RAZAVI INTERNATIONAL JOURNAL OF MEDICINE
Year:2023 | Volume:11 | Issue:1|Papers Count:8

Background: Children with Autism Spectrum Disorders (ASD) need special care that can create anxiety in parents, particularly their mothers, and endanger their well-being. Objectives: The present study aimed to compare the effectiveness of Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) in the resilience of mothers with autistic children. Methods: This quasi-experimental study was performed on mothers referred to special educational and medical centers for autism in Mashhad. A total of 45 mothers of children with autism were selected using convenience sampling and were randomly assigned to two experimental groups and one control group. The experimental groups of CBT and ACT underwent interventions based on the treatment plans of Bieling et al. and Vowles and Sorrell, respectively, in eight 90-minute sessions. The research tool was the resilience questionnaire of Connor and Davidson. Results: Based on the results, the control group significantly differed from CBT and ACT training groups (P<0. 001). This difference was more pronounced for the ACT group in the components of perception of individual competence and spiritual effects (F=37. 24, F=37. 87, respectively, and P=0. 00), while for the CBT group, more differences were observed in the components of trust in individual instincts (F=03. 19), positive acceptance (F=94. 91), and control (F=06. 13, and for all P=0. 00). Conclusion: The obtained results confirmed that CBT is more effective than ACT in the resilience of mothers with autistic children. It is recommended that CBT be used to promote the mental health of these mothers.

Background: Adiponectin and CTRP-9 are adipose tissue secreted adipokines mediating various tissue functions. Objectives: The present study aimed to investigate the effect of eight weeks of aerobic training and omega-3 ingestion on the levels of CTRP-9 and adiponectin in overweight and obese women. Methods: A total of 40 women within the age range of 20-35 years (mean age: 27. 29±, 3. 27 years) and mean body mass index of 29. 6±, 1. 93 kg. m2 participated voluntarily in the present study. The participants were then randomly assigned into four groups (10 cases per group) of placebo, omega-3, training, and training+omega-3. The aerobic training program lasted eight weeks (three sessions per week),moreover, the omega-3 and training+omega-3 groups consumed 2, 000 mg of omega-3 supplements daily. Blood samples were collected pre-and post-intervention (48 h after the last training session or omega-3 consumption). Following that, adiponectin, CTRP-9, and insulin levels were measured by ELISA. Data analysis was performed using the analysis of covariance and Bonferroni post-hoc test. Results: A significant decrease in the CTRP-9 levels and insulin resistance, as well as a significant increase in the adiponectin levels in the training and training+omega-3 groups were observed, compared to the placebo and omega-3 groups (P<0. 05). Conclusion: Based on our findings, it seems that the positive effects of aerobic training alone or combined with omega-3 supplementation are partially exerted by increased and decreased adiponectin and CTRP-9 levels, respectively. Furthermore, omega-3 supplementation can increase the effectiveness of aerobic training by modulating CTRP-9 and adiponectin levels.

Background: Organ transplantation is one of the great advances in modern medicine and the treatment process in many diseases begins with the provision of transplanted organs. Unfortunately, the need for organ donors is much greater than the number of people who donate. Objectives: With a significant gap between waitlisted patients and those who undergo liver transplantation (LT), it is crucial to have efficient allocation of this scarce resource and improve the performance of LT centers. Methods: In the present research, using the DEMATEL-modified ANP method, an attempt was made to identify, weigh, and prioritize the key factors influencing the transplantation process in the LT system. For this purpose, the liver transplant center at Mashhad University of Medical Sciences, Mashhad, Iran, was piloted to study the transplant process and interview the medical staff as specialists to draw a relationship map. Results: The obtained results indicated that the accuracy of patient selection for transplantation, surgical equipment, and the level of expertise of personnel were important factors in LT success. Then, by analyzing the results, management suggestions regarding the improvement of the quality of the services and systems were presented. Conclusion: The findings of this research can help health policy-makers and decision-makers to better understand the determinants of the performance of a transplantation center and suggest improvement plans. This means saving more lives and, at the same time, minimizing the cost of service.

Background: Diabetes mellitus is a common metabolic disorder that involves several organs, leading to chronic vascular and nonvascular complications. Objectives: The present study aimed to assess the effectiveness of self-compassion training in psychological symptoms and self-care in patients with type 2 diabetes. Methods: This semi-experimental study was conducted based on a pre-test post-test control group design The statistical population of the study consisted of all patients with type 2 diabetes from diabetes association and hospitals in Gilangharb in 2020, among whom 30 patients (self-compassion training and control group) were selected via the convenience sampling method. Data were collected using Psychological Symptoms Questionnaire and Tobert and Glasgow self-care questionnaires. Data were analyzed in SPSS software (version 24) using multivariate and univariate analysis of covariance tests. Results: The results demonstrated that self-compassion training was effective in psychological symptoms (P<0. 01) and self-care (P<0. 01) in patients with type 2 diabetes. Conclusion: As evidenced by the obtained results, it can be concluded that self-compassion training was effective in psychological symptoms and self-care in patients with type 2 diabetes and it can be effective as an efficient treatment method to improve psychological problems in these patients.

Background: Pulmonary artery hypertension is difficult to diagnose because of its nonspecific symptoms. Although echocardiography and more accurately catheterization can recognize pulmonary artery pressure, chest X-ray is widely used because of its availability. The Objectives: This study was to evaluate the accuracy of chest radiography parameters for the estimation of pulmonary artery pressure. Methods: This cross-sectional study included 81 subjects with a definite diagnosis of pulmonary artery hypertension. Mean pulmonary artery pressure (mPAP) was determined by catheterization. Hilar enlargement, projection of the right heart border (PRHB), hilar enlargement + PRHB, and the ratio of these parameters to the thoracic diameter were compared to mPAP to evaluate correlations. Results: The average mPAP was 74. 7±, 21 (ranging from 28 to 120 mmHg). Spearman's test revealed that mPAP had a significant correlation with a hilar enlargement (r=0. 489, P<0. 001), hilar/thoracic ratio (r=0. 482, P<0. 001), hilar enlargement + PRHB (r= 0. 517, P<0. 001), and hilar + PRHB/thoracic ratio (r=463, P<0. 001). Conclusion: Hilar enlargement and hilar/thoracic ratio on the chest radiography are proper parameters for the estimation of pulmonary artery pressure.

Background: Colonoscopy is the most accurate tool for the diagnosis of large intestine diseases, allowing one to observe the inner wall of the large intestine,nonetheless, the invasiveness of colonoscopy causes anxiety in patients. Objectives: The present study aimed to assess the effect of education using multimedia tools on pre-colonoscopy anxiety in female patients. Methods: The study tools were Spielberger State-Trait Anxiety Inventory (STAI) and a Knowledge questionnaire which were completed on the visit day. The patients completed the STAI and Knowledge questionnaire again before receiving the colonoscopy. The data were analyzed in SPSS software (version 24) using the analysis of variance (ANOVA) test. Results: Based on the results, patients in the booklet group had lower anxiety scores on the day of the colonoscopy, as compared to their counterparts in the multimedia group. There was no significant difference between the control and multimedia groups in terms of anxiety scores on the day of the colonoscopy. Nevertheless, there was a significant difference in the knowledge scores of the three groups on the colonoscopy day, and this difference was quite evident in the multimedia group. Moreover, the results of the two-way ANOVA test indicated that an increase in patients' knowledge on the days of visit and colonoscopy increased their anxiety on the colonoscopy day. Conclusion: As evidenced by the results of the present study, although multimedia tools increased patients’,understanding and knowledge of the colonoscopy procedure, they were not useful in the reduction of patients' anxiety. Therefore, the use of multimedia tools for the reduction of pre-colonoscopy anxiety was not effective in patients with high levels of anxiety.

Background: Health-related quality of life (HRQOL) can predict the amount and impact of the disease, damages, and inabilities,moreover, it can assess an individual's psychological health. Objectives: The present study aimed to assess the mediating role of social health in the relationship of parenting stress and child-parent interaction with HRQOL in parents of children with a specific learning disorder (SLD). Methods: This descriptive-correlational study was conducted using path analysis. The study population comprised all parents of children with SLD in Andimeshk in 2020-21, among whom 174 parents were selected via convenience sampling. The research instruments included the SF-36 Questionnaire (Weber, 1992), Parenting Stress Index (Abidin, 1992), Child-Parent Relationship Scale (Pianta, 1994), and Keyes's Social Health Questionnaire (Keyes, 1998). The proposed model was evaluated using path analysis with AMOS software (version 25). Results: The results pointed to a significant relationship between child-parent interaction and HRQOL (β, =0. 204, P=0. 004), social health and HRQOL (β, =0. 383, P<0. 001), parenting stress and social health (β, =-0. 561, P<0. 001), as well as child-parent interaction and social life (β, =0. 152, P=0. 016). Furthermore, the indirect paths of parenting stress and HRQOL mediated by social health (P<0. 001), as well as the relationship between child-parent interaction and the HRQOL mediated by social health (P=0. 021), were all significant. Conclusion: The final model achieved a desirable good fit,therefore, this model could be considered an important step in understanding effective factors in the HRQOL in parents of children with SLD.

Background: This study aimed to compare the effectiveness of pharmacotherapy and modular cognitive-behavioral therapy, as well as their combination, in intolerance of uncertainty and meta-worry among female university students with generalized anxiety disorder. Objectives: Paying attention to psychological, cognitive-behavioral and biological dimensions in patients with generalization anxiety disorder causes continuity of therapeutic effects. Methods: The present study was a semi-experimental research. The statistical population comprised all female students of the Islamic Azad University of Mashhad, of which 60 people were selected by a convenience sampling method and were randomly assigned to three experimental groups and one control group. All groups were initially pretested,afterward, the first experimental group received modular cognitive-behavioral therapy during ten 90-minute sessions,the second experimental group received pharmacotherapy and one daily dose of paroxetine,and the third experimental group received combination therapy,however, the control group was placed on the waiting list. At the end of the treatment period and three months thereafter, the participants were given a post-test and a follow-up test. The required data were collected through questionnaires, namely Freeston Intolerance of Uncertainty Scale and Wells Anxious Thoughts Inventory. The data were analyzed in SPSS-24 software using the repeated measures analysis of variance. Results: The results demonstrated that all three therapeutic approaches compared to the control group were effective in reducing intolerance of uncertainty and meta-worry. However, the combination therapy was significantly superior to any of the two treatment approaches alone (P<0. 05). Conclusion: Considering the biological and psychological underpinnings of generalized anxiety disorder, the combination of psychological and drug therapies seems to be a more effective approach to improving anxiety states.