elham faghihzadeh

Functional neurological disorders (FND) is one of the most common causes of neuropathy, However, its cause continues to be mysterious. Understanding the underlying mechanisms of FND is crucial for treatment strategies. The study was conducted on brain images(rs-fMRI) taken from two volunteers (FND patient and healthy subject) who had the same characteristics.

We fitted Gaussian Graphical Models to a single subject data using a network approach.

Based on the results of the networks, the number of significant edges was more in the left hemisphere in the patient, but in the healthy person, the number of these non-zero edges was more in the right hemisphere. Both the networks related to the healthy person and the patient had high density. Therefore, it indicated that the regions considered by these 2 people were strongly related to each other. The results showed the existence of more links and positive relationships between the regions, most of which showed a strong relationship. Among these connections, there were also negative connections. The networks of the healthy participant with almost symmetrical structures and the patient with FND showed different characteristics, including asymmetry between the hemispheres.

this study is the first to demonstrate that the brain regions of both FND patient and healthy participant can be conceptualized as networks. The findings of this study add to a growing body of literature that FND patient brain regions can be analyzed using network approaches.

Data obtained from functional magnetic resonance imaging (fMRI) have a complex structure. Considering the special features of this type of data in analyses is of particular importance. Previous studies on generalized anxiety disorder (GAD) as a prevalent mental disorder using functional neuroimaging have had conflicting results. In this study, we apply a Bayesian spatiotemporal model to this type of data which considers both spatial and temporal dependence among regions which is one of the most essential features to consider.

In this single-subject study, we analyze data from a patient with GAD and a healthy participant. Both participants are 24-year-old women who are assigned an emotion reactivity task (matching neutral and negative facial expressions) inside a scanner. The spatial Bayesian variable selection method is used to detect blood oxygen level-dependent activation in fMRI data.

Activation areas in neutral and negative facial expressions are provided for both participants by posterior probability map. The results of our study show a greater level of activity in the GAD participant in comparison to the healthy participant in responding to the negative matching task.

the GAD patient showed more neural activity in response to negative facial expressions than the healthy participant in brain regions related to emotional response in the areas of the frontal Pole, middle frontal gyrus, insular cortex, and frontal orbital cortex. Moreover, the inferior frontal gyrus in the patient with GAD showed more reaction to negative emotional stimuli.

 The quick speech in noise (Q-SIN) test shows how difficult it is to perceive speech in noise by determining signal-to-noise ratio (SNR) loss. The lists with high-frequency words have a better ability to identify SNR loss which have been created in Persian. Although a Persian version of Q-SIN with emphasis on high frequency is available، but there is no Q-SIN lists with high-frequency words; therefore,this study aims to develop new lists and the lists with high-frequency words for Q-SIN test and determine their equivalency in normal-hearing people which was condcuted in Tehran University of Medical Sciences.

 The sentences were first developed. Then, their content validity and face validity were determined. In this regard، 36 sentences were used to make new Q-SIN lists and 36 sentences were used to make Q-SIN lists with high-frequency words. Based on the Q-SIN test development criteria، six regular lists (lists 1-6) and six lists with high-frequency words (lists 7-12) were tested on 46 people (23 males and 23 females) aged 18-35 with normal hearing

 The content validity index for new and high-frequency words lists were 0. 74 and 0. 736، respectively. The equivalency test results showed that among the first 6 lists، the lists no. 1, 2, 3, and 4 were equal. Among the six lists with high-frequency words, the lists no. 7, 8, 10, 11 were equal. There was no gender differences between six regular lists and high-frequency lists (P>0.05). 

 The Q-SIN word lists with equivalency can be used for normal-hearing people in clinical practice.

One of the main steps for designing a comprehensive palliative care program in patients with cancer is to achieve knowledge about pain acceptance.

This study aims to determine the level of pain acceptance and its related social determinants of health in patients with cancer.

This cross-sectional study conducted on 152 patients with cancer hospitalized in the oncology wards of Valiasr and Ayatollah Mousavi hospitals in Zanjan. Participants were included in the study by convenience sampling from June to September 2021. To collect the data, a threepart questionnaire including demographic factors, social determinants and chronic pain acceptance was utilized. Statistical analysis was performed by t-test and one-way analysis of variance (ANOVA) using SPSS software version 25.

Most of the participants were male (52%), illiterate (56.6%) and in the age group of 61-75 years (40.1%). The mean (SD) of the total pain acceptance score was 53.37 (19.36), which represents a lower than mean pain acceptance among the participants. The mean of pain acceptance according to the two variables of transportation system (P< 0.001) and occupation (P= 0.003) showed a statistically significant difference.

The findings of the study indicate that pain acceptance in the participants is not desirable. It is essential to plan and put into effects programs in order to improve pain acceptance methods. Moreover, considering the relationship between social determinants of health and pain acceptance, it requires to pay more attention to social determinants of health during the development of interventions to improve patients‟ pain acceptance.

 This study aimed to evaluate the prevalence of domestic and non-domestic violence (outside home) in Iran during 2015.

 This descriptive cross-sectional study was conducted on individuals aged 15 and older living in urban and rural areas of Iran. A total of 36,600 people from 31 provinces of Iran were selected by systematic and cluster random sampling using the postal code available in the country’s post office software. A researcher-made survey questionnaire was used for evaluating violence. The data were analyzed using SPSS software version 20.

 A total of 23.1% of individuals have admitted domestic violence towards their families in the last 12 months, and 8.1% have admitted non-domestic violence in the past 30 days. The prevalence of domestic and non-domestic violence was higher among males than females and in urban areas than rural places. In addition, the highest prevalence rate of domestic violence in the last 12 months was related to Lorestan province. Tehran province had the highest prevalence rate of non-domestic violence during the last 30 days. However, the lowest prevalence rate of domestic and non-domestic violence was related to Qom province.

 Based on the results, the prevalence rate of 23.1% of domestic violence and 8.1% of non-domestic violence necessitates preventing and treating this social problem. Therefore, health authorities need to take necessary action to raise awareness and reduce the risk-taking behaviors of the population in Iran.

Breast cancer, the most common malignancy among women, affects many aspects of their lives. The present study was conducted to compare marital satisfaction in women with breast cancer and healthy women.

This descriptive comparative study was performed on 95 women with a definitive diagnosis of breast cancer and 95 healthy women who referred to the health centers and breast cancer clinics of Mostafa Hospital in Ilam, Western Iran in 2019.  Data were collected using demographic and Enrich Marital Satisfaction Questionnaires. Data analysis was carried out by SPSS software (version 20) using independent t-test and Chi-square test.

The mean total score of marital satisfaction in the healthy group was higher than breast cancer group (125.41± 10.17 vs 96.27 ± 9.46) (P˂0.001). The mean score of marital satisfaction dimensions including marital satisfaction (38.65± 4.70 vs 27.11± 4.16); communication (35.10 ±5.59, vs 28.91 ±6.41); conflict resolution (30.54 ±6.45, vs 25.74 ± 5.90) and ideal distortion (21.12 ±3.36 vs14.51 ± 2.79) was also higher in the healthy group compared with breast cancer group (P˂0.001).

Breast cancer can result in reduced marital satisfaction in different dimensions. Therefore, providing appropriate psychological counselling help women with cancer and their spouses to enhance their marital satisfaction.

Mental disorders are the most common health problems that affect different population groups. According to the national survey in 2015 based on General Health Questionnaire-28 (GHQ-28), 23.44% of Iranians older than 15 years were suspected of having a mental disorder. The study aimed to determine the mental health status of the population over 15 years of age in the Islamic Republic of Iran, one year after the outbreak of COVID-19 in 2020.

The population-based study was performed on 24584 individuals over 15 years of age in Iran between December and February, 2020. The GHQ-28 was completed through telephone interviews. Data were analyzed using descriptive statistics, chi-square test, independent t-test, and multiple logistic regression at 95% confidence level.

The results showed that the mean age of participants was 44.18±16.47 years. The prevalence of mental disorders was 29.7%. Mental disorder was associated with female gender (OR=1.195, 95% CI 1.10–1.29), 25–44 years (OR=1.206, 95% CI 1.06–1.36), urban life (OR=1.116, 95% CI 1.04–1.19), illiteracy (OR=1.286, 95% CI 1.11–1.48), being divorced (OR=1.924, 95% CI 1.50– 2.45), and unemployment (OR=1.657, 95% CI 1.40–1.94). Among the participants and their families, 14.7% and 32.3% were infected with the disease, respectively. The COVID-19 mortality rate in their families was 13.2%. The prevalence of mental disorders in infected people (40% vs. 27.3%) and bereaved families (39.6% vs. 35.3%) was more than the non-infected groups.

Our results showed that in Iran, the mental health of the general population had a rising trend compared to 2015, especially in people infected with COVID-19 and bereaved families. The observed difference may be due to the prevalence of the COVID-19 epidemic and rapid demographic, social, and economic changes in Iran. Planning to improve mental health in the mentioned population should be considered for the post COVID-19 era.

Exposure to death and the resulting anxiety is a significant dimension of the mental health of patients suffering from chronic diseases, including heart failure.

Illness perception affects adherence to health-promoting behaviors and health outcomes. Hence, the purpose of this study was to investigate the effect of a perception-based intervention on death anxiety in patients with heart failure.

Following a randomized clinical trial design, 120 patients suffering from heart failure, recruited using convenient sampling, were categorized into two groups of control and intervention using the randomized minimization method. The intervention group received three 30-minute sessions of training, while the control group only received routine interventions. Data were collected using a demographic information checklist, brief illness perception questionnaire (BIPQ), and Templer Death Anxiety Scale. Data analysis was administered by independent t-test, paired t-test, chi-square, and Wilcoxon tests using SPSS version 22.

There was a significant difference between the study groups concerning anxiety scores before and after the intervention (P<0.001). Death anxiety scores before the intervention were not significantly different between the two groups (P=0.640), but there was a statistically significant difference in death anxiety scores after the intervention (P<0.001).

Regarding the importance of death anxiety in patients with heart failure, this study demonstrated the importance of using perception-based interventions.

The acceptable noise level (ANL) assesses the noise that a person can tolerate during a running speech. Although it is a strong test, it has not yet become popular in clinical practice. One of the reasons is its contradictory results. Since it is a psychoacoustic test, psychological factors can affect its output. Investigation of these factors can provide more accurate results. This study aims to investigate the effects of noise and work-related fatigue on the ANL in normal-hearing people.

Participants were the male workers in the administration (n = 26) and production (n = 26) departments of an automotive manufacturing industry in Iran. They were evaluated before and after leaving the workplace in order to determine the effects of noise exposure, fatigue as well as their simultaneous effects on the ANL.

In both groups, the ANL showed a significant increase after work compared to its level before work, and the background noise level (BNL) was significantly decreased. There was no significant difference in the BNL between administration and production groups before work. The most comfortable level (MCL) showed no significant increase. Moreover, the MCL changes were not significantly different in the production group compared to administration group, but the BNL and ANL changes were significantly higher.

Noise exposure and work-related fatigue affect the ANL. During the ANL test, earlier exposure to noise and the amount of fatigue should be controlled.

Studying different pathological aspects of lesions in multiple sclerosis (MS) patients could be useful to modify the diagnosis and treatment of this neurological disorder. Magnetic resonance imaging (MRI) modalities have the potential to investigate variations in brain tissue because of inflammatory and neurodegenerative processes in various types of MS-related lesions.

This study was done to investigate the quantitative changes in MRI-based parameters, like perfusion and magnetization transfer ratio (MTR) of different types of brain lesions, to demonstrate the ability of MRI to detect structural and pathological differences in MS lesions.

Quantitative MRI modalities were performed on 18 patients with five different kinds of lesions (T1 holes, acute and chronic white matter (WM), and acute and chronic gray matter (GM) lesions) using a 3 T MRI scanner. The following protocols were used to characterize the pathology of lesions: (I) fluid-attenuated inversion recovery (FLAIR); (II) pre- and post-contrast T1-weighted; (III) dynamic contrast-enhanced (DCE); and (IV) MTR imaging. Quantitative comparison of Ktrans, cerebral blood volume (CBV), cerebral blood flow (CBF), and MTR was done to find the best parameter to distinguish different lesions. Finally, a multivariate classifier was applied to introduce the best parameter to indicate differences in lesions.

Five lesions were characterized by perfusion and MTR parameters. The pathological changes were measured, including: (I) the highest value of parameters in both acute WM and GM lesions; (II) the lowest value of four parameters in both chronic WM and GM lesions; (III) MTR had the highest rank among parameters using the classifier.

The degree of pathological alterations due to inflammatory and neurodegenerative processes in MS-related lesions was indicated through the used parameters in different kinds of lesions. Inflammation was the dominant process in acute lesions, while neurodegeneration and tissue loss were observed mostly in chronic lesions. Both inflammation and neurodegeneration were detected in T1 holes. Perfusion parameters and MTR were reasonable parameters to describe differences in brain lesions. Thus, it could be confirmed that magnetization transfer imaging (MTI) and DCE-MRI are high-sensitivity methods to detect microstructural changes in the brain and subtle changes in the blood-brain-barrier. Classification of the parameters indicated that MTR was the best biomarker than others to show variations in lesions pathology.

The qualities of care in emergency wards (EWs) represent the general state of all services provided in the hospital. Nurses, as the largest group of health care providers, play a significant role in the quality and safety of health services and they are often involved in moral situations and moral decisions in clinical situations. The aim of this study was to investigate the correlation between moral distress and the quality of safe nursing care in emergency department nurses.

This descriptive cross-sectional study was conducted at the EWs of teaching hospitals in Tehran in 2018. Data were collected through the Corleychr('39')s Moral Distress Scale (CMDS) (2004) and Rashvandchr('39')s Assessment of Safe Nursing Care (ASNC). Data analyzed using the IBM SPSS software (Version 22) by using descriptive statistics (frequency distribution, mean index, and standard deviation) and Pearson correlation tests, independent t-test, and one-way ANOVA.

The mean score of moral distress in EW nurses was high. The mean score of the quality of safe nursing care was also moderate. There was a negative significant correlation between the quality of safe nursing care and moral distress frequency (r=-0.057, p=0.014) and a significant negative correlation between the quality of safe nursing care and the severity of moral distress (r=-0.038, p=0.022).

Given the correlation between quality of safe nursing care and moral distress in EW nurses, health planners and administrators are suggested to reflect on this issue and successively develop and implement appropriate programs such as holding symposiums With the aim of making effective changes in procedures, and taking advantage of nurseschr('39') opinions, to prevent and reduce moral distress.

Drug addiction is known as one of the health, medical and social problems of the present century. Beyond the harmful physical and mental consequences for addicts, drug abuse can cause serious social problems. The aim of this study was to evaluate drug and alcohol abuse in individuals aged 15 yr and over in Iran in 2015.

This descriptive cross-sectional study was done on individuals aged 15 yr and older who lived in urban and rural areas of Iran. Overall, 36,600 individuals were selected by systematic and cluster random sampling. The postal code was used to access the samples in 31 provinces of Iran. In each province 1200 individuals (50% men, 50% women) were evaluated. The used instrument was the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and data were analyzed using SPSS software.

The results showed 4.6% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.4% used Amphetamine stimulants, 6.1% used Sedative drugs, and 2.6% used Alcoholic beverages on a regular basis. Within the last 12 months, 3.9% of individuals used Opium and its derivatives, 0.4% used Cannabis, 0.3% used Amphetamine stimulants, 5.8% used Sedative drugs, and 1.9% used Alcoholic beverages. With the exception of Sedatives drugs men used more drugs than women and residents of rural areas used more opium and its derivatives than other groups of drugs. Based on the provincial distribution, Kerman and Qom used the highest and lowest prevalence percentage of Opium and its derivatives respectively.

Overall, 2340000 individuals were addicts used Opium and its derivatives in 2015, therefore, medical and health officials should take all necessary measures to deal with these serious social problems.

Patient monitoring in cardiac intensive care unit (CICU) is considered to be non-invasive and safe, but it can cause unintentional catastrophic consequences due to the alarm fatigue. The aim of the study was to determine the status of monitoring system alarms and nurses’ alarm fatigue.

 This descriptive, cross-sectional study was carried out in cardiac intensive care units of a hospital in Fars province from January to March 2019. The alarm status of 24 monitoring devices was observed for 100 hours in 100 patients under the physiological monitoring. Patients under monitoring were included in the study using a continuous and convenience sampling. Also, 62 nurses working in five CICUs of this hospital completed the alarm fatigue questionnaire (through census). The data obtained from the observation and the questionnaires were analyzed by the SPSS software version 16 using descriptive statistics.

The auditory alarms of monitoring devices were turned off and only visual alarms could be recorded. In the visual alarms recorded during 100 hours, 131 alarms (53.47%) were technical, followed by the false, nuisance, and ultimately real or actual alarms with rates of 40 (16.33%), 38 (15.51%) and 36 (14.69%), respectively. The mean (and standard deviation) score of alarm fatigue among nurses was 21.04 (7.52), and the alarm fatigue score for %50 of nurses was higher than the average score.

Turning off the auditory alarms can lead to serious risks to patients. Also, a high proportion of technical, nuisance, and false alarms can cause alarm fatigue in nurses. Adopting solutions in accordance with standard guidelines and checking physiological monitoring devices in hospitals are necessary in order to reduce false, nuisance, and technical alarms. Failure to pay attention to these issues leads to the alarm fatigue among nurses, which itself results in numerous consequences such as compromising the patients’ safety.

Exposure to Sulfur Mustard (SM) leads to short- and long-term adverse effects on various organs, including the skin. Despite several studies on long-term clinical manifestations of skin toxicity in SM-exposed individuals, the pathogenesis of SM-induced skin disorders is not fully understood.

As part of Sardasht-Iran Cohort Study (SICS), this study aimed to find out the possibility of any correlation between the serums level of Nitric Oxide (NO) and skin problems due to the long-term effect of SM as well as the kind of skin illness. In this historical cohort study, 372 male SM-exposed subjects and 128 age-matched unexposed controls were studied. Clinical evaluation was carried out for all participants, and their serum concentration of NO was measured.

According to our results, the Mean±SD serum level of NO in the exposed group with skin disorders were significantly higher than that in the exposed group without skin disorders (1483.00±488.754µg/mL vs. 1364.50±487.887µg/mL; P=0.024). Also, among the exposed group, there was a significant elevation of serum NO associated with the type of lesion. For ezxample, specific lesions like mustard scar were associated with higher levels of NO compared to non-specific lesions like xerosis, itching, seborrheic dermatitis, etc. Also, a significant elevation in serum NO levels was found in the exposed subjects with pigmentation disorders (both hypo- and hyper-pigmentation) compared to the exposed participants without these skin problems (P

Our results show the highest serum level of NO in the exposed group with specific lesions and the lowest or normal level of NO in the unexposed group with no skin illness. The elevated serum levels of NO may be associated with the progression of some skin complications in the SM-exposed subjects. This finding serves as a basis for further research on the molecular mechanisms and pathways involved in the pathogenesis of skin disorders in SM-exposed patients.