سیامک فرخ فرقانی

The present study was conducted with the aim of design the post-traumatic growth pattern in burn patients. The qualitative research method was based on grounded theory, and the statistical population of the research was burn patients who were identified and introduced to the researchers through the support Association for Support of Burned Patients (Phoenix), Shahid Motahari Clinic and Hospital in 2019. The sampling method was initially purposeful and gradually continued as theoretical sampling. Based on the theoretical data saturation method, the sample size was 15 people who were interviewed. The post-traumatic growth questionnaire was used for screening, and those who scored higher than the average in this scale and met other entry criteria were selected. All the interviews were analyzed with Granheim and Landmann content analysis approach and with open, central and selective coding. The findings related to the concepts of post-traumatic growth included the main concepts of positive religious beliefs and a new outlook on life, The second finding in relation to the influencing factors (barriers and facilitators) of post-traumatic growth showed that the barriers include the main concepts of society's reactions, individual limitations, lifestyle disorders and individual mental states, and the facilitators include multifocal support, altruism. , motivation, modeling, mental and social security, dynamic interaction with others. The last finding of the research regarding the process of post-traumatic growth in burn patients showed that this process includes the main concepts of positive developments, spiritual changes and personal strength (resilience). The results of this research can be used as a model for formulating therapeutic and rehabilitation interventions in accordance with the existing cultural context for burn patients.

Burn is one of the traumatic events that causes posttraumatic stress disorder (PTSD). The burn survivors often experience major psychological problems. This study evaluated the effectiveness of psychosocial model-based treatment plan on emotion regulation strategies in people with PTSD after burn injury. The research method was semi experimental with pretest-posttest design with control group. All patients referring to Tehran Shahid Motahari Burn Rescue Hospital participated by using simple random sampling method in 2017. Thirty patients with PTSD diagnosis were selected to the experimental and control groups. The treatment program was conducted during 12 sessions and followed up after two months in the experimental group. The tools of study included a structured diagnostic interview based on the 5th edition of diagnostic and statistical guide (DSM-5), PTSD index (PCL-5) and emotion regulation questionnaire (ERQ). The results were analyzed by multivariate analysis of covariance and t correlation. Findings: The results showed that the treatment program increased the re-evaluation component (as a positive emotion regulation strategy) and decreased repression scores (as a negative strategy) in PTSD patients due to burn injuries and this effect has been lasting for two months. Based on the results, it can be concluded that psychosocial therapeutic program is an effective program for PTSD patients and can affect their emotion regulation strategies.

Objective Because burns are one of the traumatic events that causes Post-Traumatic Stress Disorder (PTSD) and the scar caused by an accident causes changes in the skin and the appearance of the patient, these people will have problems in their social relationships that affect their lives and social skills. Therefore, the present study was conducted with the aim of evaluating the effectiveness of psychosocial model-based treatment plan on social skills of people with PTSD resulting from burn.
Materials & Methods The present study was carried out in two stages. In the first stage, following the review of literature and therapeutic theories and concepts based on the psychosocial perspective, a plan was developed. Then, in order to validate the treatment program, 10 specialists and experts in clinical and health psychology department were consulted to determine the validity of the proposed plan. In the second stage, after designing and validating the program, a quasi-experimental design with pre-test and post-test design with control group was implemented. The statistical population included all female patients referring to Tehran Shahid Motahari Burn Rescue Hospital in 2017. They were evaluated in a two stage sampling. In the first step, according to simple random sampling method, a semi-structured diagnostic interview was conducted based on DSM-5 psychiatric disorders criteria by a clinical psychologist and by performing a PTSD checklist screening. In the second stage based on simple random sampling method, 30 patients were selected from the subjects with PTSD (In each group of 15 people, with a drop in the post-test phase, 13 patients in examination group and 15 in the control group remained). The psychosocial treatment program was conducted in 12 sessions and followed up for two months in the experimental group. Measurement tools including semi-structured diagnostic interviews based on DSM-5, PTSD Checklist-5 (PCL-5) and Social Skills Inventory (SSI) were used to collect data, and the results were analyzed in SPSS V. 22 by performing MANCOVA to examine the effect of intervention and dependent t test on the survival of the treatment.
Results The results showed that the program had acceptable content validity so that the Content Validity Index (CVI) based on the Lawshe method for the treatment program was 0.85 (with a minimum acceptable value of 0.62 for this number of specialists), and the CVI based on the Waltz and Bausell method for the treatment program was 0.92 (The minimum acceptable value is 0.79). Accordingly, the content validity and the CVI of the program are acceptable. The results of the treatment intervention showed that considering the higher mean scores of the experimental group compared to control group in the post-test and follow up stage, the psychosocial model-based program improved social skills, including social expression, emotional expression, social sensitivity, emotional sensitivity, social control, and emotional control in people with PTSD due to burn injuries (P<0.05). The results of t dependent test to determine the survival rate of treatment by comparing pretest and follow-up of the experimental group showed that the effect of the plan on improving social skills remained in the follow-up phase (P<0.05).
Conclusion Based on the results, patients with PTSD due to burned scar have a disadvantage in terms of proper social communication and social skills. Also a psychosocial model-based therapeutic program can effectively improve the social skills of patients with PTSD due to burns

Burn has a major impact on the life quality of patients and disrupts their physical, mental, social and spiritual well-being. The aim of the present study was to investigate the effect of treatment program based on psycho -social model on improving life quality in individuals affected by PTSD resulting from burn. The research method was quasi-experimental with pretest-post-test design with control group. The statistical population included all patients referring to Tehran Shahid Motahari Burn Hospital in 2017. 30 patients with PTSD diagnosis were replaced in two experimental and control groups using a simple randomized sampling method. The research tools were as follows: a diagnostic structured interview based on DSM-5, post-traumatic stress disorder checklist (PCL-5) and World Health Organization Quality of Life Questionnaire (WHOQOL-26). The treatment program was conducted during 12 sessions and was followed up after two months of the experimental group. The results were analyzed using multivariable analysis of covariance and paired-samples T Test. The results of multivariate covariance analysis showed that the F value was significant for dimensions of life quality including physical dimension (F=4.398), mental dimension (F=4.810), social dimension (F=8.120), and then, physical environment (F=10.49) (p≤0.05). Therefore, the treatment program based on psycho-social model is effective on the dimensions of the life quality. The results of dependent t-test were significant to investigate the survival rate of the treatment program. The psycho-social treatment program can be used as an effective and special treatment to improve the life quality of individuals with post-traumatic stress disorder due to burns.

Introduction & Objective: There is frequent patient complain after crooked nose rhinoplasty operations even in apparently straight noses due to remnant of nasal deviations or asymmetries. Authors believe that middle vault skeletal asymmetry can be the source of these deformities. Introducing a practical classification and addressing the corrective plan for each class may help the surgeons to produce more straight noses post-operatively. Fifty-one rhinoplasty cases were selected randomly. Pre-operative pictures of faces and intraoperative pictures of upper lateral cartilages before and after separation from septum were taken. Hundred and two upper lateral cartilages were analyzed for shape, size and curvature of horizontal and vertical sub-units. Five different shapes were found so we divided them to 5 groups according to topographic characteristics of each cartilage. This pragmatic classification will help the surgeon to be more concern about the middle vault and will have a plan to correct each variation.

Introduction & Burns are usually considered as the most violent trauma. Wound healing is a complex process that is usually associated with various growth and biological factors. During the process of wound healing, the dressing used for restoration and repairing tissues of the dermis and epidermis of wound. Medicinal plants provide initial treatment compared to synthetic materials are inexpensive, safe and natural can be a source of useful and effective in the treatment of burns. The aim of this study was to evaluate the effects of Adib Derm on the healing of full- thickness second degree burn wound in Rat.
In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 24 adult male rats with an approximate weight of 250- 300 grams, with deep burns of 2 cm 4×2 dimensions were prepared and divided into 2 groups of 12. We used Adib derm (Adib exir pharmaceutical company - Iranian scholar) in first group and Vaseline gas in the second group (control) to dressing every day until healing is complete and the wound healing process by shooting as every 7 days with Image J, ver. 1.45, (NIH, Maryland, USA) was monitored. On 14 and 28 to determine the amount of collagen and inflammatory cells were sent for pathological sample from burn wounds.
The results showed that during days 7 to 21 in each group reduced wound size (P According to the results of the present study, the effect of this ointment on the recovery of burn wounds was not as much as we expected. Thus, it is suggested that further studies perform with a larger sample size and with the change in the method of dressing and superficial burns.

Facial nerve palsy is very common and all expression muscles of the face are paralyzed as a sequence. Inability to blink, facial asymmetry and oral incontinence following the paralysis leading to physical, psychological and social problems and reduce the quality of life. Paralysis of the oral cavity muscles can interfere with eating, drinking, talking and smiling. Many different types of procedures introduced for reconstruction of movement around orbital or oral cavities in these patients. In the first part of this study we discuss about the etiology and pathophysiology of the entity, signs and symptoms, and also peri-orbital treatments. In this section we review the oral problems and the options for their treatments. Primary repair, using nerve grafts, nerve transfer, regional muscle transfer, free functional muscle transfer accompanied with nerve transfer and static slings are the techniques that will be discussed. Also the maseter nerve as a newly re-introduced nerve transfer for acute and delayed reconstructions will be described.

Facial nerve palsy affects individuals of all ages, races, and sexes. Psychological and functional implications of the paralysis present a devastating management problem to those afflicted. Facial paralysis following trauma, surgery or due to idiopathic (unknown), eye health at risk. The most devastating sequelae of facial nerve paralysis is the loss of eyelid function. The inability to blink and protect the globe can lead to exposure keratitis, corneal abrasion and even the loss of vision. For this reason, treatment of eye complications for facial paralysis is of major importance. Various methods such as medical treatments (botulinum toxin) or surgical (internal or external weights on the upper eyelid or tarsorraphy) are used. So careful planning and long-term it is necessary to revive the eyelids and face. In this study reviews the various eye problems and the way we treat it.

Introduction & Free flaps are one of the procedures used to treat patients that need to plastic surgery. This study was performed to determine the complications of free flaps in patients in Hazrat-e-Fatemeh Hospital in five-year period since 2009 to 2014.
In this observational study that was performed as a cross-sectional descriptive survey, 64 consecutive patients under free flap surgery in Hazrat-e-Fatemeh Hospital in five-year period since 2009 to 2014 were enrolled and the complications of free flaps and contributing factors were determined among them. Data were analyzed using SPSS software, version 19 and chi-square test and analysis of variance was used to express the results.
The findings from the study showed that in patients results in 53 patients (82.8%) was good; in 7 patients (10.9%) percent need repair due to partial necrosis in 2 patients (3.1%) required to remove the flap due to partial necrosis in 2 patients (3.1%) due to the need to remove the complete necrosis flap.
According to the obtained results, it may be concluded that nearly 17 percent of patients under free flap surgery may experience some complications that cause to repair or removal flap which it would have no known contributing factors to be developed.

Introduction & Epidermolysis Bullosa is a group of inherited bullous disorders characterized by massive blistering of the skin developing in response to minor trauma. The presented statistics of this disorder varies a lot in the world and there is not an exact fact about this disease. In a lot of countries¡ there is not an EB patient registry system and all of these patients are not diagnosed and recorded. Since the first steps of EB patients’ registry have been started in Iran¡ we decided to collect¡ analyze and publicize patients’ statistical data in Iran.
After launching a conclusive EB patient data registry system by Burn Research Center of Iran University of Medical Sciences¡ we started to call patients to EB patient health house. Patients’ information such as age¡ gender¡ address¡ educational status¡ parents’ family relation and pathology result were recorded. Then the physician examined the patients’ different parts of the body such as gastrointestinal system¡ teeth damages¡ age damages¡ psychological problems and contracture of upper and lower limbs were registered. This information was analyzed by statistical program.
342 of EB patients have been diagnosed and registered in Iran (4.2 patient in 100.000 person) with an approximately equal ratio between males and females. Most of the patients were in the school age and students and about 11% of them and academic studies. In 82% of them there was a close or far family relation. The majority patients’ diagnosis was based on clinical tests and less than one third had pathological approval¡ among which 78% of the patients were of dystrophic type¡ 10% junctional and about 8% of simplex type. Most of the complications included first dysphasia and in the second place tooth damage.
Based on this study¡ the frequency of EB in Iran is less than other countries. Although¡ the data completion is to be done in order to screen all the patients. The majority of the patients live in Tehran¡ Isfehan¡ Khozestan and Fars and the dystrophic type in Iran is significantly more common with a great difference in comparison to other countries. Patients screening and assessment based on pathology leads to an exact disease type determination. It is considered that gradually¡ registering all the patients¡ the number of simplex type patients is increased.

Addiction to opioid drugs is considered as a problem throughout the world. Addiction can be studied concerning: social, medical and psychological aspects. The social aspect of addiction is quite important. For example, the negative result of addiction test is a requirement for marriage and job by law. On the other hand, frauds in addiction tests have been reported (such as displacement of urine from bladder, alkalization or acidification of urine and taking of diuretics or oral contraceptives). In the present study, two different chronic morphine administration protocols (tolerance and dependency models) were applied. Estrogen and progesterone were given prior and simultaneously with morphine. After the last injection of morphine, urine samples were taken every 6 h for 24 h. Then morphine was quantitatively detected by High Performance Liquid Chromatography (HPLC). Data analysis was performed using two-way ANOVA and repeated measures ANOVA test followed by Student-Newman-Keuls test. Conjugated morphine was measured by the subtraction of free part of morphine from the total one in the urine samples. Our results indicated that prior administration of estrogen and progesterone increased the metabolism of morphine 6 and 12 h after the last injection, while no significant change was detected after 18 and 24 h. In summary, it can be concluded that estrogen and progesterone transiently affect the metabolism of morphine. Thus, the effect of the sex hormones on morphine metabolism is not clinically important.