فهرست مطالب ali reza shafiee

Diplomacy is a peaceful solution to achieve the goals and national interests of countries at the lowest possible cost, and if the principles of its use are well observed, it will achieve to the goals. nowadays, the use of cyberspace in the field of diplomacy has been considered by different countries. current study was conducted with the aim to identify the components of public-defense diplomacy of the I.R.I with an emphasis on the cyberspace in both formal and informal areas and by asking the question, what are the official and informal factors influencing the components of the public-defense diplomacy of the I.R.I with an emphasis on the cyberspace? The statistical population includes Experts who are knowledgeable about diplomacy and cyberspace issues, who are aristocracy in the defense field. This research is of applied type and has been collected in a field method through questionnaires, library documents and Internet sites. The results show that in the field of formal diplomacy to hold online defense courses, strengthen defense diplomacy and convince neighboring and rival countries from the context of cyberspace have the most effective and in the field of informal diplomacy, the dissemination of defense information by observing the principles of protection in order to deterrence, the broadcasting of defense programs on the official website of the Ministry of Defense and the critique of defense and military policies of neighboring countries and the regions, from the perspective of the statistical community in this research, have a higher priority.

Surgical treatment of basicervical femoral neck fractures, which is biomechanically similar to intertrochanteric fractures, is an internal fixation by DHS and anti-rotation screw. Since devise failure is one of the most noticeable complications of these surgical procedures, this study aimed to compare the bipolar Hemi-arthroplasty with DHS plate internal fixation in elderly patients with a basicervical femoral neck fracture.

This is a randomized controlled clinical trial in which 60 patients with femoral neck fractures were divided into two groups of 30 control (DHS fixation) and intervention (Bipolar hemiarthroplasty) randomly. Functional evaluation was completed by the HHS questionnaire and VAS scale for pain assessment, postoperative complications at 6 months and one year postoperatively. Data were analyzed using Stata software.

The overall mean age in the control group was 73.95± 9.85 and in the intervention group 74.22±7.85 years. Three patients in the intervention group and 6 patients in the control group were excluded. HHS in Sixth months and one year after surgery were significantly higher in the bipolar group compared to the DHS group(p-value<0.0003and p-value < 0.0097). there were no significant differences in VAS between the two groups (p-value<0.4557 and p-value < 0.4578).The rate of device failure in the control group was 2 cases.

Overall, the results of this study show that bipolar hemiarthroplasty surgery is more effective than internal fixation by DHS plate in improving the patients' quality of life based on the HHS scores, and the lower failure rate as well as diminishing of the reoperation rate.

Open wedge high tibial osteotomy (OWHTO) is commonly utilized to correct genu varum. To decrease various complications of OWHTO, some modifications are needed.

In a parallel randomized controlled clinical trial, 42 patients were divided into two groups: conventional OWHTO (control group) and OWHTO with the cut in the sagittal plane or distal tubercle osteotomy (OWHTO/DTO) (intervention group). Evaluation of the following items was conducted pre- and post-operatively: Knee Society Score (KSS) questionnaire, incidence of postoperative complications, patellar height by Blackburne-Peel (BP) ratio and Insall-Salvati Index (ISI), posterior tibial slope (PTS), tibiofemoral angle (TFA), Q-angle, medial proximal tibial angle (MPTA), three joint alignment radiography, and union radiological parameters

The differences between preoperative and postoperative variables including the KSS, PTS, TFA, BP Index (BPI), ISI, MPTA, and Q-angle within the intervention and control groups were not statistically significant. In four cases (3 in the control group and 1 in the intervention group), the delayed union was observed but the complete union was achieved after a mean of 23 weeks. No nonunion was observed.

Our results showed equal effectiveness for OWHTO/DTO compared with the conventional OWHTO.

The purpose of this double-blind randomized clinical trial study was the evaluation of intravenous tranexamic acid on hemorrhage volume during Surgery and surgeon's satisfaction in intertrochanteric fracture surgery.

A total of 62 intertrochanteric fractures (AO class 1 to 3) were randomly divided into two groups of 31. In the control group patients (69.2± 6.1 years old) treated with placebo and the intervention group receiving1gr tranexamic acid (69.7± 6.4) have exposed under the surgical operation by lateral approach and proximal femur’s plates., the amount of gauze and post operative blood losses measured with the amount of blood in the drain 48 hours after surgery. Also the hemoglobin levels compared before and after surgery. In the end, Surgeon satisfaction was measured by Likert scale.

The amount of intraoperative bleeding in suctiondid not differ statistically between the arms (P-value = 0.465).Furthermore, the mean of gauze number in the intervention group was significantly lower than the control group (P-value <0.05). although  the mean amount of blood in the drain 48 hours after surgery in the control group was higher than the intervention group B, but it was not statistically significant (P-value = 0.05). The mean of hemoglobin in the control group was significantly lower than group B (P-value <0.05).the proportion of patients in need of transfusion in the control group was significantly higher than the intervention group (P-value <0.005). Mean of satisfaction in the intervention group was significantly higher than the other arm (P-value <0.05).

The evaluation of intravenous tranexamic acid duringintertrochanteric fracture surgery can reduce hemorrhage volume during Surgery, reduce the need ofblood products’ transfusionand finally improve surgeon satisfaction.

Methamphetamine consumption is associated with cognitive and neuropsychological damage. Determining the effect of this substance on the activities and characteristics of the human brain can lead to the prevention and treatment of complications caused by abuse. There are diverse chemical formulas in Iran with unknown properties. Moreover, few studies have focused on electrophysiological changes in this field which accounts for a robust study in Iran.

In this descriptive-analytic study, 18 recently abstinent methamphetamine dependent individuals with the matched non-user counterparts were recruited. Brain signals were recorded through EEG with open eyes. Absolute and relative power values were calculated based on frontal, parietal, temporal and occipital regions for each group.

Remarkably, it was revealed that absolute power values were lower in Cz, Pz and Fz electrodes in terms of four frequency bands in delta and theta waves (p = 0.01). Interestingly, relative power values were lower among methamphetamine users in delta and theta frequency bands compared to the control group.

methamphetamine users have more decreased delta, theta and beta frequency bands especially at parietal regions. Chemical or subtle structural changes may be responsible for this result (p = 0.048).

Multiple sclerosis (MS) is a chronic inflammatory disease characterized by central nervous system lesions that can lead to severe cognitive and physical disability, as well as neurological deficits such as attention and memory decline. The complications may bring about many difficulties for patients in educational and occupational functioning and low quality of life. Considering the remarkable prevalence of cognitive deficits and its important effects on the occupational and social functioning of MSpatients, this study was conducted to investigate cognitive deficits in these patients compared to a control group. This case-control study was carried out on 34 MS patients selected from among patients admitted to Imam Reza Hospital and Razi Psychiatric Hospital in Tabriz, Iran. Moreover, a control group of 34 age and gender-matched patients admitted to internal wards was formed. The Persian version of the paper and pencil cognitive assessment package (PCAP) was used to assess cognitive functions. Data analysis was performed using SPSS version 22 software through descriptive statistics (mean and standard deviation) and inferential statistics (Student t-test and Pearson’s correlation test). A P value of < 0.05 was considered statistically significant. The results of t-test showed that MS patients had lower PCAP mean scores than the control group in cognitive functions (executive function, attention, focus and work memory) (P < 0.05). The findings of this preliminary study confirmed that MS patients suffered from cognitive impairments. The assessment of cognitive functions must be done in MS patients. Cognitive enhancement therapy would be helpful for afflicted patients.

The purpose of this study was to investigate the association of socioeconomic status and dimensions of mental health with suicidal tendency among students of the University of Tabriz, Iran. The present descriptive and correlational study was conducted on 900 students of the University of Tabriz in the academic year of 2016-2017. The study tools included the Beck Scale for Suicidal Ideation (BSSI), Symptom Checklist-90-Revised (SCL-90-R), and Socio-Economic Status Questionnaire (SESQ) of Ghodratnama et al. Correlation results showed that depression (r = 0.514, P < 0.01), psychoticism (r = 0.478, P < 0.01), and obsessive-compulsive disorder (OCD) (r = 0.463, P < 0.01), respectively, had the highest correlation with suicidal ideations. Somatization was also correlated with suicidal ideations (r = 0.231, P < 0.05). Of the components of socioeconomic status, income (r = -0.401, P < 0.01), and the economic class component (r = -0.321, P < 0.05) had the highest correlation coefficients, respectively. Results of regression analysis indicated that the mental health variable predicted suicide in merely 58.6% of people. Moreover, with the addition of the socioeconomic status variable to the equation, both variables predicted an average of 71.6% of the overall suicidal ideations among individuals. Results indicated that mental health difficulties and socioeconomic problems might have a negative impact on the development of suicidal thoughts. Therefore, it is highly recommended that students’ mental health and social/financial problems be taken into consideration by educational managers responsible in universities, a mission that would be included in curriculum plans.

Diabetes mellitus type 2 is a chronic disease which may lead to development of serious complications. These complications increase the burden of disease and decrease the quality of life in affected patients. The purpose of this study was to examine the eight dimensions of quality of life and general health in women with type 2 diabetes in Tabriz. Material and Methods: In this cross-sectional descriptive study, the study population consisted of all female patients with type 2 diabetes. Sample size included 300 participants who were selected based on cluster sampling method. The study tool was General Health Questionnaire and Health Survey of Weir and Sherburne SF-36. Non-parametric binomial test was used to analyze the data. Based on the results, 58% of women with type 2 diabetes had mental disorders. The results also showed that 6% of women with type 2 diabetes had severe physical symptoms, 9% anxiety, 2% social dysfunction and 1% depression. The mean of quality of life components for physical function was 57.30, physical role 57.89, emotional role 57.54, vitality 56.08, mental health 60.29, social function 63.97, physical pain 56.91 and 53.16 for general health. Diabetes is a chronic disease which affects the patients’ mental health. Therefore, their mental health status should be evaluated in the diabetes treatment programs by practitioners.  

Personality characteristics, health status, clinical course and prognosis of patients with panic disorder affect pharmacological and psychological treatment of these patients. The purpose of this study was to study personality patterns of patients with panic disorder (PD) by grouping them according to an important condition, that is, agoraphobia. As little data exists in the filed of personality profiles and it's potential impact on the course of panic disorder, we conducted the study in an Iranian population in Tabriz city during 2015 - 2016. A total of 120 patients with panic disorder were selected and evaluated using psychiatric interviews, as well as NEO Five-Factor Inventory and Millon Clinical Multiaxial Inventory-III (MCMI). From 96 patients who completed the study, 10.42% were diagnosed to have panic disorder with agoraphobia. The mean age of the patients was 35.12 ± 9.50 years old. The most common comorbid psychiatric condition was major depressive disorder in both groups of with and without agoraphobia. None of the patients exceeded from the cutoff point described for MCMI. Patients with agoraphobia scored higher in borderline personality, anxiety, and post-traumatic stress scales. Patients without agoraphobia had higher scores for narcissistic personality. There was no significant difference in scores of NEO-FFI with regard to the presence of agoraphobia, and all the patients scored high in agreeableness and conscientiousness. Despite comparable scores of NEO between PD patients with and without agoraphobia, they scored significantly different in MCMI for borderline and narcissistic personalities, anxiety, and post-traumatic stress disorder

Personality characteristics, health status, clinical course and prognosis of patients with panic disorder affect pharmacological and psychological treatment of these patients. The purpose of this study was to study personality patterns of patients with panic disorder (PD) by grouping them according to an important condition, that is, agoraphobia. As little data exists in the filed of personality profiles and it's potential impact on the course of panic disorder, we conducted the study in an Iranian population in Tabriz city during 2015 - 2016. A total of 120 patients with panic disorder were selected and evaluated using psychiatric interviews, as well as NEO Five-Factor Inventory and Millon Clinical Multiaxial Inventory-III (MCMI). From 96 patients who completed the study, 10.42% were diagnosed to have panic disorder with agoraphobia. The mean age of the patients was 35.12 ± 9.50 years old. The most common comorbid psychiatric condition was major depressive disorder in both groups of with and without agoraphobia. None of the patients exceeded from the cutoff point described for MCMI. Patients with agoraphobia scored higher in borderline personality, anxiety, and post-traumatic stress scales. Patients without agoraphobia had higher scores for narcissistic personality. There was no significant difference in scores of NEO-FFI with regard to the presence of agoraphobia, and all the patients scored high in agreeableness and conscientiousness. Despite comparable scores of NEO between PD patients with and without agoraphobia, they scored significantly different in MCMI for borderline and narcissistic personalities, anxiety, and post-traumatic stress disorder.

Psychiatric disorders could be evaluated in terms of behavioral activation and inhibition systems. Dysregulation of these systems may lead to development of manic or depressive episodes in patients with mood disorders. This study aimed to identify Behavioral Approach System (BAS) and Behavioral Inhibition System (BIS) hypersensitivity as the functional brain system behaviors in patients with major depressive disorder and bipolar mood disorder I, compared to healthy individuals. This case-control study was conducted in Razi Psychiatric Hospital, a mental health referral center in Northwest of Iran. The study consisted of two groups of patients, one with major depressive and the other with bipolar mood disorders and one healthy group. Each group had 40 patients (20 men and 20 women). The study data were collected through BIS and BAS questionnaire, Beck Depression Inventory (BDI-II), Young Mania Rating Scale (YMRS). The obtained data were analyzed by SPSS version 18. The findings showed a significant negative correlation between BIS, BAS and BAS subscales with the severity of depression and positive correlation with mania symptoms (P<0.05). BAS and BIS dysregulations may predispose people to mood disorder symptoms. BAS is hyperactive during manic phase and may predict the symptom severity of bipolar mood disorder

Sleeve gastrectomy is an effective procedure for weight loss. However, some serious complications may occur during this operation such as strictures, bleeding, and leak. According to previous studies, the rate of leak was 1.06%. Using endoscopic stents have been hampered by some drawbacks the most important of which is repeated migration. The current study aimed to discuss the prevalence and management of leak after laparoscopic sleeve gastrectomy operated at Modarres Hospital, Tehran, Iran.
This cross-sectional study was conducted on patients with morbid obesity undergone laparoscopic sleeve gastrectomy at Modarres Hospital, Tehran, Iran. In addition to the patients’ demographic data; their leak complications, first symptoms and signs, WBC count, and method of management were extracted and collected from their medical files.
A total number of 1263 patients were enrolled in this study. Of them 8(0.63%) patients suffered from leak after the operation. The mean (SD) age of patients with leak was 32.33(6.02) year. The mean (SD) BMI of patients with leak was 45.75(2.07) kg/m2. The mean (SD) of WBC count of the patients with leak was 13680(7272.68). The symptoms of the patients began on different days (3-240 day). Management of the patients was different but most of the patients underwent endoscopic stent.
It seems that stent insertion is a useful method for treatment of leak after sleeve gastrectomy, especially in immediate leak.

The aim of this study was to compare the therapeutic and adverse effects of haloperidol to the combination of haloperidol and promethazine (antipsychotic + antihistamine) for controlling patients with aggressive or violent behavior referred to psychiatric emergency rooms. Using a double-blind randomized controlled trial, 100 psychiatric patients admitted to emergency room of Taleghani hospital, Tehran/Iran, randomly received intramuscular haloperidol or haloperidol plus promethazine. The patients were observed at 20, 40, 60, 120 minute intervals and then at 6, 12 and 24 hourly intervals to determine if they were tranquil or asleep, need for further injection, serious adverse effects, acute dystonia, akathisia, need for other medications, and need for admission to hospital based on clinical judgment. The mean age of patients was 36.25 years and 69% were male. Patients receiving promethazine plus haloperidol were more tranquil after 2, 6 and 12 hours and sustained sleep after hours 2 and 6. Adding promethazine to haloperidol decreased the need for repeated involvement of the psychiatrist on duty, using additional medications and hospital admission. Patients taking the combination of haloperidol and promethazine did not experience more adverse effects than those taking only haloperidol. The combination of haloperidol plus promethazine can be safely used in emergency rooms for controlling patient with agitation and aggressive behavior resulting in a sustained tranquilization or asleep and lower need for further intervention.

Robinow syndrome (RS) is an infrequent genetic condition that is characterized by a dysmorphic face, dental anomaly, short stature, mesomelic limb shortening, hand and foot anomalies, and hypoplastic genitalia. The Robinow syndrome has been reported from the Arab countries and other Asian countries, but has not been reported in Iranian population so far.. A new born (one day old) infant that had the signs of Robinow syndrome.. We describe an Iranian new born infant with Robinow syndrome signs in order to improve the science and epidemiology related to this disorder..

This study was performed to determine the lifetime prevalence of psychiatric disorders concomitant with attention deficit/hyperactivity disorder (ADHD) among primary school students. One thousand six hundred fifty-eight primary school students (781 females and 877 males) were selected in a cluster random manner in 2010. The first screening was performed by the Conner''s teacher rating scale revised and Teacher ADHD rating scale-IV and then the students, in whom the ADHD was diagnosed by a child and adolescent psychiatrist according to DSM-IV-TR, were evaluated by K-SADS-PL semi-structured interview to detect the psychiatric comorbidities. The prevalence of psychiatric comorbidities in ADHD subjects was 62.5%. Oppositional defiant disorder (29.4 %), specific phobia (21.9 %), and enuresis (17.5 %) were the most common co-morbidities. The most common comorbidities in ADHD -IA (inattentive type) (n = 29) were specific phobia (34.5 %), oppositional defiant disorder (20.7 %), chronic motor tic disorder (17.2 %), and enuresis (17.2 %). The most common comorbidities in ADHD-HI (hyperactive/impulsive type) (n = 15) were chronic motor tic disorder (33.3 %), oppositional defiant disorder (26.7 %), and specific phobia (26.7 %). The most common comorbidities in ADHD-C (combined type) (n = 116) were oppositional defiant (31.9 %), enuresis (19 %), and specific phobia (18.1%). The frequency of chronic vocal tic disorder was higher in ADHD-HI compared with ADHD-C (P = 0.01). The results of this study indicated that the frequency of other psychiatric comorbidities in primary school students with ADHD is high that may affect disease course and treatment. Hence, evaluation for other comorbidities in ADHD patients should be considered.

Patients with bipolar mood disorder constitute a relatively large number of individuals hospitalized in psychiatric hospitals. This disorder is highly comorbid with other psychiatric disorders and may effect their clinical course. The goal of this study was to determine the co-occurrence rate of anxiety disorders and substance abuse with bipolar mood disorders and their impact on clinical course.153 bipolar patients (type I) were selected among the hospitalized patients at Razi Psychiatric Hospital in Tabriz, Iran, from September 2007 to October 2008 through convenience sampling method. The participants were evaluated by a structured clinical interview based on DSM-IV criteria (SCID), Hamilton Rating Scale for Depression (HRSD) and Young Mania Rating Scale(YMRS). Co-morbidity of anxiety disorders was 46.15%. Occurrence of anxiety disorders was 28% for obsessive-compulsive disorder, 26.6% for generalized anxiety disorder, 4.2% for phobia and 2.1% for panic disorder. Co-morbidity of substance abuse was 7.7% and the highest occurrence of substance abuse was 5.6% for alcoholism and 4.2% for opium. No significant difference was observed between the severity of disease and duration of hospitalization in bipolar patients with or without anxiety disorder. The severity of disease and duration of hospitalization in bipolar patients with substance abuse was higher compared to bipolar patients without substance abuse (P<0.05). This study suggests that there is a high co-morbidity between anxiety disorders and substance abuse with bipolar disorder. Further, this study suggests that co-occurrence of substance abuse disorder with bipolar disorder increases the everity of the disease and duration of hospitalization.