Razavi International Journal of Medicine
Volume:9 Issue: 3, Summer 2021

Surgical site infection is a risky complication following coronary artery bypass graft (CABG) surgery that may increase mortality and morbidity. Hence, it seems that further investigation regarding this complication may be necessary, in order to improve prevention and treatment processes. The aim of this study was to determine the frequency of sternal wound infection and saphenous vein wound infection in patients undergoing CABG and its correlation with the determinants. This is a cross-sectional study that was undertaken from 2015 to 2019 on 2459 patients undergoing CABG surgery with off-pump and on-pump methods. Demographic and background information of our patients were recorded. After infection, secretions were sampled and cultured. Results of the study showed that the frequency of sternal and saphenous harvesting site infection in patients was 3.7% (n=91), and these infections were often diagnosed two weeks after surgery (50 patients, 54.9%). Age and sex were identified as two significant risk factors of surgical site infection after CABG surgery (p=0.0001). Most patients came back with an infection two weeks after surgery (54.9%). Gram-positive bacteria had the greatest role in infection (35.2%) with Staphylococcus epidermidis acting as the predominant strain (n=13).Discussion and The results suggested that two factors with a crucial role in the incidence of infection, are female gender and age of 50-60 years old. Diabetes, previously identified in the literature as a risk factor for surgical site infection, did not have a significant effect in this study and further research is warranted.

Multiple sclerosis is considered a chronic disease in which physical and mental disorders are common among these patients. This study aimed to compare the effectiveness of Lazarus multimodal therapy and cognitive-behavioral therapy on psychological distress, working memory, and anxiety in patients with multiple sclerosis. The research method was a quasi-experimental research with pre-test, post-test, and follow-up and a control group. The statistical population of the study was the patients who were members of the "MS Patient Support Society" in Tehran who had been referred to this center during January and March 2017. The sample consisted of 48 people selected by convenience sampling method from members of the MS community. The data were obtained through the Kessler psychological distress scale (K10), the Wechsler's Working Memory Index, and the Beck Anxiety Inventory (BAI). The repeated measurement method and SPSS.22 software were used to analyze data. Findings showed that Lazarus Multimodal Approach and cognitive behavioral therapy had a significant effect on decreasing anxiety (p <0.001), psychological distress (p <0.001), and increasing working memory (p <0.001). The Lazarus Multimodal Approach was more effective than cognitive-behavioral therapy in decreasing anxiety, psychological distress, and increasing working memory (p <0.001). It can be concluded that Lazarus' Multimodal Approach and cognitive behavioral therapy was effective on anxiety, psychological distress, and working memory and can be used to reduce psychological problems in patients with multiple sclerosis.

Cancer is one of the most common diseases in the world, and more than 30,000 Iranians die of cancer every year. This study aimed to predict the quality of life based on early maladaptive schemas and personality traits in women with breast cancer. The research method was descriptive-correlational. The statistical population of the study included all women with breast cancer, 240 women who were referred to Jam Hospital in Tehran in 2019, 144 people were selected by the available method. Data were obtained using the quality of life questionnaire, Young Schema Questionnaire (YSQ-SF), Personality Traits Questionnaire, and Early Ineffective Schema Questionnaire. Data were analyzed by Pearson correlation coefficient and linear regression using SPSS22 software. The results showed that the quality of life has a predictive role based on early maladaptive schemas and personality traits in women with breast cancer (p <0.001). The results of the regression coefficient show that quality of life can predict agreeableness (Beta=0.38), social isolation/alienation (Beta=-0.26), distress (Beta=-0.22), pleasantness (Beta=0.26), and obedience (Beta=0.17). It can be concluded that the quality of life has a predictive role based on early maladaptive schemas and personality traits in women with breast cancer.

Diabetes mellitus is a metabolic disorder in the body whose prevalence is constantly increasing. The aim of this study was to compare the effectiveness of metacognitive therapy and behavioral activation on executive functions of elderly people with type 2 diabetes. This study was a quasi-experimental study with pretest, posttest, and control group design, and a three-month follow-up. The statistical population included people with type 2 diabetes who were referred to five endocrine clinics located in area 11 and were at least 60 years old and 75 years old at most. Forty-five women and men participated in this study through a purposeful and voluntary sampling method. Wisconsin card was used for data collection. Data were analyzed using descriptive statistics such as mean and standard deviation and inferential statistics by analysis of covariance and repeated measure ANOVA with SPSS.25 software. The results showed that show that there is no statistically significant difference between metacognitive and behavioral activation groups in the subscales of executive function, and the mean post-test of the groups is almost equal (p <0.05). Correct reaction time, first patterns attempt were significantly different compared to the control group (P>0.05). It can be concluded that meta-cognitive therapy and behavioral activation increased effective executive functions.

One of the important goals of the educational system is to provide the ground for all-round growth and training healthy. Present study aimed to investigate the mediating role of academic self-efficacy in the relationships between academic engagement and achievement goals with social adjustment among high school students. The research method was descriptive-correlation with the path analysis-based design. The statistical population included all male high school students in Tehran in 2017-18 such that 546 students were randomly selected by multi-stage cluster sampling. For the data collection, Morgan-Jinks Student Efficacy Scale (MJSES), Zarang Educational Conflict Questionnaire, Sinha and Singh’s Adjustment Inventory and Elliott and Church’s Achievement Goal Questionnaire were used. The results showed that the coefficient of academic engagement (0.50) and achievement goals (0.30) were significant in predicting self-efficacy. The self-efficacy coefficient in adjustment prediction was also significant (0.82). The direct effects of academic engagement (0.06) and achievement goals (-0.29) on predicting adjustment were insignificant and significant, respectively. Based on this data, academic self-efficacy mediates the relationship between academic engagement and adjustment. The role of academic self-efficacy is in the relationship between achievement goals and adjustment was partly. The implication of the findings is that educational approaches, while emphasizing students’ mastery of prerequisites and successful experiences, should consider academic self-efficacy as a fundamental principle and rely on persuasion and explanation in interactions.

The main purpose of this study was to compare the effectiveness of Emotionally Focused Therapy and self-compassion skills training on differentiation of self and Sexual Intimacy in women affected by Infidelity. It was a quasi-experimental study and the statistical population included all women affected by Infidelity in Mashhad in 2019-2020. A statistical sample of 45 women were selected using available sampling and were randomly assigned to experimental and control groups (15 people in each group). The intervention groups received emotionally focused training and self-compassion separately for 8 sessions of 90 minutes and the control group was on the waiting list. The Differentiation of Self-Inventory Revised(DSI-R) of Skowron and Schmitt (2003) and the Sexual Intimacy Questionnaire of Batlani et al. (2010) were used to collect data. Data were analyzed by repeated measures analysis of variance using the SPSS 24 software. The results showed that both treatments were effective in increasing the level of differentiation of self and Sexual Intimacy, but the effectiveness of training of the emotionally focused approach to self-compassion in the differentiation of self was tangible and significant (p <0.05). The findings showed that the emotionally focused therapy training can be used as an effective intervention to improve the psychological resilience of women affected by Infidelity through creating new patterns in the relationship.

It is necessary to help couples to solve problems related to marital life, identifying the factors affecting intimacy and marital adjustment of couples, which can be improved using different approaches. This study aimed to investigate Gottman Couple Therapy's effectiveness on intimacy and marital adjustment of couples with marital problems. The present study was an applied and quasi-experimental design with pretest-posttest and follow-up with a control group. The statistical population of this study was all couples referred to counseling clinics in 2020. The sample consisted of 30 couples referred to counseling clinics in district 1 of Tehran, selected by convenience sampling method. The data were collected through the marital intimacy scale (Thompson and Walker, 1983) and marital adjustment questionnaire (Spanier, 1976). Data were analyzed by repeated measure analysis of variance and SPSS.22 software. The results showed that Gottman couple therapy was effective in increasing intimacy (p <0.001) and marital adjustment (p <0.001) of couples with marital problems. Based on the findings of this study, it can be said that Gottman couple therapy is effective on intimacy and marital adjustment of couples with marital problems. Therefore, Gottman's couple therapy can improve couples' relationships and reduce their marital problems.

Violence against women and girls is currently one of the most important and specific forms of violence against human rights.

The aim of this study was to determine the effectiveness of a cognitive-behavioral intervention based on psychological capital on experience avoidance and suicidal ideations in girls victims of domestic violence in Isfahan.Materials &

The research design was quasi-experimental with a pretest-posttest design with a control group. The statistical population consisted of all girls’ victims of domestic violence in Isfahan who were referred to a Counseling Center in Isfahan in 2019. The sample consisted of 30 girls who were selected by purposive sampling method and randomly assigned to one experimental group (cognitive-behavioral intervention based on psychological capital) and a control group (each consisting of 15 people). The research tools included Beck Scale for Suicidal ideations (BSSI) and Acceptance and Action Questionnaire (AAQ-II). Data were analyzed by SPSS.22 software and univariate analysis of covariance.

The findings of this study showed that cognitive-behavioral intervention based on psychological capital was effective on experience avoidance (p <0.001) and suicidal ideation (p <0.001) in girls’ victims of domestic violence in Isfahan.

It can be concluded that cognitive-behavioral therapy based on psychological capital is an effective treatment to reduce problems related to experience avoidance and suicidal thoughts of girls’ victims of domestic violence and can be used to improve psychological problems of girls’ victims of domestic violence.

Among the factors affecting the rate of marital conflict reduction, we can mention the variable of marital boredom, which is directly and indirectly affected by various factors. This study aimed to develop a causal model of marital boredom based on the degree of differentiation and resilience mediated by couples' emotional self-regulation. The present study was a correlation and structural equation modeling. The statistical population of the study included all couples who were referred to the counseling centers of Gachsaran in 2019 with the problem of marital conflict. To collect data from the emotional self-regulation strategies, the resilience questionnaire, the marital boredom scale, and the marital conflict questionnaire have been used. Pearson correlation coefficient and structural equation modeling with SPSS.22 and Smart.PLS software was used to analyze the research data. The significance level in this study was considered 0.05. The results showed that the direct path coefficient between resilience with emotional self-regulation (p <0.001, β=0.63). Also, the path coefficients between resilience and marital boredom (p= 0.009, β=-0.15), and emotional self-regulation with marital boredom (p <0.001, β=-0.48) were negative and significant. The calculated goodness-fit indices of RMSEA = 0.061, AGFI= 0.93 showed the emotional atmosphere of the family in the relationship between the variables of life expectancy and academic performance played a mediating role. It can be concluded that the model of marital boredom and its components including resilience and emotional self-regulation has a significant effect on marital conflict.

It is necessary to help pregnant women to solve pregnancy problems by identifying the factors affecting depression, anxiety, and stress. The aim of this study was to determine the effectiveness of acceptance and commitment therapy on depression, anxiety, and stress in nulliparous pregnant women. The research method was semi-experimental with a pretest-posttest design with a control group. The statistical population of this study included all pregnant women referred to hospitals in Tehran in 2019, among whom 34 eligible volunteers were selected by convenience sampling method and randomly assigned to two groups of acceptance and commitment and control group. The experimental group received acceptance and commitment therapy in 9 sessions of 120 minutes. Data were collected using a depression, anxiety, and stress questionnaire (Lovibond and Lovibond, 1995). Data were analyzed using repeated-measures ANOVA and SPSS.22 software. The significance level in this study was considered to be 0.05. The results showed that acceptance and commitment therapy intervention significantly decreased depression (p <0.001), anxiety (p <0.001), and stress (p <0.001) in nulliparous pregnant women. It can be concluded that acceptance and commitment therapy was effective in reducing depression, anxiety, and stress in nulliparous pregnant women, and it can be used to improve the psychological problems of pregnant women.

Percutaneous intervention(PCI) is an accepted method of reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI). Establishing coronary blood flow during angiography does not always result in proper cardiac circulation. There are many factors related to patient outcomes after primary PCI. ST-segment resolution (STSR) is one of these factors that can be achieved noninvasively and indicates reperfusion. However, the relationship between STSR and echocardiographic findings is not widely studied. The aim of the present study is to evaluate electrocardiogram (ECG) and echocardiography findings in post-STEMI patients undergoing PCI. A total of 340 patients who had STEMI and underwent successful PCI were chosen by convenience sampling and enrolled in this follow up study. After considering the exclusion criteria, 12-lead ECG was performed on each patient at 60min, 90min, 120min, 24 h and 2 months after PCI. Additionally,a transthoracic echocardiogram (TTE) was performed after PCI, and 2 additional TTEs were performed—one each at 24 hpost-PCI and 2 months after PCI. ST-segment resolution was evaluated in every ECG, and the results were compared with the TTE findings. The mean±SD for the time duration between the onset of symptoms and calling EMS, the door-to-balloon time, and the time duration between the first medical staff visit andangioplasty were 114.4±56.63 min, 35.58±4.43 min and 60.58±4.43 min, respectively. Ejection fraction and end systolic volume in patients with ST-segment resolution greater than 30% at 60min, 90min, 120min and 24 h after PCI were significantly higher than that in patients with resolution lower than 30%. This finding was not observed 2 months after PCI. While delays in managing patients with STEMI had favorable outcomes in our center in contrast to similar studies, attempts should be made to reduce these delays. STSR greater than 30% at 90min and 120min after successful PCI in patients with STEMI is significantly related with higher ejection fractions and lower end-systolic volumes. However, if the STSR occurs after 24 hours, then these patients are more likely to have lower ejection fractionsand larger end-systolic volumes.

Our study is assessing the epidemiological aspects of nonalcoholic fatty liver disease (NAFLD) in Iranian population and evaluates the relationship between NAFLD and metabolic syndrome.

We conducted this cross-sectional study on 145 subjects who were diagnosed with NAFLD and referred to the Gastroenterology clinics of Ghaem Hospital, Mashhad, Iran in the year of 2013. Using ultrasonography method, we diagnosed NAFLD as a fatty liver manifestation in the absence of other liver complications. We used National Cholesterol Education Program Adult Treatment Panel III criteria (ATPIII) as a guideline to establish metabolic syndrome diagnosis.

Metabolic syndrome had an overall prevalence of 49.7% among our subjects. The results showed no difference in mean AST and ALT levels between the groups of patients with and without metabolic syndrome. Our results were unable to maintain an association between our targeted liver enzymes (AST and ALT) and different features of metabolic syndrome. In multivariate linear regression models, the presence of metabolic syndrome was unable to predict AST (p=0.631, r2=0.002) or ALT (p=0.122, r2=0.017) abnormalities.

The present study has shown a high prevalence of metabolic syndrome in Iranian patients who diagnosed with NAFLD. Contrary to previous reports, despite the high prevalence of metabolic syndrome conditions in NAFLD patients, we found that the presence of metabolic syndrome had not increased the risk of NAFLD in the population undergone our study.

Distress tolerance has been observed as an important structure in creating new insights against the onset and persistence of psychological trauma and prevention and treatment.

This study aimed to investigate the role of commitment in the relationship between early maladaptive schemas and distress tolerance in conflicted couples.

The method of this study was descriptive-correlational. The study population consisted of married men and women residing in Kerman. The sampling method was cluster sampling method, through which 400 participants (200 females and 200 males) were selected. Data collection tools included Simmons Distress Tolerance Questionnaire (2005), Adams and Jones Marital Commitment Questionnaire (1997), and Young's Early Maladaptive Schemas Questionnaire (1990). Data were analyzed using correlation and structural equation analysis by spss.22 and Amos.22.

The results indicated the moderating role of marital commitment variable in the inverse relationship between maladaptive schemas of three areas of cuts/exclusion, impaired performance, and emotional inhibition with distress tolerance (p <0.01).

It can be concluded that although the areas of early maladaptive schemas reduce distress tolerance and commitment of women, the high level of communication commitment among couples can increase distress tolerance in them.

Anxiety disorders and psychological manifestations play a significant role in the incidence of psychosomatic disorders. Moreover, Personality traits are one of the psychological constructs associated with psychosomatic symptoms. This study aimed to determine the effectiveness of acceptance and commitment therapy on distress and psychosomatic symptoms in patients with gastrointestinal dysfunction with type D personality. The present study was a semi-experimental pre-test, post-test design with a control group and follow-up. The statistical population in this study was all patients with functional gastrointestinal disorders (FGID) who were referred to behavioral sciences research center in Isfahan in 2019, 30 patients were selected by targeted sampling method (patients with gastrointestinal dysfunction, except gastrointestinal cancer patients, who had a high de-personality score). Data were obtained using the D-14 personality type scale, ROME III questionnaire, psychological distress, and stress-anxiety-depression disorders (DASS-21). Data analysis was performed using repeated measure analysis of variance by spss.22. The results showed that acceptance and commitment therapy was effective in decreasing distress (p <0.001) and psychosomatic symptoms (p <0.001) in patients with gastrointestinal dysfunction with type D personality. It can be concluded that acceptance and commitment therapy effectively distress and psychosomatic symptoms of patients with gastrointestinal dysfunction with type D personality and improve psychological problems in patients with gastrointestinal dysfunction.

After a childhood and following human beings to adolescence, changes have been achieved in him (or her), including the tendency of individuals to gain independence. The aim of this study was to investigate the relationship between metacognitive strategies and attachment styles with the sense of school belonging in high school students in Zahedan.

The present study was a correlational study; The statistical population of the present study was all high school students in Zahedan, and the sample consisted of 370 people who were selected by simple cluster-random sampling. The questionnaires that were considered to collect information from the sample group were: Barry et al.'s Feeling of Belonging Questionnaire (2004), O'Neill and Abedi Metacognitive State Questionnaire (1996), and Collins and Reid Attachment Questionnaire (1991). For the statistical analysis of data, the Pearson correlation coefficient and structural equation model (SEM) were used using Amos.22 and SPSS.22 software.

Results showed that metacognitive awareness (β=0.31, p <0.001), cognitive strategy (β=0.24, p=0.045), planning (β=0.23, p=0.003) and self-review (β=0.28, p <0.001) had positive effect on school belonging. Secure attachment style (β=0.17, p=0.021) has positive effect on school belonging. Avoidance attachment style (β=-0.27, p <0.001) and ambivalent attachment style (β=-0.23, p=0.003) had negative effect on school belonging.

It can be concluded that metacognitive strategies components have a positive and direct effect on school belonging to school belonging. A secure attachment style has a positive effect on school belonging. Avoidance attachment style and ambivalent attachment style had a negative effect on school belonging.