Lymphangioleiomyomatosis, a multisystem disease characterized by cystic lung lesions can result in respiratory failure and is considered to be sex hormones related. No effective treatment for lymphangioleiomyomatosis is currently available. We report a 35-year-old patient in her second pregnancy. She also had experienced five episodes of spontaneous pneumothorax at the age of 30. Despite excessive estrogen production during pregnancy she had mild non-progressive exertional dyspnea without limitation of daily activities during pregnancy without deterioration of respiratory status.

Background & Objective: Lose a loved person is considered as painful experiences, but most people cope well with their loss and do not need professional help. Their experiences involve feelings of sadness, a deep sense of pain and the perception of their life never being the same compared to before the loss. However, reviews showed that the process of grieving in individuals experience grief after a loss of loved ones may be harder, which can impair their cognitive, emotional and behavioral functioning. This bereavement can be associated with physical decline, mental health problems, change in social roles, cognitive deficits and fewer relationships with others, which make the grieving process more difficult. For some the grieving process may be distorted termed COMPLICATED grief, which is a form of chronic grief with intense separation distress related to the loss. The resulting syndrome of COMPLICATED grief causes substantial distress and functional impairment even years after a loss, yet knowing when and how to intervene can be a challenge. As a result, grief work will be one of the common challenges that social workers, psychologist and grieved people will face. Providing a mindfulness based cognitive therapy for people with COMPLICATED grief can be a benefit for their individual growth in understanding a sense of bereavement and for the purpose of social interconnection. This Therapy will cover bereavement life with a concept of mindfulness and how it can be utilized for people in their day– to– day lives. Overall, the goal for this project for participants was to learn coping skills, gain knowledge in the mechanism of mindfulness during the grieving process and how they can integrate mindfulness principles into their grieving process to better facilitate their coping with their loss. Methods: In the present study, we used multiple baseline experimental single case study design. Three women with COMPLICATED grief were selected from patients of counseling service centers by using purposeful sampling method, along with inventory of COMPLICATED grief (ICG). This questionnaire describe an emotional, cognitive, or behavioral state associated with COMPLICATED grief. The ICG consists of 19 items and answers are given on a 5– point scale ranging from never (0) to always (5). ICG gives a possible range of 0– 76 with high scores indicating high levels of CG. The ICG has shown high internal consistency, test– retest reliability. In this study, Cronbach's alpha was calculated 0. 92. Patients underwent the treatment process subsequent to obtaining treatment requirements. The efficacy of mindfulness– based cognitive therapy was carried out in three phase of intervention (baseline, treatment and follow– up) by using Inventory of COMPLICATED grief. In this project, Data analyzed with visuals inspection, improvement percentage and reliable change index (RCI) strategies. In addition, to examine the efficacy of this psychological intervention (MBCT), it used the six indices of Ingram (2000). These six indices include magnitude of change, universality of change, generality of change, generality of change, stability, and acceptability. Results: Finding showed mindfulness– based cognitive therapy is both clinically and statistically (p<0. 01) significant efficient on the reduction of people with symptoms of COMPLICATED grief Conclusion: Mindfulness– based cognitive therapy has appropriate efficacy in the symptom reduction of people suffering from COMPLICATED grief.

Dear Editor-in-Chief, The recent report on “The Adverse Effects of Pregnancies COMPLICATED by Hemoglobin H (HBH) Disease” is very interesting. Rabiee et al. reported a pregnant case COMPLICATED with HBH disease.Indeed, this problem might not common in the Middle East but it is very common in Southeast Asia.The authors hereby would like to share the experience on this topic. In the recent report by Tongsong et al., the maternal outcomes of normal mothers and those with HBH disease were not different. The common identified problems are fetal growth restriction, preterm birth and low birth weight.

A 51-year-old man presented with fever, chills, and significant weight loss of 6 months’ duration. Three months earlier, the patient had undergone percutaneous nephrolithotomy for right-sided kidney calculus.

This was a case of acute pancreatitis who COMPLICATED by left side hemiplegia and dysarthria. It diagnosed as Lacunar infarction and therapy with intravenous heparin started according to neurologist order. In third day of admission, the patient suddenly got dyspnea, tachycardia and tachypnea. Infusion of heparin continued with clinical diagnosis of pulmonary emboli and also warfarin added to his therapeutic regimen. The clinical condition of patient gradually got better and on 7th day of admission, he could tolerate oral regimen without any respiratory difficulty and his hemiplegia improved. On the following day, he discharged from ward with prescription of warfarin.

Introduction: Psychiatric problems like suicide, self-harm, and injurious behaviors are important and common in chronic diseases like diabetes. This study aimed to compare suicidal ideations and self-injurious behaviors in patients with type 2 diabetes with and without complications referring to diabetes research center in Yazd, 2017. Methods: In this case-control study, simple random sampling was used. The data were collected using standard questionnaires. Beck Scale for Suicidal Ideation (BSSI) was used to investigate suicidal ideations and Sanson questionnaire was used for self-injurious behaviors. Finally, the collected data were entered into SPSS version 19. Also, t-test was used to compare the means and Chi-square test was used to compare the frequency distributions. Result: A total of 360 patients were studied in two groups of 180 (COMPLICATED and non-COMPLICATED). Of these patients, 189 (52. 5%) were male and 171 (47. 5%) were female. Moreover, only 1 patient (0. 3%) had self-injurious thoughts and 1 patient (0. 3%) had high suicidal ideations. There was no significant difference between the frequency distribution of self-injurious thoughts and suicidal ideations in the two groups (p=0. 371). There was no significant difference between the frequency distribution of self-injurious thoughts and suicidal ideations in the two groups according to the gender (p=0. 285, p=0. 432). Conclusion: The results showed that the frequency of self-injurious thoughts and suicidal ideations in type 2 diabetes mellitus patients is low and the complications of the disease do not affect this abundance.