Journal of Research in Medical Sciences
Volume:27 Issue: 2, Feb 2022

Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.

A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders‑5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1‑h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL‑BREF) and Depression subscale of DASS‑42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other’s work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).

Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL‑BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow‑up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow‑up) in both groups.

ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

Glioblastoma multiforme (GBM) is the most common and malignant brain tumor. The current standard of care is surgery followed by radiation therapy (RT). Radiotherapy treatment plan evaluation relies on radiobiological models for accurate estimation of tumor control probability (TCP). This study aimed to assess the impact of obtained magnetic resonance imaging (MRI) data before and 12 weeks after RT to achieve the optimum TCP model to improve dose prescriptions in radiation therapy of GBM.

In this quasi‑experimental study, MR images and its relevant data from 30 patients consisting of 9 females and 21 males (mean age of 46.3 ± 15.8 years) diagnosed with GBM, whose referred for radiotherapy were selected. The data of age, gender, tumor size, volume, and signal intensity using analysis of MRI data pre‑ and postradiotherapy were used for calculating TCP. TCP was calculated from three common radiobiological models including Poisson, linear quadratic, and equivalent uniform dose. The impact of some radiobiological parameters on final TCP in all patients planned with three‑dimensional conformal radiation therapy was obtained.

A statistically significant difference was found among TCP in Poisson model compared to the other two models (P < 0.001). Changes in tumor volume and size after treatment were statistically significant (P < 0.05). Different combinations of radiobiological parameters (α/β and SF2 in all models) observed were meaningful (P < 0.05).

The results showed that among TCP radiobiological models, the optimum is the Poisson. The results also identified the importance of TCP radiobiological models in order to improve radiotherapy dose prescriptions.

As the diagnostic criteria for psychosomatic research‑structured interview (DCPR‑SI) is a rater‑assessed questionnaire, it has not been used vastly in community‑based studies and clinics. Describing and investigating self‑assessed form of DCPR are an attempt to apply it easier and more worthwhile for medical settings. The aim of this study was to describe and present self‑assessed form of DCPR self‑assessed (DCPR‑SA) and test its validity and reliability.

The DCPR‑SI was translated to Persian according to the best practice methodology and the guideline for adaptation of self‑report measures. In this cross‑sectional study, 540 patients and healthy individuals were recruited and answered DCPR‑SA and some related questionnaires. Inter‑rater (test–interview) and test–retest reliability were determined. Construct, concurrent, discriminant, and known‑group validity were tested.

The kappa coefficients were expressed substantial and almost perfect agreement (0.617–0.784, P ≤ 0.05). In addition, phi correlation coefficients were indicated adequate test–retest reliability for each cluster (0.548–0.754, P ≤ 0.05). Three domains (anxiety‑related symptoms, functional symptoms, and dysfunctional traits and emotional patterns) were confirmed by factor analysis. The results of the discriminate validity analysis were promising.

The findings show that the DCPR‑SA is valid and reliable and can be used by medical professionals as a psychosomatic screening tool and can be used properly in Persian‑speaking population.

Ischemic heart disease and psychiatric disorders are among the leading causes of morbidity and mortality. Plans for providing basic health services to community members require knowledge of the current state. Therefore, the aim of this study was to systematically review the literature to estimate the prevalence of psychiatric disorders among patients with ischemic heart disease.

In this study, PubMed, Embase, and Web of Science were systematically searched to find studies published before June 6, 2021. The systematic review included all original articles on the prevalence of psychiatric disorders among patients with ischemic heart disease. Two independent researchers evaluated the quality of studies, using the Joanna Briggs Institute questionnaire. All analyses were performed in Stata/MP version 16. A random‑effects model was used for data analysis.

Of 1672 studies initially identified, 13 studies were included in our meta‑analysis, with a total of 2233 participants. The overall prevalence of psychiatric disorders was estimated at 46.85% (95% confidence interval [CI]: 36.08–57.62; I2 = 100%; P < 0.001 for heterogeneity). The most common disorder was depression (27.80%; 95% CI: 18.27–37.34; I2 = 99.99%; P < 0.001 for heterogeneity). Based on the results, the prevalence of psychiatric disorders had increased by 25.55% from 2000 to 2021 compared to1984–2000.

The prevalence of psychiatric diseases in people with ischemic heart disease is high and increases over time. It is recommended that preventive measures be taken worldwide.

Type 2 diabetes mellitus (T2DM) is a growing health problem in Egypt, with a significant impact on morbidity and mortality. Measurement of the carotid Intima-media thickness (CIMT) allows early detection of atherosclerotic blood vessel diseases. Apelin is an adipose tissue-derived hormone that may be associated with insulin resistance (IR). This study aimed to assess the level of serum apelin in patients with T2DM and its relation to IR and CIMT.

A case-control study was conducted on 60 patients with T2DM and 30 healthy controls. T2DM was diagnosed based on American Diabetes Association criteria. The study was carried out at Al-Zahraa University Hospital, Cairo, Egypt, through the period from June to December 2019. The laboratory investigations included serum apelin and blood glucose hemostasis markers. CIMT was assessed using B-mode ultrasonography.

Patients’ group had a statistically significant higher apelin level than healthy controls (407.96 ± 291.07 versus 83.32 ± 10.55 ng/dL, P < 0.001). The correlation analysis showed that the serum apelin level correlated positively with glycemic indices, body weight, and waist circumference (P < 0.05). At cutoff value of >96 ng/dL, the serum apelin exhibited a sensitivity of 98.3% and specificity of 96.7%, positive predictive value of 98.1%, and negative predictive value of 96.5%, with a diagnostic accuracy of 95.1%. Serum apelin correlated positively with CIMT (r = 0.296, P = 0.022). Logistic regression analysis showed that systolic and diastolic blood pressures, Homeostasis Model Assessment of IR, and CIMT were independent predictors of serum apelin.

Serum apelin may be correlated with the degree of carotid atherosclerosis and hence can be used as a prognostic biomarker.

Mature inflammasome markers play a role in the development of Type 1 diabetes (T1D). This cross‑sectional study aimed to derive ratios from the serum levels of interleukins (ILs): IL‑1β and IL‑18 and to relate their values with glycemic index and anti‑inflammatory markers (IL‑4 and IL‑10) in children with T1D.

This study was conducted at Hawler Medical University in Erbil‑Iraq from April to July 2018. Healthy subjects (Group I, n = 40) and patients (Group II, n = 76) were recruited from primary schools and the Center of Diabetes in Erbil, respectively. Glycemic indices (including fasting serum glucose, insulin, glycosylated hemoglobin, and peptide C) and pro‑ and anti‑inflammatory markers (including high‑sensitivity C‑reactive protein, IL‑1β, IL‑18, IL‑4, and IL‑10 and the ratio of neutrophil or platelet to lymphocyte) were determined.

Cutoff values of 105 pg/mL, 85 pg/mL, and 1.235 for serum IL‑1β, IL‑18, and IL‑1β to IL‑18 ratio, respectively, were found to be significant discriminators of glycemic index and anti‑inflammatory markers with respect to the calculated area under the curve.

A ratio of IL‑1β to IL‑18 adjusted to 1.235 can serve as a useful marker of assessment of glycemic index. This ratio does not discriminate the status of anti‑inflammatory markers (IL‑4 and IL‑10) in children with T1D.

Hepatitis B virus (HBV) is one of the most dreadful viruses causing high mortality rates and serious damages to hepatocytes. The aim of this study was to assess the frequency, related causes/risk factors, and treatments of HBV infection in Iran by systematic review and meta‑analysis.

The data were obtained by a literature search in the PubMed, Scopus, SID, and Web of Sciences databases. Keywords included prevalence, risk factors, causes, treatment, and HBV. The Persian equivalents of these keywords were also searched. The time span included 2004 to2021. The Q and I2 statistics were used to check heterogeneity among studies. The data were analyzed using Stata (version 14).

The frequencies of HBV infection and its pharmaceutical therapy were P = 6% (95% confidence interval [CI]: 4–9, I2 = 95.2%, P < 0.001) and 19% (95% CI: 18%–30%, I2 = 98.9%, P < 0.001), respectively. The most common risk factors/causes of HBV were narcotic consumption, blood‑related factors, and transmission from infected individuals with the respective frequencies of 27% (95% CI: 16%–38%, I2 = 88.7%, P < 0.001), 32% (95% CI: 11%–53%, I2 = 99.8%, P < 0.001), 25% (95% CI: 10%–41%, I2 = 99.3%, P < 0.001), and 15% (95% CI: 7%–22%, I2 = 98.4%, P < 0.001), respectively.

The most important causes of HBV infection were transmission from infected people, narcotic consumption, and blood‑related factors. The main therapeutic intervention for HBV was pharmaceutical therapy.

We aimed to investigate the prevalence of nephrocalcinosis (NC) among children with diagnosed congenital adrenal hyperplasia (CAH). Our findings would be helpful for earlier diagnosis, management, and prevention of NC‑related complications.

In this cross‑sectional study, children with CAH, aged <18 years old who were regularly referred for follow‑up, were included. The information of the patients was extracted from their medical files, and they underwent renal ultrasonography for evaluation of the presence of NC.

From 120 studied patients with CAH, four patients (3.3%) had NC. The prevalence of NC was higher in males than females (P = 0.05). Mean age and age of CAH diagnosis had a trend to be lower in CAH patients with NC than those without. Regression analysis indicated significant association between NC and sex (P = 0.027, r = 2.24).

The results of this study indicated a 3.3% prevalence rate of NC for children with CAH. NC had a trend to be more prevalent in male children with CAH. Though it was not significantly different but given that the mean age and age at diagnosis of CAH in children with CAH and NC was lower that CAH patients without NC, it is suggested that in patients with CAH and NC other factors such as genetic background or unknown disease related factors are associated with hypercalcemia and NC.

The present study was performed to investigate and compare renal functions of single‑kidney patients after 12 h of percutaneous nephrolithotomy (PCNL) surgery through assessing major markers of renal function with focus on serum level of cystatin that performs a consistent accuracy in various conditions.

This pilot quasi‑experimental study was done on 92 patients with single kidney having staghorn calculus who had undergone PCNL and were referred to the Al‑Zahra Hospital, Isfahan, Iran, during 2019–2021. Serum levels of cystatin C, creatinine, estimated glomerular filtration rate (eGFR), and neutrophil gelatinase‑associated lipocalin (NGAL) urine level were evaluated before and 12 h after surgery.

The mean cystatin C decreased significantly 1.58 ± 0.55 versus mg/L 1.46 ± 0.52 after 12 h after surgery (P < 0.001). Furthermore, the mean levels of creatinine (2.04 ± 0.71 vs. 1.89 ± 0.60 mg/dL) and NGAL (39.72 ± 12.87 vs. 24.05 ± 10.89 μg/ml) were decreased significantly after 12 h of procedure (P < 0.05) while the mean eGFR (57.62 ± 27.59 vs. 64.68 ± 31.88 ml/min/1.73 m2) was increased significantly after 12 h (P < 0.001).

Due to significant improvement in all markers of renal after PCNL, this procedure can be considered a potentially effective and safe approach for treating large stone in single‑kidney patients.

This study aims to evaluate the association between demographic and smoking variables with the severity of lung function loss (Stage I to IV) and spirometry data in smokers.

Three hundred and fifty smoker men over the age of 20 who had visited in AL-Zahra hospital were involved. Spirometry tests were performed for measuring forced vital capacity (FVC), FEV1, and FEV1%FVC. COPD was categorized into four stages by the (Global Initiative for Chronic Obstructive Lung Disease) criteria of postbronchodilator FEV1/FVC <0.70. FEV1/FVC <70%, in combination with FEV1 ≥80% (Stage I), or 50%≤FEV1 <80% (Stage II), or 30%≤FEV1 <50% (Stage III), or FEV1 ≤30% (Stage IV). Independent t-test, Spearman correlation analysis was used for data analysis. To determine the predicting factors for pulmonary function multiple regressions analysis was performed.

43 (19.5%) of men were defined as Chronic Obstructive Lung Disease (COPD) which 7% of them were Stage I, 23.3% were Stage II, 39.5% were III and 30.2% were stage IV. In 60 (27.1%) of men, the index of Fev1/FVC was <80%. The criteria of PRIS in 74 (33.5%) of the patients and BDR in 59 (26.7%) of participation was positive. There were significant differences in the mean of FEV1 with respect to history of lung disease in relatives (P = 0.035), lung disease hospitalization (P < 0.001) and previous diagnosis of asthma variables (P < 0.001). The mean of FVC was significantly different in patients categorized based on lung disease hospitalization (P < 0.001) and previous diagnosis of asthma (P = 0.018). Furthermore, there was a significant difference in the mean of FEV1/FVC for variables as follows: Time to start smoking after waking up (P = 0.007), lung disease hospitalization (P < 0.001) and previous diagnosis of asthma (P < 0.001). There was a significant association between stages of lung function loss and age of onset of smoking (β-0.355 P = 0.019) and pack per year (β = 0.354 P = 0.02). A linear regression model showed that lung disease hospitalization and age were the influential variables on FEV1 with (B = −21.79 confidence interval [CI]: −28.7, −14.87, P < 0.001and B = −0.418 CI: −0.63, −0.21, P < 0.001), respectively. The only significant influential variable on FVC was lung disease hospitalization (B = −15.89 CI: −21.49, −10.296, P < 0.001). Body mass index, lung disease hospitalization, time to start smoking after waking up in the morning and age had significant relationship on FEV1/FVC with (B = 0.71CI: 0.32, 1.11, P < 0.001, B = −14.29, CI: −19.61,-8.97, P < 0.001, B = 6.54, CI: 2.26, 10.82, P = 0.003 and B = −0.44, CI: −0.59, −0.28, P < 0.001), respectively.

The age of onset of smoking and pack-year appears to be associated with the severity of COPD. Hospitalization history due to lung disease, age, the time between waking up in the morning and first cigarette use, BMI, lung disease history in relatives, previous diagnosis of asthma have a negative relationship with lung function.