption in the body. Considering the importance of controlling postoperative shivering and limiting the use of shiver drug therapy, this study was designed to evaluate the effects of warming intravenous fluids on postoperative shivering in ENT surgery. Methods: This study was a single-blind clinical trial on 70 patients undergoing ENT surgery. Patients were randomly divided into two groups, receiving warmed fluid and fluid intake group with room temperature. The vital signs of the patients were recorded after intubation until recovery at specified intervals. Also, the incidence and severity of chills in patients were investigated and noted. Results: The severity of chills in the experimental and control groups was statistically significant. The use of warm serum significantly reduced shivering in the experimental group (p = 0.006). Conclusion: The infusions of warm fluids help to reduce postoperative shivering. Due to the lack of hemodynamic complications, it is possible to use warm fluids before induction of anesthesia as a safe method. [ABSTRACT FROM AUTHOR]

Background: Considering the potential role of zinc deficiency in the quality of life of patients with cirrhosis and complications of the disease, in the present study we aimed to assess the prevalence of zinc deficiency and its relation to the stage of the disease and complications in the affected patients. Materials and Methods: In this cross-sectional study, 76 patients with cirrhosis from Qom, Iran, were included during a 1-year period. Data including the level of liver stiffness, severity of the liver disease based on Child-Pugh, MELD (Model for End-Stage Liver Disease), APRI (Aspartate aminotransferase to Platelet Ratio Index), AAR (Aspartate aminotransferase to alanine aminotransferase ratio), FIB-4 (Fibrosis-4), and King scoring systems, and complications including hepatic encephalopathy, were collected by a checklist and were analyzed by using SPSS software version 21. Independent samples t test and Pearson correlation coefficient were used appropriately and p < 0.05 was considered significant. Results: Of the 76 patients, 50 were men and 26 were women with a mean age of 49.46 ± 14.53 years and mean liver stiffness of 28.29 ± 16.11 kPa in fibroscan. The mean serum level of zinc was 78.4 ± 18.1 μg/dL, which was significantly higher in patients with child A than patients with child B and C classes (p = 0.007). This finding was significant in other scoring systems including AAR (p = 0.020), KING (p = 0.000), MELD (p = 0.004), and FIB-4 (p = 0.006). No significant relation was detected between serum zinc level and hepatic encephalopathy, bleeding from esophageal varices, and spontaneous bacterial peritonitis. Conclusion: Severity of zinc deficiency is related to the severity of liver cirrhosis but is not related to complications. [ABSTRACT FROM AUTHOR]

Introduction: Neuropathy is one of the most prevalent side effects of type II diabetes mellitus. This disorder is an early complication in type II diabetic patients. Therefore, the present study aimed to determine the prevalence and severity of neuropathy among subjects with type II diabetes. Materials and Methods: The present descriptive-analytical study was carried out on a total of 195 patients with type 2 diabetes in Zahedan, Iran, in 2018 using systematic sampling. To determine the severity of neuropathy, the nerve and muscle measurement tests of electromyography and nerve conduction velocity were performed. Neuropathy was categorized into three sensory, motor, and autosomal groups. Then, the obtained data were analyzed using SPSS software (version 22). Results: The results of the present study showed that the overall prevalence of neuropathy in diabetic patients referring to the diabetic clinic was 42.1% (n=82). Regarding the distribution of neuropathy in patients with type 2 diabetes in Zahedan, 72% (n=59), 24.4% (n=20), and 3.7% (n=3) of the patients were diagnosed with sensory neuropathy, motor neuropathy, and autonomic neuropathy, respectively. There was no significant relationship between the studied variables, such as age, disease duration, blood sugar, triglyceride, and hypertension, with the type of neuropathy. Conclusion: According to the obtained results, the prevalence of neuropathy has been increasing in diabetic patients; therefore, special health planning is required to control diabetes for the reduction of the complications of the disease. It is recommended to provide access to periodic screening methods for patients and individuals at risk with positive family history, previous cardiovascular disease, hypertension, and age of over 30 years. In case diabetes can be better controlled, the associated side effects can be decreased, which in turn can reduce the effects of disability and treatment costs. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate and compare salivary IL6 level in children with early childhood caries, before and 3 months after treatment. Materials & Methods: In this study totally 32 children aged 3 to 6 years (12 without any caries, 10 with mild caries: 1 < dmft < 4, 10 with severe caries: dmft > 5) were included. Salivary samples were taken from all children at least 1 hour after eating food. The group with severe ECC were treated as a full-mouth rehabilitation under general anesthesia. The group with mild ECC were treated in clinic. Group with no ECC followed with no treatment. 3 months after full-mouth rehabalitation, salivary samples gathered again. Data analysis was performed using Kolmogorov-Smirnov, Wilcoxon, Kruskal Wallis tests with SPSS version 22 software. Results: Baseline IL6 was higher in patients with severe ECC (p value = 0.007 and P = 0.001) but there was no statistically significant difference in baseline levels between first two groups. (p value = 0.059). After treatment only severe ECC group had statistically significant difference of salivary IL6 after treatment. (p value = 0.007). Conclusion: Our findings show that salivary IL6 level could be a partial predictor of ECC lesions. Treatment in sever ECC caused statistically significant decrease in IL6 but IL6 change was not significant in mild group. [ABSTRACT FROM AUTHOR]

Background: Neonatal jaundice is an increase in serum bilirubin that is the most common cause of hospitalization in newborn infants. Often the cause of the jaundice is unknown, but many predisposing factors are involved in the development of jaundice. This study was conducted to determine the relationship between the type of delivery and the incidence and severity of jaundice in the neonates. Methods: This descriptive cross-sectional study was performed on 170 newborns in Al-Zahra and Children’s hospitals, Tabriz, Iran in 2016. The data was collected through a questionnaire and included sections: infant information, maternal information, and questions about mother's disease, history of jaundice in the siblings and the type of management. Data were analyzed by appropriate statistical tests and the value of P<0.05 was considered as a meaningful level. Results: A total 170 Infants with jaundice were enrolled that 60.1% were boys and 39.9% girls. The route of delivery were vaginal birth in 39.8% of the patients and 60.2% were delivered by cesarean section. There was a significant relationship between hyperbilirubinemia (10-14.9 mg/dl) and type of delivery (P =0.01). The jaundice was appeared between days 4 to 7 of birth in 41.4% of cases and in 25% of patients was observed in the first 24 hours after birth. The most common blood group among mothers were A and O (35.2%) and their Rh type in 98.8% cases were positive. The gestation age in 70.3% of newborns was ranged from 34 to 37 weeks with a significant correlation with the incidence of jaundice. Conclusion: This study showed, delivery by cesarean section is associated with jaundice in the newborn. Therefore, the promotion of normal vaginal delivery in the country is recommended as a fundamental policy to improve the health of mothers and reduce the rate of cesarean section. [ABSTRACT FROM AUTHOR]

Background and Aim Male Androgenic Alopecia (MAA) is one of the most common causes of hair loss in men. Minoxidil solution is one of the most commonly used medications for MAA treatment; however, it has several cutaneous side effects including itching, scaling and erythema, which cause the discontinuation of its consumption. Methods & Materials In this double-blind randomized clinical trial, 51 males with MAA were treated with 5% minoxidil solution and 7% chamomile extract. At the same time, 49 patients as controls were matched with this group and treated with 5% minoxidil solution alone. Both groups were treated and followed up for 6 months. Ethical Considerations This study has received its ethical approval from the Research Ethics Committee of Arak University of Medical Sciences (code: IR.ARAKMU.REC.1395.456) and is a registered clinical trial (Code: 2017042420258N41). Results In both groups, the severity of itching and scaling gradually decreased. in the control group, erythema increased, while in the chamomile group, erythema also decreased. All three side effects of itching, scaling and erythema were lower in the group treated with chamomile extract and minoxidil solution than in the group used minoxidil solution alone. Conclusion It seems that simultaneous administration of 7% chamomile extract and 5% minoxidil solution leads to a reduction in the severity and duration of cutaneous side effects caused by minoxidil solution use in treatment of MAA. It can increase the patient's compliance to the treatment and eventually the chance of MAA treatment. [ABSTRACT FROM AUTHOR]

Background: Nasal obstruction is one of the common problems of patients. The most common structural cause of it is septal deviation. Septoplasty is the third common head and neck procedure. Splint is one of the most commonly used surgical devices for septal support, prevent adhesion and accelerate mucus healing. However, some studies have shown increased incidence of epistaxis, sleep disturbances, discomfort, PND, infection and perforation in patients using splint. This study was designed to compare the complications of septoplasty with and without nasal splint. Methods: In this study, 48 septoplasty candidates which admitted to Imam Reza Hospital during the second half of 2015 were enrolled. They were divided into two equal groups of intervention (suture) and control (splint). The two groups were evaluated for perforation, hematoma and pain, 2 weeks after surgery. All data was collected and analyzed. Results: The mean age of the patients was 27.65 ± 6.7 years and the sex ratio was 1:1.4. The severity of pain was lower in the intervention group (without splint) based on VAS and VRS (P <0.01). There was no significant difference in the incidence of headache, sleep disturbances, epistaxis and epiphora after surgery in the two groups. Infection, hematoma and perforation of the nasal wall were not recorded in any of the studied groups. Conclusion: The complications due to septoplasty in patients without splint are not more common and the amount of postoperative pain is significantly lower in these patients. Therefore, splint shouldn’t be used in patients who have septoplasty alone. [ABSTRACT FROM AUTHOR]

Background and Aim Obsessive-Compulsive Disorder (OCD) is the fourth most common psychiatric disorder. It consists of symptoms, including intrusive thoughts, rituals, behaviors, preoccupations, and compulsions. This study aimed to evaluate the effectiveness of attention bias modification and selective serotonin reuptake inhibitors in reducing the symptoms of OCD. Methods and Materials study population comprised patients with OCD referring to the outpatient clinic of Amir Kabir Hospital in Arak City, Iran. Of them, 80 patients were randomly assigned to the two groups. The first group received the selective serotonin reuptake inhibitors, and the other group received the treatment modality to determine the effectiveness of the Yale-Brown OCD scale and dot-probe task tests. Ethical Considerations The Research Ethics Committee of Arak University of Medical Sciences approved this study (Research Ethics Code: IR.ARAKMU.REC.1396.284). Results Treatment of attention bias modification in comparison with selective serotonin reuptake inhibitors did not show a significant difference in the reduction of attention bias (P=0.377). Also, a significant difference between the two groups in reducing the symptoms of OCD (P=0.007), indicates that selective serotonin reuptake inhibitors are more effective in diminishing the symptoms of OCD. Besides the attention bias modification decreased the symptoms of OCD, but these results were not significant (P=0.228) Conclusion Attention bias modification is a significant improvement in reducing attention bias and can be used with other interventions. However, it appears that the reduction in the severity of OCD symptoms, as against this intervention, continues to be the preferred treatment for pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background: Leprosy is still a global health problem, especially in developing countries are important, and Iran is an endemic area for leprosy in the Middle East. Leprosy is a disease caused by the intracellular bacterium Mycobacterium leprae, is a chronic infectious disease of humans that causes inflammatory lesions in the skin and peripheral nerves with the granuloma. Numerous studies, the important role of host genetics in susceptibility to leprosy are confirmed. CTLA4 gene is one of the four exons. Polymorphisms have been identified in the CTLA4 gene with susceptibility to a wide range of autoimmune and infectious diseases dependent on T cells are connected. The aim of this study was to investigate the relationship between polymorphisms of CTLA-4 +49 A / G and susceptibility to leprosy and its impact on the type and severity of disease. Methods: In this study, 157 treated leprosy patients living in nursing homes in Tabriz Baba Baghi and 185 healthy human subjects were enrolled as controls. First blood samples (8-10 ml) of patients Gene polymorphism CTLA-4 +49 A / G were determined, and then the genotype frequencies in two groups were compared. In addition, for each patient clinical forms of the disease, the performance, age at onset, duration of illness, symptoms, age, sex and relationship between genotypes and allele polymorphism review was studied. Results: The average age was 11.90 ± 65.87 years and the highest prevalence of leprosy at the age of 16 to 30 years old. The most common side effects of organ failure, neurological diseases, leprosy protests eye and ear, nose and throat incidence was 33%. Conclusion: Gene CTLA-4 (+49 A / G) showed that the frequency of AA greater was than the other two types. [ABSTRACT FROM AUTHOR]

Background: Depression, causes problems in social and individual aspects of life, so is the major disease burden in modern societies. There is complex relationship between personality and depression, so some special forms of personality may predispose the person to the depression, and depression and its symptoms may manifest different as a result of the various personalities. Methods: This research case control study consisted of 128 patients with major depressive disorder and 131 normal people. Data have been collected through TCI questionnaire and Hamilton scale for depression. Results: In patients with major depression the Harm-avoidance, Reward-dependence and persistence, Self- Directedness and Cooperativeness have significant differences with normal people. Patients with major depressive disorder experience high levels of Harm-avoidance and Reward-dependence and Persistence, with low levels of Self-directedness and Cooperativeness than normal people. Conclusion: The depressed patients and normal people are different with temperament and character, and these differences can influence severity of depression. [ABSTRACT FROM AUTHOR]

Introduction: Scoring systems are considered as a guideline for caring personnel in intensive care units (ICU) to evaluate patients’ status or estimate recovery chance. Nine Equivalents of Nursing Manpower Use Score (NEMS) is one of these systems. Considerably, the credits of obtained scores of NEMS in different days after patients’ admission or deciding about current status of patients according to previous scores of NEMS are not clear properly. So, this study was performed to evaluate the mean alteration trends and credit of Nine Equivalents of NEMS in internal patients’ admission in intensive care units. Materials and Methods: In a descriptive-prospective study, the information of 156 patients that admitted in critical care units of Edalatian hospital of Mashhad city, were calculated and recorded until 7 days according to demographic questionnaire and NEMS. A purposeful sampling method was adopted and all eligible patients were included. Then using the ROC curve, the validity of daily NEMS scores of patients were demonstrated. Results: The curve of mean alteration trends of NEMS of expired patients was increased and for discharged patients was decreased during seven days of admission in ICU. Also, the ROC curve showed that with increasing duration of hospital stay, NEMS ability to diagnosis of critically ill patients was improved. Conclusion: The credit of NEMS increases with duration of hospital staying. So, it is suggested when using the NEMS, the scores of final days of hospitalization in ICU be considered more seriously.

Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology) criteria and 2010 ACR/EULAR (European League Against Rheumatism) classification criteria for diagnosis of rheumatoid arthritis. Methods: In this Cohort prospective study, patients with early arthritis were evaluated according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013) in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-cyclic citrullinated peptide (Anti-CCP) and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9%) and 76 females (73.1%) with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA) rather than other arthritis (P=0.0001). Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints involvement was 81% and 59%. The sensitivity, specificity, positive and negative predictive values for 2010 ACR/EULAR criteria were 65%, 40%, 81%, and 23%, respectively. The sensitivity, specificity, positive and negative predictive values for 1987 ACR criteria were 51%, 62%, 83%, and 25% respectively. Conclusion: In comparison to the old diagnostic criteria, the new one has higher sensitivity and lower specificity.

Background: The aim of this study was to develop a therapeutic plan based on hypnotherapy for patients with irritable bowel syndrome (IBS) and determine the effectiveness of this treatment on the intensity of IBS symptoms and rumination of patients with IBS. Materials and Methods: The research design was a quasi-experimental with a pre-test, a post-test, and 3 months of follow-up. Of the patients who were referred to gastroenterology clinics in Tehran, 32 patients with IBS were randomly divided into two groups; hypnotherapy group and control group. Medical treatment along with hypnotherapy was individually conducted for eight sessions in the intervention group and the control group received only medical treatment. IBS Symptom Severity Scale (IBS-SSS) and rumination were completed in pretest, post-test, and follow-up stages by the patients and data were analyzed with repeated measures analysis of variance. Results: The variable scores of symptoms severity and rumination in experimental group was significantly lower than the control group (p < 0.05) and the effect of the therapeutic plan persisted until the follow-up stage. Conclusion: The results showed that hypnotherapy can be an effective treatment for patients with irritable bowel syndrome. Therefore, psychological treatment is essential for the management of these patients. [ABSTRACT FROM AUTHOR]

Background and Aims: The type IV Pilin is an important colonization factor for opportunistic pathogens of Pseudomonas aeruginosa, which plays a role in the formation of biofilms and binding to the host cells. Each type of Pilin is coded with a particular auxiliary gene. This specific relationship can be used as a therapeutic target for detecting P. aeruginosa strains as well as its molecular classification. The purpose of this study was to evaluate the frequency of different types of auxiliary genes in cystic fibrosis, burns, and environmental samples. Materials and Methods: Pseudomonas aeruginosa samples were collected from patients with cystic fibrosis, burns as well as environmental wastewaters during 2016-2017. Samples were cultured and identified using standard microbial and biochemical methods. DNA extraction was performed by boiling and PCR was performed through specific primers. Results: Totally, 90 isolates of P. aeruginosa samples (35 environmental, 30 burns, and 25 cystic fibrosis) were examined. tfpO and tfpZ were positive in 71 and 2 isolates, respectively . Conclusion: The results indicated that Pseudomonas aeruginosa Pilin types are very diverse. Regardless of the source of the samples, the most common tfp was tfpO. Taking into account the fact that tfpZ was found only in burns, it can be assumed that this particular type may appear in severe clinical conditions. Ultimately, larger statistical population and use of more comprehensive typing methods is suggested for better results. [ABSTRACT FROM AUTHOR]