Journal of Guilan University of Medical Sciences
Year:2020 | Volume:29 | Issue:115|Papers Count:7

Background Acute Myocardial Infarction (AMI) is the first and the most important leading cause of mortality in Iran. Psychological factors play a key role in the onset and exacerbation of this disease. Objective The purpose of this study was to evaluate the effect of Dialectical Behavior Therapy (DBT) on perceived stress and coping skills of patients following AMI. Materials and Methods This is a clinical trial with pre-test/ post-test/follow-up design conducted in 2018 on 30 patients with diagnosed AMI after discharge from Noor Heart Clinic in Rasht, Iran. The patients were randomly divided into intervention (5 females and 10 males) and control (8 females and 7 males) groups. Assessment tools included the Perceived Stress Scale and the Ways of Coping Questionnaire that were completed before and after intervention and during a 3-month follow-up period. The intervention group received DBT at 8 sessions of 90 minutes per week for 2 months. Data were analyzed using independent t-test, repeated measures ANOVA, and Bonferroni Post Hoc test. Results The DBT had significant effects on the perceived stress (F=6. 21, P<0. 05), problem-focused coping strategy (F=5. 00, P<0. 05) and emotion-focused coping strategy (F=15. 20, P<0. 001). Conclusion Dialectical behavior therapy can reduce the perceived stress and improve the coping skills of patients following AMI.

Background Several studies have reported that cigarette smoking affects sperm parameters, especially semen quality, but their results are contradictory. Objective This retrospective study aims to evaluate the relationship of sperm parameters with smoking in men with idiopathic infertility. Materials and Methods This retrospective study was conducted on 1744 infertile men with at least one year of idiopathic infertility. They were divided into two groups of smokers (n=379) and non-smokers (n=1365) according to their smoking habits and based on their inclusion and exclusion criteria. The semen analysis was extracted from subjects’ medical records, and the collected data were analyzed in SPSS V. 19 software. Results Smoking significantly reduced semen volume in smokers (2. 88± 1. 50 mL) compared to non-smokers (3. 28± 1. 77 mL) (P=0. 002). There was a significant decrease in sperm motility in smokers (36. 1± 21. 9%) compared to non-smokers (34. 4± 19. 6%) (P=0. 009). However, the association of smoking with sperm motility between men with normal and abnormal semen volumes was not statistically significant, and there was no significant difference in sperm count and morphology between infertile smokers and nonsmokers (P>0. 05). Conclusion Smoking causes a significant reduction in semen volume, but has no significant effect on sperm count, morphology, and motility in men with abnormal and normal semen volume.

Background Cognitive impairment is a common complication of Severe Traumatic Brain Injury (STBI). One of cognitive problems following STBI is impaired executive functions which involve high-level cognitive processes and their dysfunction can lead to reduced quality of life. Objective This study aims to investigate the cognitive impairment in men with STBI compared to healthy men. Materials and Methods This causal-comparative study was conducted from February 2017 to July 2019 on 20 male patients aged 30-55 years with a history of STBI in the past one year admitted to the intensive care units of Shohaday-e-Haftom-e-Tir and Baqiyatallah hospitals in Tehran, Iran and 64 healthy men who had met all inclusion criteria. Both groups were measured by the Wisconsin Cards Sorting Test (WCST). Results There were significant differences between the two groups in WCST parameters including the number of categories completed, perseverative errors, correct and wrong responses, response time, number of trials to successfully complete first category, and conceptual level responses (P<0. 01). Patients with STBI had a lower overall WCST score than the healthy subjects. Conclusion It is necessary to pay special attention to cognitive impairment in STBI patients in their clinical and legal evaluations and psychological interventions.

Background Diabetes is one of the most common diseases affecting people's mental health and the body. Therefore, psychological interventions seem necessary to solve the problems caused by this disease. Objective The present study aimed to compare the effectiveness of Compassion-focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT), and commitment to self-care behavior and glycosylated hemoglobin in patients with type 2 diabetes at Tonekabon City Hospital. Materials and Methods This clinical trial was a one-step cluster sampling study, including 200 patients who were randomly selected from all patients with type 2 diabetes in Tonekabon City Hospital and, at the same time, the scale of self-care behavior of Tobert, Glasgow, and Hamspon (2002). A total of 45 people were randomly selected and divided into three groups of 15 people, including two intervention groups and one control group, 12 compassionate therapy sessions, and 12 admission-based treatment sessions, each lasting 45 minutes. Meetings for each intervention were performed twice a week with an interval of 3 days. At the end of treatment, all three groups were retested. Results Due to the comparison of the mean differences between the two treatment groups for self-care and glycosylated hemoglobin (5. 012) (-2. 145), respectively, Acceptance and Commitment Therapy was more effective than compassion-focused therapy. Conclusion The results owed a positive trend and increased self-care behavior and balanced glycosylated hemoglobin level in the follow-up and effectiveness of both approaches and the superiority of the acceptance and commitment-based treatment approach. Therefore, this treatment can be used in different conditions to improve the lives of patients with type 2 diabetes.

Background For many years, Canal Wall Down (CWD) tympanomastoidectomy has been the gold standard for treatment of cholesteatoma; however, this method has long-term complications for the patients. The Intact Canal Wall (ICW) tympanomastoidectomy has relatively lower complications, but access to the middle-ear recesses is difficult in this method. Therefore, endoscopy is used to visualize the underexposed recesses. Objective This study aims to compare the incidence of residual cholesteatoma using the two methods of CWD and endoscopic-assisted ICW. Materials and Methods In this prospective randomized clinical trial, participants were 40 patients with cholesteatoma in the middle ear and mastoid who were candidates for tympanomastoidectomy. They were randomly divided into two groups. In the first group, ICW was performed with endoscopic assisted visualization, while in the second group, conventional CWD technique was performed without ossicular reconstruction. All the patients were microscopically examined at 3, 6, 9 and 12 months after surgery. Revision middle ear surgery and possible ossicular reconstruction under local anesthesia were performed one year after the surgery. The presence of cholesteatoma pearl in the middle-ear, evaluated by using a 2. 7mm 30° endoscope, was recorded as the sign of residual cholesteatoma. Fisher’ s exact test and Mann-Whitney U test were used for statistical analysis. Significance level for the tests was set at 5%. Results The incidence of residual cholesteatoma was not statistically significant between the two groups (P>0. 05). In each group, 20% (n=4) had residual cholesteatoma. The difference in time interval from the first to second surgery was not statistically significant between the study groups (P>0. 05). Conclusion Endoscopic-assisted ICW tympanomastoidectomy is comparable with CWD tympanomastoidectomy in eradication of cholesteatoma, having possibly fewer complications. It is recommended that more studies be conducted with a larger sample size and longer follow-up period.

Background Adolescence is an important and vital period in the human lifespan. Adolescent girls’ health is affected by special cultural and social factors; investing in their health requires careful planning and effective intervention. For any planning, accurate knowledge of their needs is necessary. Objective This study aims to assess the healthcare needs of adolescent girls in Iran. Materials and Methods This descriptive cross-sectional study was conducted on 850 female students who were studying in first-and second-grade high schools in Rasht, Iran. They were selected using a multistage cluster sampling technique. In this study, a demographic form and the Female Adolescents Health Needs Questionnaire (FAHNQ) were used for data collection. The collected data were analyzed in SPSS V. 21 software using descriptive statistics. Results According to the participants, the top priority healthcare need was related to the emotional need (23. 47± 12. 22%), followed by social (21. 02± 11. 68%), educational (18. 63± 16. 01%), physical (15. 12± 10. 34%) and spiritual needs (13. 86± 11. 99%). Conclusion The decision-makers in the health sector should pay more attention to the emotional needs of adolescent girls to promote their primary health.

Background Stroke is one of the most important causes of disability-adjusted life years lost. Low socioeconomic status is associated with increased stroke-related morbidity and mortality. Objective This study aimed to investigate in-hospital mortality rate caused by severe cases of ischemic and hemorrhagic stroke and its relationship with patients’ socioeconomic status. Materials and Methods This comparative analytical study with a cross-sectional design was conducted from April 2018 to March 2019 on 384 patients diagnosed with severe stroke admitted to the neurology department of Poursina Hospital in Rasht, Iran, who were selected using a purposive sampling method. They completed a demographic checklist and the Socio-Economic Status Questionnaire. Data analysis was carried out in SPSS V. 21 software. Results It was reported a stroke death rate of 59. 9%, of which 75. 7% occurred in the hospital. Strokerelated mortality rate had a significant relationship with age (P=0. 021), gender (P=0. 047), not owning a home (P<0. 001) and socioeconomic status (P<0. 001). Conclusion Some demographic factors including old age, male gender, not owning a home, and low socioeconomic status increase the risk of stroke-related mortality.