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Oppositional defiant disorder (ODD) can have negative consequences in personal, social, family, and academic dimensions. Thus, it is crucial to find appropriate solutions to improve symptoms and reduce the consequences of this disorder. This study aimed to examine the effect of intensive short term dynamic psychotherapy on clinical symptoms and academic performance in adolescents with ODD using a quasiexperimental pretest-posttest design with a control group. The statistical population included all ODD adolescents in high schools within district 4 of Tehran, from which 30 individuals were purposefully selected and randomly assigned to the experimental and control groups. Intensive short term dynamic psychotherapy was administered to the experimental group, while the control group received no intervention. Data were collected using the Oppositional Defiant Disorder Rating Scale (ODDRS) and the Student Academic Performance Questionnaire (SAPQ), and one way analysis of covariance was used to analyze the data in SPSS-19. The results showed that intensive short term dynamic psychotherapy was effective in improving clinical symptoms and academic performance in adolescents with ODD (p<0.05). Therefore, it can be concluded that ISTDP can improve clinical symptoms and academic performance in male adolescents with ODD. To empower and improve the mental health of individuals with ODD, it is recommended to conduct an educational program based on this treatment in counseling and psychotherapy centers. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematous (SLE) and rheumatoid arthritis (RA) are autoimmune diseases in which the antigen-antibody system plays an important role. As blood group and Rh are determined by the presence or absence of antigens on the surface of red blood cells (RBCs), we aimed to determine the distribution of ABO and Rh blood groups in SLE and RA patients and its association with disease manifestations. Methods: This short communication is based on a study that was conducted on 434 SLE and 828 RA patients. We evaluated the distribution of ABO and Rh blood groups in RA and SLE patients. Results: This study projected that in lupus patients, Coombs-positive autoimmune hemolytic anemia and arthritis were more common among the B blood type and Rh-positive group, respectively. Furthermore, there was no relation between ABO and Rh blood group and rheumatoid factor (RF) and anti-Cyclic Citrullinated Peptide (anti-CCP) seropositivity. Moreover, there was no difference in distribution of blood groups in RA and SLE patients. Conclusion: The higher frequency of blood group B in hemolytic anemia, and positive Rh in arthritis in lupus patients, develop the hypothesis of probable role of ABO blood group antigen in some manifestations of lupus. [ABSTRACT FROM AUTHOR]

Background: Vitamin D has immunomodulatory function. Polymorphisms of the gene encoding the vitamin D receptor detected by BsmI may be source of diversity in its action. An association between vitamin D receptor gene BsmI polymorphisms and lupus nephritis has been reported. This study was performed to evaluate vitamin D receptor gene BsmI polymorphisms in lupus nephritis. Methods: Twenty nine patients with lupus nephritis enrolled in this study. Vitamin D receptor gene typing was performed based on polymerase chain reaction-restriction fragment length polymorphism. Finding: Vitamin D receptor genotyping of BsmI polymorphisms was 20.6% for BB, 51.7% for Bb, and 27.5% for bb without statistically significant difference (P = 0.090). In 21 patients that renal biopsy was done, the Bb genotype was the most (42.8%). There was not any correlation between renal histology and vitamin D receptor gene BsmI polymorphisms (P = 0.068). Conclusion: There was no relationship between vitamin D receptor gene BsmI polymorphisms and lupus nephritis. [ABSTRACT FROM AUTHOR]

Background: Soluble FAS (sFAS) is an apoptosis "programmed cell death" marker and results from shedding of FAS molecules during activation of FAS mediated apoptosis. There are several important reasons that Apoptosis is deregulated in active systemic lupus erythematosus and FAS is over expressed by T-cells; although the role of its soluble form (sFas) is unclear. We have investigated the correlation between serum levels of sFAS and active organ damages in lupus patients. Methods: Our study was performed on 114 systemic lupus erythematosus patients, compared with 50 randomly selected sex-, age- and race-matched healthy controls. The patients were randomly selected in different phases of disease activity. All the physical examinations and laboratory parameters were collected for determination of the SLEDAI index. sFAS, AntidsDNA, C3, and C4 levels were determined using a commercially available ELISA kit. Findings: There was a significant difference between serum levels of sFAS in the case and control groups (P = 0.001). We found a significant correlation coefficient between the sFAS and SLEDAI2K variables (P = 0.001, r= 0.494). It was a significant statistical difference between serum levels of sFAS in patients with rising in amount of proteinuria more than 0.5 g/l in 24h urine sample collection and without it (P = 0.04), and central nervous system (CNS) damage versus normal CNS patients (P = 0.006). It was not difference between sFAS and cardiac damage (P = 0.05) but it was near significant difference. Conclusion: We found a correlation between sFAS serum levels and central nervous system involvement and rising in amounts of proteinuria in systemic lupus erythematosus patients. [ABSTRACT FROM AUTHOR]

Stress is an inevitable part of life. It is a universal phenomenon and general experience of human which is necessary for his/her survival and growth. It affects everyone irrespective of age, gender, race, economical condition or educational level. Although stress can be natural and necessary, if it is strict, continuous and repetitious and an individual is not able to respond to it effectively or if supportive sources are limited, it becomes a negative phenomenon which brings about physical and psychological disorders. The present study aimed to determine occupational stress level and conditions causing stress among nurses of educational hospitals in Qazvin Province. This is a sectional study on 194 nurses working in health care centers of Qazvin Province. Demographic questionnaire and Philip Rice's occupational stress questionnaire were completed by the nurses. In addition, they were requested to answer four more questions about insomnia and then the data was collected and analyzed using SPSS statistical software. Occupational stress has very high prevalence among nurses. The study showed that 91/2% of them experienced high levels of occupational stress. There is a significant relation between wards and occupational stress. In addition, the most important stressors among the nurses were recognized and the ways they respond to them were also studied. Moreover, the relation between the nurses' occupational stress and insomnia was examined. This study showed that the level of occupational stress among nurses was significant and there was a clear and meaningful relation between stress and the ward they work in. Among the stressors were physical tiredness due to work, emergency situations, heavy workloads and performing tasks requiring less knowledge and last but not least having multiple chiefs. It was also found out that nurses' occupational stress played a pivotal role in their insomnia status. [ABSTRACT FROM AUTHOR]

Background: Soluble Fas (sFas) is a marker of apoptosis that appears to increase in the serum of systemic lupus erythematosus patients and may have a correlation with disease activity. The exact role of sFas in apoptosis is not clear. The purpose of this study is to assess the correlation between serum levels of soluble Fas (Apo/1-CD95) and the activity of systemic lupus erythematosus. Patients and Methods: Our study was performed on 114 systemic lupus erythematosus patients who were compared with 50 randomly selected sex, age and race-matched healthy controls. Disease activity was defined according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K). All physical exams and laboratory parameters were collected to determine the SLEDAI. sFas levels were determined using a commercially available ELISA kit. Results: There was a significant difference between serum levels of sFas in the case and control groups (P=0.001). A significant correlation coefficient existed between the sFas and SLEDAI2K variables (P=0.001, r=0.494). Significant statistical difference was found between serum levels of sFas in the active and inactive phases of disease according to SLEDAI= 9 or≥10, (P=0.002). The sFas levels were 270 - 300 pg/mL for SLEDAI≤9 and 355-502 pg/mL for SLEDAI≥10, with a confidence interval of 95%. Conclusion: This study shows a significant elevation of sFas levels in the sera of systemic lupus erythematosus patients with active disease; therefore it can be used as an appropriate marker for evaluation of disease activity. [ABSTRACT FROM AUTHOR]

Introduction: Fractures caused by osteoporosis are prevalent among elderly females, which reduce quality of life significantly. This study aimed at comparing cost-effectiveness of Zoledronic acid in preventing and treating post-menopause osteoporosis as compared with routine medical treatment., Methods: This cost-effectiveness study was carried out retrospectively from the Ministry of Health and insurance organizations perspective. Costs were evaluated based on the cost estimation of a sample of patients. Outcomes were obtained from a systematic review. The Cost-Effectiveness Ratio (CER) and incremental cost-effectiveness ratio (ICER) for outcome of femoral neck Bone Mineral Density (BMD), hip trochanter BMD, total hip BMD and lumbar spine BMD and cost-benefit of consuming Zoledronic Acid were calculated for fracture outcome obtained from reviewing hospital records., Results: The results and the ICER calculated for study outcomes indicated that one percent increase of BMD on femoral neck BMD requires further cost of $386. One percent increase of BMD on hip trochanter BMD requires further cost of $264. One percent increase of BMD on total hip BMD requires further cost of $388, one percent increase of BMD on lumbar spine BMD requires further cost of $347. The Cost Benefit Analysis (CBA) calculated for vertebral and hip fracture, non-vertebral fracture, any clinical fracture, and morphometric fracture for a 36-month period were about 0.82, 0.57, and 1.06, respectively. Vertebral and hip fractures, and non-vertebral fractures or any clinical fracture for a 12-month period were calculated as 1.14 and 0.64, respectively. In other words, Zoledronic acid consumption approach is a cheaper and better approach based on an economic assessment, and it can be considered as a dominant approach., Conclusion: According to the cost-effectiveness of zoledronic acid in the prevention and treatment of osteoporosis in women, despite the costs, it is recommended that insurance coverage for the drug should be considered in the period after menopause and the benefits of this drug. This can reduce the costs imposed on the patients and also it can reduce the economic burden on the community, particularly as a result of the fracture., Competing Interests: There is no conflict of interest to be declared.