امیر حسین جلالی

Displacement of large vessels is one of the cyanotic diseases of the heart. In this disease, systemic and pulmonary circulation are parallel. The absence of a shunt between these two routes causes premature death of the baby. Congenital heart diseases are more common in babies weighing less than 2500 grams than in the normal population. Low birth weight is an important risk factor for the mortality of newborns, and therefore, the association of abnormality of placement of large vessels with low birth weight makes their treatment management more difficult. In this case report, we describe a newborn with a birth weight of 1450 grams, who underwent surgery for complete transposition of great vessels at 27 days of age.

Most of the emotional disorders and behavioral problems due to the unbalanced and changing situation of the family and social life have affected different groups of children and adolescents. Family  Health problems and deficiencies, displacement of social groups and pressures caused by them, unreasonable population growth, rampant migration and displacement, widespread poverty and addiction, depression, aggression, and the glories of the absence of a guardian in many families, as well as the long-term ignorance of children's parents about the problems they face, Experience and do not update and Lack of sufficient knowledge  about how to manage these issues and many other important issues, have caused the emotional and behavioral disorders of children in this century to reach an unprecedented extent. Therefore, several screening questionnaires around the world have been designed to Screen children in terms of psychosocial and emotional problems and the validity and reliability of the questionnaires have been confirmed.

This study was a test (questionnaire) in which the questionnaires were completed by mothers of children aged 4-11 years, one of whose parents worked in the centers of Tehran Psychiatric Institute, Iran Psychiatric Hospital, and HazratRasoul Hospital. Sampling was selected by a simple non-random sampling method (sample available). Samples were selected from mothers who themselves or their spouses working in Tehran Psychiatric Institute, Iran Psychiatric Hospital, and Hazrat Rasoul Akram Hospital. According to the number of questions in the questionnaire (18 questions), 180 samples were needed to examine the factor structure of the questionnaire. Also, 30 samples were selected from 180 samples to check the reliability of the retest according to the mother's desire and the possibility of attending the retest (which also requires identification of the individual).The PSC questionnaire included questions that focused on internal and external problems and impaired concentration in children and adolescents.The questionnaire has 17 items that are scored under the three headings of "never", "sometimes" and "often". A question has also been added to the questionnaire that includes suicidal ideation and previous suicide attempts. A value of zero was considered for the title "never", a value of one was considered for the title "sometimes" and a value of two was considered for the title "always". By adding the total points, the total score was calculated. Items by the questioner A blank was considered equal to zero. If three or more questions in the questionnaire were not answered, the questionnaire would be removed from the study. The total score was calculated from 0-36. Scores were categorized into three categories: internalized problems, externalized problems, and concentration disorders. The positive items of each category included the total score of each item, which was more than 7.7.5, respectively. Simultaneously with the above questionnaire, SDQ and CSI-IV questionnaires were given to mothers to complete. SDQ Questionnaire is a screening questionnaire of abilities and problems among children and adolescents aged 4-16 years, which is completed by parents and completed by adolescents for the age group of 11-16 years. The questionnaire also provides information on whether the child has problems in these areas and if so, what functional impairments have led to them. This questionnaire was prepared by psychiatrists in the United Kingdom for early screening of psychiatric problems as well as the abilities of children and adolescents. SDQ questionnaire is available on websites and has been translated into 80 living languages of the world. The duration of the questionnaire is about 5-10 minutes and includes 25 questions. All versions of this questionnaire ask about 25 attributes, some positive and some negative. These 25 items are divided into 5 scales. Emotional symptoms (5 items), Behavior problems (5 items), Hyperactivity / Attention Deficit Disorder (5 items), Communication problems related to peers (5 items), Homosexual friendly behaviors (5 items). Another questionnaire used to identify psychiatric disorders in the world is the CSI-IV questionnaire.it was the gold standard test for comparing the results. The parent form of this questionnaire has 98 questions and the teacher form has 87 questions. The disorders that are screened are as follows: Child coping disorder, Behavioral disorder Generalized anxiety disorder, Social phobia, Separation anxiety disorder, Major depressive disorder and Depression, Schizophrenia is a pervasive growth disorder, asperger's, vocal and motor tics.  The time to complete the questionnaire is about 10 minutes.

After translating the questionnaire into Persian and reviewing its content and face validity by 16 psychiatrists and clinical psychologists working in the field of children and adolescents, the results were as follows: They had 94%. Face validity was also checked by the relevant team, which obtained a total of more than 95% of the total face validity questions. In the face validity assessment conducted by ten mothers participating in the project, a total of more than 87% validity was obtained. The reliability indices of the questionnaire and its dimensions were also analyzed and internal consistency or Cronbach's alpha was calculated, which was suitable for all questions and each area separately and more than 0.7. The reliability of the quantitative retest test for 30 participants using the coefficient Spearman correlation was analyzed, which in all cases showed a high correlation. The similarity between the diagnosis was assessed by PSCA tool with SDQ and CSI-VI tools separately using Kappa statistical test, which had diagnostic similarity in ADHD. The similarities between the diagnosis of mood disorders and anxiety by PSCI tool with SDQ and CSI-VI were also examined, according to which PSC was significantly successful in distinguishing SAD (Social anxiety disorder) from CSI-VI questionnaire and emotion disorder from SDQ. There was a significant similarity between the diagnosis of externalizing disorder of PSC with ODD of CSI-VI and the conduct of SDQ. Finally, the similarity between the diagnosis of psychiatric disorders was examined. Due to the lack of a total score in the CSI-VI questionnaire, this study was performed only on PSC and SDQ. Based on this, PSC was able to identify disorders as much as SDQ.

The Persian version of PSC is suitable for early assessment and screening of psychiatric disorders in schools, clinics, and primary health care.

The waiting list is a list of selected patients in the surgical queue. If demand exceeds capacity, the waiting list grows rapidly, which may lead to unacceptable waiting for patients, especially those in need of acute medical care. Patients waiting for heart surgery are placed on the waiting list for surgery, and sometimes the waiting time is longer than patients expect. Reducing the waiting time for medical services, including heart surgery, is one of the challenges of the health system. In this regard, the present study was performed by identifying an effective solution to reduce the queue length of patients undergoing cardiac surgery.

In this article, the process of scheduling open heart surgery at Shahid Rajaei Hospital was reviewed and improved with a discrete event simulation approach in Arena simulation software. After designing the process, the existing bottlenecks leading to the long waiting time of the patients were identified. The waiting time and the number of patients visited were determined as the objective function and the patient flow was improved by presenting improvement scenarios and selecting the best scenario.

Simulation results on 66 selected patients in 7 months from October 2020 to May 27, 2021 show that Scenario number 10 has the most improvement in performance criteria but is not applicable in practice. Therefore, due to system limitations, Scenario 2 was selected as the best scenario. Implementing Scenario 2 could reduce the waiting time by 40 percent and increase the number of patients visited by 21 percent.

Patient prioritization methods allow patients with higher needs to receive more services than those with lower urgent needs, although they also have longer waiting times for patients with lower urgent needs.

The aim of the present study was to assess the knowledge and attitude of patients with gender identity disorder (GID), presenting to Tehran Psychiatric Institute, toward Acquired immunodeficiency Syndrome (AIDS).

58 patients with gender identity disorder (41 female-to-male and 17 male-to-female) were selected using convenience sampling. The subjects completed the questionnaire proposed by Family Health Organization. Subsequent to determining the distribution by statistical methods, data were analyzed using parametric and non-parametric tests suitable for group comparison.

About 70% of the subjects believed that an apparently healthy individual could be infected with human immunodeficiency virus (HIV). Only five subjects (8.6%) considered themselves to be at risk for HIV infection. With regard to routes of transmission, 70% believed anal sex carries lower risk than vaginal sex.

Subjects had a low level of knowledge regarding sexually transmitted diseases. Therefore, all individuals with GID should be provided with sufficient information about AIDS and sexually transmitted diseases.

Introduction &

Dialysis vascular access complications are important causes of morbidity in chronic hemodialysis patients. The aim of the present study was a comparison of auxillary loop and atraight grafts patency and its complications for hemodialysis access.

In this cohort study conducted at Shahid Beheshti Medical University, 58 patients who underwent placement of loop or straight access grafts were included in the study. Demographics, primary and secondary patency rates and complications like thrombosis, infection, bleeding, steal syndrome and other complications were compared in these two groups. The collected data was analyzed by the SPSS statistical software using the chi-square test, t-test, and logistic regression.

Thrombosis rates were 51.1% and 53.8% in straight and loop groups respectively (P=0.862), steal syndrome rates were 2.2% and 7.7% in straight and loop groups respectively (P=0.341), psudoanevrism were 11.1% and 23.1% in straight and loop groups respectively (P=0.270), bleeding rates were 4.4% and 0% in straight and loop groups respectively (P=0.439), infection rate were 8.9% and 7.7% in straight and loop groups respectively (P=0.892), and primary patency rate after 1 month were 88.9% and 92.3% respectively (P=0.721), and primary patency rate after 24 month were 31% and 55.5% respectively (P=0.058). Secondary patency rate after 3 month were 75.6% and 92.3% respectively (P=0.189), and secondary patency rate after 24 month were 37.9% and 66.7% respectively (P=0.044).

PTFE vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, there was no significant different between two groups for complications and early patency, but late patency was better in loop group. More study is necessary for final judgment.