The Effect of Transcutaneous Electrical Nerve Stimulation on Acute Pain in Patients with Tempromandibular Disorder

 Introduction: Temporomandibular disorder (TMD) related pain can affect the individual's daily activities, psychosocial functioning, and quality of life. The aim of the study is to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on acute pain in patients with TMD. Materials and Methods: This is a double blind randomized clinical trial study. Patients were studied in two groups: In group1(Control group), patients received pharmacological agents with 7 sessions of passive TENS , patients in group 2  received the same protocol with 7 sessions of  active TENS (Every session 15 min). Age and gender were variables and pain severity (based on visual analogue scale) and maximum mouth opening (MMO) 30 days after treatment were outcomes of the study. Results: Sixty patients were studied in two groups. Seven days after treatment, the mean of pain severity was 3.63±0.80 in group1 and 2.67±0.66 in group 2., The mean of MMO was 37.06±1.68 mm in group1 and 38.47±1.48 mm in group2.Analysis of the data showed a significant difference between the two groups for MMO. (P=0.001) Conclusion: It seems use of TENS may improve pain relief in conjunction with pharmacological agents in patients with TMD. 

Assessing the Effects of Acceptance-commitment and Psychodrama Therapies in Nurses With Social Anxiety Disorder

Objectives: Social anxiety disorder (SAD) is one the most prevalent psychiatric disorders and generates severe negative effects on patients' mental, individual, and social health. Decreased responsibility, absenteeism, and poor life quality can be the consequences of this disorder. Considering the effective empirical background of both therapeutic approaches in reducing social anxiety symptoms and the lack of research on combining both interventions to reduce anxiety, this study was performed to determine the effects of acceptance-commitment therapy (ACT) and psychodrama therapy on nurses' social anxiety. Methods: This randomized trial research was conducted at Torbat Heydarieh University of Medical Sciences in 2017 with a pre-test-post-test design. A total of 48 nurses with SAD who were referred to the university counseling center were chosen at random and entered into 4 equal groups (12 subjects) (an intervention group and 3 control groups). The intervention group received a combination of psychodrama and ACT therapies in twelve 90-minute treatment sessions (2 meetings every week). The control groups were provided with psychodrama therapy, ACT, and no treatment. The study data were collected by Connor's social anxiety questionnaire (2000). The collected data were analyzed by analyses of variance and covariance. Results: A decrease was observed in the social anxiety scores in the four groups of the study after psychological therapies. The Mean±SD of the social anxiety score in the treatment group based on psychodrama was 64.75±13.37 before the study period and 49.08±6.71 after that. While in the ACT group, it was 59.65±12.21 and 42.66±8.05 before and after the study, respectively, and in the group provided with a combination of both therapies, it was 62.75±13.49 before the study period and 35.75±7.19 after that. A lack of significant difference (P=0.86) could be detected in the mean anxiety score in the group of control. However, the social anxiety score of the group with a combination of both therapies significantly decreased (P<0.001) compared to other studied control groups.   Discussion: The data analysis showed that a combination of ACT and psychodrama therapies significantly reduced the social anxiety of nurses