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Background and Objectives: Brucellosis is considered the leading zoonotic disease of the Middle East. The disease has a wide spectrum of clinical manifestations and can result in complications with severe morbidity. The aim of this study was to evaluate the frequency, distribution and characteristics of arthritis in Iranian children with brucellosis. Design and Setting: A retrospective descriptive study conducted in a referral children center in Tehran from 1997 to 2005. Patients and Methods: Arthritis in children with brucellosis who were admitted to a specialized hospital was detected by clinical signs of the involved joint(s) and characteristics of joint fluid aspiration. Socio-demographic information was recorded. Results: Of 96 patients diagnosed with brucellosis, 24 (25%) had Brucella arthritis 14 (58.3%) males and 10 (41.7%) females. Most common manifestations were fever in 21 patients (87.5%) and fatigue in 18 patients (75%). Monoarthritis was recorded in 15 patients (62.5%) of the cases with involvement of the knee in 8 (45%) and hip in 5 (29%), the ankle in 2 (8%) patients while 9 (37.5%) patients suffered from polyarthritis. None of the patients had axial joints involvement. Seventy-five percent of the subjects (18 patients) were from urban areas and 66.7% (16 patients) had consumed un-pasteurized cheese. Recurrence was not seen in any of the 24 patients who received a combination of co-trimoxazole for 6 weeks and gentamicin for 5 days. Conclusion: Childhood brucellosis is a challenging disease in Iran that has serious complications like arthritis. Therefore all physicians who work in endemic areas should be familiar with this disease and consider the possibility of brucellosis in all children who present with arthritis and arthralgia.

Background: Methotrexate (MTX) and actinomycin D (ActD) have been used as first-line chemotherapy agents in the treatment of low-risk gestational trophoblastic neoplasia (GTN). Although low-risk GTN is considered a curable disease, its reported primary remission rates of 49 to 93% reflect the difficulties of treatment and different factors influencing it. Hence, this study aimed to determine the remission rates and related factors of single-agent chemotherapy resistance in low-risk GTN patients. Methods: This retrospective study included patients with diagnosed low-risk GTN who received either MTX once a week (IM, 30mg/m²) or ActD once every two weeks (pulsed IV, 1.25mg/m²). Then, the patients were followed-up until complete remission or single-agent treatment failure to assess resistance rate and related factors. Results: Eighty-four patients were included in the study (18 patients were receiving MTX and 66 patients were receiving ActD). 85.7% of all participants achieved complete remission after first-line chemotherapy (72.2% in MTX vs 89.4% in ActD). There was a significant association for higher tumor size (P=0.046), the occurrence of metastasis (P=0.019), and pretreatment β-HCG levels (P=0.005) with resistance to treatment. Conclusion: This study demonstrated higher tumor size, the occurrence of metastasis, and pretreatment β-HCG levels have been associated with increased resistance to first-line chemotherapy agents. [ABSTRACT FROM AUTHOR]

Background and Objectives: Multiple sclerosis is a common neurological disease that typically manifests itself in advanced and chronic stages. The unknown nature of the etiology of this disease is a big problem. The current study was carried out to evaluate the efficacy of acceptance and commitment based study on psychological issues like anxiety, depression and rumination in a 13 and a 16 year old adolescents with multiple sclerosis. Materials and Methods: The present study was a single case of multiple baseline type of treatment process. Participants in this study were patients who referred to the Hamadan Child and Adolescent Psychological Clinic in the summer of 1399 and in addition to MS suffered from significant psychological disorders such as anxiety, depression and rumination. The study sample consisted of 2 adolescents 13 and 16 years old with MS who volunteered to participate in this study. According to the ethical criteria after the study, members of the control group also received the independent variable (acceptance and commitment-based education) during 8 sessions. Beck Depression Inventory (2000) and Beck Anxiety Inventory (1988) and the Nolen-Hoxima (1991) Ruminant Response Scale were assessed in ten sessions before treatment, at the end of each treatment session, and after the last session. Results: The results showed that the rate of improvement in anxiety after 8 sessions of treatment for the first client was 42% and the rate of recovery for the second client was 47% and the overall recovery rate for both clients was 44.5%. The rate of recovery of depression for the first and second clients was 0.50, 0.50 and 0.6%, respectively, and the rate of overall recovery was 65.06%, the rate of recovery for the first client was 65%, and for the second client was 58%, and the overall recovery rate was 61.5% (P < 0.001). Conclusions: The results of the study of these two subjects indicated the clinical effectiveness of acceptance and commitment therapy on the subjects' anxiety, depression and rumination approaches. Finally, it can be said that this method of treatment is effective and to further evaluate its effectiveness, controlled evaluation studies are needed to achieve a definitive result. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to determine the effectiveness of impulse control training and dialectical behavioral therapy on unplanned, motor and cognitive impulsivity in adolescent girls with disordered mood disorders. Materials and Methods: The present study is a quasi experimental study with two experimental groups and one control group. The statistical population of the present study was girls with disordered mood disorder who were available in each group of 7 patients after diagnosis. Measurement tools included clinical interview based on DSM-5 and bart (1994) impulsivity scale. During this period, the control group did not receive any intervention. The results were analyzed using multivariate analysis of covariance. Results: The results showed that there was a significant difference between the mean scores of the impulsivity subscales of the experimental group of impulse control and dialectical behavior therapy with the control group (P < 0.001). There is a significant difference dialectically (P < 0.001). Conclusions: In the field of treatment and work with people who are in a state of crisis and impulsivity, impulse control and dialectical behavior therapy, considering its nature, seems to be very effective and promising. [ABSTRACT FROM AUTHOR]

Background: Patients need peace of mind to disclose their information to medical staff and with the lack of trust or in specific health status, they may avoid providing sensitive information for their care or might change the information. This research was done to examine the impact of perceived health status and trust propensity on privacy calculus. Methods: In this analytical research three questionnaires, namely Trust Propensity, Health Status (Goldberg and Hiller), and Privacy Calculus were used. The statistical population consisted of the patients of one of the Ahvaz hospitals. Following sample size determination using the Morgan table, 379 usable questionnaires were collected non-randomly. The majority of respondents were younger than 30 and male. After face, content, and construct validities, the reliability was examined through Cronbach’s alpha and composite reliability and the hypotheses were examined by partial least square method, using SmartPLS. Results: Patients’ privacy calculus was associated with trust propensity and perceived health status (P<0.05), while trust propensity had no correlation with perceived advantages and disadvantages of privacy disclosure. The relationship between perceived health status and advantages and disadvantages of information disclosure was positively significant (P<0.05). Conclusion: In order to improve patients’ provision of rich information to medical staff, their trust propensity should be improved. [ABSTRACT FROM AUTHOR]

Meta-cognition is one of the high cognitive processes of brain which has positive relationship with other cognitive capacities and is considered as a predisposing factor in lots of psychopathologies. The aim of the present study was to examine the relationship between meta-cognition and anxiety and depression in the mothers of children with mental disorders. It was a study conducted on the mothers of 2 to 14 year-old children. 143 mothers with mental disorders (developmental disorders and disruptive behavior disorders) were selected through purposive sampling. They were assessed using meta-cognitive beliefs questionnaire, Spielberger anxiety questionnaire, and Beck depression inventory-II. Data analysis showed that there was a significant difference in the rate of anxiety, depression and meta-cognition among the mothers of children with mental disorders. Psychological health of these mothers was low so the use of a systemic approach will be useful in solving the problems of such families. [ABSTRACT FROM AUTHOR]

Adjustment disorders are disorders that a person cannot match with a traumatic event. People with depression, anxiety disorder and depression are susceptible to abusive behaviors, therefore, this study aimed to investigate the effect of group behavioral activation on depression, anxiety and stress in adjustment disorders by using a single case design. Three chronic patients who met DSM-5 criteria for adjustment disorders were treated according to the treatment manual of group behavioral activation therapy. The treatment outcome was measured before, during and after the treatment using depression anxiety stress scales. The results revealed this treatment in reducing the symptoms of depression, anxiety and stress was effective. The baseline scores of depression, anxiety, and stress in the first patient were 24.73, 17.54, and 28.70, respectively; the improvement rate in each of the subscales was 62%, 71% and 63%, and the overall improvement in the three subscales was 65%. For the second patient, the baseline scores of depression, anxiety, and stress were 27.73, 17.37, and 29.01, respectively; the improvement rate in each of the subscales was 54%, 68% and 59%, and the overall improvement in the three subscales was 60%. The improvement rate of the third patient was higher than that of the first and the second patients. The improvement rate in depression, anxiety, and stress was 61%, 60% and 67%, and the overall improvement in the three subscales was 63%. The overall improvement of the research variables was 62%. The results of these three patients indicated that the clinical effect of group behavioral activation therapy in treating the symptoms of depression, anxiety and stress in patients with adjustment disorder and marital problems. [ABSTRACT FROM AUTHOR]

The negative mood affectivity is the psychological consequences of parents who having children with special needs. The aim of present study was comparing the effectiveness of dialectical behavior therapy and cognitive behavioral therapy on the regulation of the negative mood affectivity (depression, anxiety, and stress symptoms) among mothers having children with special needs. This quasi-experimental study was done with 24 mothers of children admitted to the rehabilitation center for persons with physical and mental disabilities who were diagnosed with depression, anxiety, and stress. Then, the participants were assigned into three groups: the dialectical therapy group, the cognitive behavioral therapy group, and the control group. The results showed that dialectical therapy was more effective in decreasing emotional disorders of mothers compared with cognitive behavior therapy, and both of them are better than control group. Therefore, it could be concluded that both interventions are beneficial for mothers whose children's disabilities, special needs, or disorders affect their mental health. Thus, the mentioned therapies are recommended for these mothers. [ABSTRACT FROM AUTHOR]

Caring of children with psychiatric disorders have significant impact on caregivers especially mothers. So aim of this study was to investigate efficacy of impulse control training on depression and anxiety in mothers of children with developmental coordination disorders (DCD). The study is quasi-experimental by using pretest and posttest with control group. The study population consisted of mothers and children with developmental coordination disorder in rehabilitation clinics in the Hamedan city. Of these 16 participants assigned to experimental and control groups were selected by convenience sampling. Psychological evaluation includes clinical interviews, according to the America Psychological Association and DSM-V Beck Anxiety Inventory (BDI-II) and Beck Depression Inventory (BAI). Impulse control was done according to Spray treatment protocol in the experimental group with 8 sessions of 90 minutes and the control group received no training. Scores of pretest, posttest and followup of 3 weeks after training in both groups were analyzed. Results showed that treatment of impulse control in reducing anxiety 8.71 and depression 10.46 in experimental group was effective in comparison of control group that efficacy of this treatment was maintained during follow-up. So the treatment of impulse control has been effective in the treatment of anxiety and depression. According to results of this study and previous researches impulse control treatment program can be program of interventions for depression and anxiety disorders and can promote mental health in patients with psychiatric disorders. [ABSTRACT FROM AUTHOR]

However, having a baby brings positive emotions such as happiness, sense of maturity and proud, parenting's issue could cause high level of stress and child's characteristics was a detrimental factor which can effect on parent's stress, so the aim of this research was comparison of stress of caring in mothers of children with developmental, external, and internal disorders and normal children. The study population included all mothers of children with developmental, emotional, and disruptive behavior disorders, and mothers with normal children in Hamadan (a city in Iran). 240 mothers (4 groups include 60 mothers) were chosen based on simple random sampling. Family inventory of life events and changes Mc Cubbin, Patterson & Wilson was used for assessing participants. The results showed that maternal stress in mothers with children who have diagnosis of disruptive behavior disorders were significantly more than of mothers of children with developmental disorders, emotional and mothers of normal children. The present study showed that disruptive behavior disorders in children have a greater impact on their mothers. So, we suggest approved psychological interventions for helping mothers of children with psychological problems, particularly children with external disorders. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this pilot study was to determine whether the MRI and biomarkers human epididymis protein 4 (HE4) and CA125 correlate with depth of myometrial invasion, histologic grade, cervical involvement and nodal metastases in patients with endometrioid adenocarcinoma of the uterus. Materials and methods: This was a prospective, observational study in women with biopsy-proven endometrial adenocarcinoma of the uterus. Preoperative pelvic MRI was performed and concentration of HE4 and CA125 were assessed before surgery. All surgical specimens were reviewed by a single expert pathologist. The results were compared with the final histopathology report of surgical staging. Results: Included were a total of 68 women with endometrioid adenocarcinoma of the uterus, most (76%) with stage I disease. Levels of serum HE4 greater than 140PM and CA125 greater than 35 ku/L were observed in 12 (17%) and 26 (38.2%) of patients respectively whose greater proportion were cases with deep myometrial invasion and high grade tumor. In the evaluation of deep tumoral invasion (> 50%) of the myometrium sensitivity, specificity, and diagnostic accuracy of MRI were 68.9%, 94.8% and 83.8% respectively. For lymph node involvement these values were 50%, 95.1% and 91.1% respectively and for cervical stromal involvement were 64.3%, 98.1% and 91.1% respectively. Conclusion: Higher stage, deep myometrial invasion, and lymph node or cervical stromal involvement increase diagnostic accuracy of MRI. Higher levels of HE4 and CA125 were observed in patients with deep myometrial invasion and higher grade of tumor. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine the rate and clinico-Pathological characteristics of ovarian metastasis of endometriod type endometrial cancer. Materials and Methods: A retrospective study of all patients with endometriod type endometrial cancer was carried out during 1990-2009. Chi-square and Fisher's Exact tests were used to analyze all the variables. P ≤ 0.05 was considered statistically significant. SPSS software (version 18), was used for statistical analysis of the data obtained. Results: Two hundred and ten patients fulfilled the inclusion criteria. Only 17 (8%) cases were identified to have ovarian metastasis. Fisher's Exact test showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included pathologic grading and depth of myometrial invasion (p<0.001 and p<0.02, respectively). Conclusion: The risk of ovarian metastasis in the patients with well to moderately differentiated endometriod type endometrial cancer and myometrial invasion limited to less than one half of the myometrium is minimal. Therefore, it is possible to preserve ovaries in young women with early stage endometrioid type endometrial carcinoma, but it is better to remove and freeze ovarian tissue to save fertility without the recurrence risk of ovarian cancer. [ABSTRACT FROM AUTHOR]

Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE). In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test. Methods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Valie- Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this crosssectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease. Results: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low first minute Apgar scores had the highest independent risk for hearing loss among newborn. Conclusion: Despite of the low prevalence of neonatal hearing loss, screening of hearing loss at early stages is important. [ABSTRACT FROM AUTHOR]

Background: Recently preoperative hematologic parameters have attracted attention for their capacity to predict tumor characteristics and recurrence. Considering the established role of tumor-associated macrophages (TAM) in the tumor microenvironment, we evaluated the role of the preoperative monocyte count as a surrogate for TAM. Methods: We retrospectively reviewed 166 patients with histopathologically proven endometrial cancers from January 2011 to March 2015 and assessed any association of preoperative monocyte count with tumor characteristics and recurrence. Results: The majority of patients had tumors with the following characteristics: endometrioid histology (83.1%), low grade (grade I-II, 71.7%) and stage I disease (68.1%). The mean ± SD monocyte, neutrophil and platelet counts were 8.23 x 109/L ± 3.56 x 109/L, 64.0 x 109/L ± 11.3 x 109/L and 261.6 x 109/L ± 74.6 x 109. Statistically significant associations were noted with between preoperative monocyte count and tumor stage (p value=0.044), recurrence (p value<0.001) and omentum involvement (p value< 0.001) but not with tumor grade (p value=0.897), depth of myometrium involvement (p value=0.479), lymphovascular space invasion (p value=0.269) and lymph node involvement (p value=0.377). Conclusion: An elevated preoperative monocyte count is related to more aggressive tumors and a higher recurrence rate in patients with endometrial cancer., (Creative Commons Attribution License)

Background: The purpose of this study was to examine the rate and clinico-Pathological characteristics of ovarian metastasis of endometriod type endometrial cancer., Materials and Methods: A retrospective study of all patients with endometriod type endometrial cancer was carried out during 1990-2009. Chi-square and Fisher's Exact tests were used to analyze all the variables. P ≤ 0.05 was considered statistically significant. SPSS software (version 18), was used for statistical analysis of the data obtained., Results: Two hundred and ten patients fulfilled the inclusion criteria. Only 17 (8%) cases were identified to have ovarian metastasis. Fisher's Exact test showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included pathologic grading and depth of myometrial invasion (p<0.001 and p<0.02, respectively)., Conclusion: The risk of ovarian metastasis in the patients with well to moderately differentiated endometriod type endometrial cancer and myometrial invasion limited to less than one half of the myometrium is minimal. Therefore, it is possible to preserve ovaries in young women with early stage endometrioid type endometrial carcinoma, but it is better to remove and freeze ovarian tissue to save fertility without the recurrence risk of ovarian cancer.