Socioeconomic characteristics and life skills of medical students: A cross-sectional study

  Background: The current medicine teaching curriculum has caused medical students several psychological ailments including depression, and stress. Our study aimed to find a relationship between some socioeconomic characteristics of medical student and their life skills at Mashhad University of Medical Sciences, Iran.   Methods: 146 Interns of Mashhad University of Medical Sciences were enrolled in our cross-sectional study by census. The framework was obtained from education department of faculty. Students reported a history of psychological disorders, and foreign students were excluded. We evaluated participant's Proficiency in computer, habitat, parent's education, and family income and life skills. Data were analyzed by SPSS Inc. Released 2007. SPSS Inc. Released 2007. SPSS for Windows, Version 16.0.   Results: Participants aged between 22 to 27 and 98 (66.2%) of them were female. Comparison between four levels of father's education (lower than diploma, diploma, bachelor and higher than bachelor) showed worldview (P=0.014), social behavior (P=0.011) and ability to use new technologies (P=0.018) had a significant difference. Regarding the mother's education, there are no significant differences among 20 life skills. There were significant differences between levels of computer proficiency and communication skills (P=0.042), interpersonal relations (P=0.011), mental health status (P=0.035), problem-solving (P=0.021), creativity (P=0.013), ability of using new technologies (P=0.001), participate in activities that improve benefits (P=0.027), and total score (P=0.043).   Conclusion: Despite mothers' education, fathers' education has a role in medical students' world view, technology access, and social behavior. However, comparison of means and subgroup analysis didn't show a logical relationship. Computer proficiency besides affecting different aspects of life skills can affect total life skill scores

Screening for Depression In Hospitalized Pediatric Patients

How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1):47-51. ObjectiveIn chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhoodmalignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad.Materials & MethodsAfter receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, aged between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded.Three groups of children (children with chronic renal disease, malignancy, and acute disease) were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI). Two specifically trained nurses with the supervisionof a psychiatrist filled out the questionnaires at patients’ bedside. Depression scores were then analyzed by SPSS software.ResultsOf 90 children, 43(47.7%) were male and 47(52.2%) were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days.Depression was detected in various degrees in 63% of patients (N=57), and 36.6% of children (N=32) had no symptoms of depression. Severe depression was not seenin any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had moderate to severe depression.There was a significant statistical relationship between the duration of illness and severity of depression. There was also a significant correlation between severity of depression and frequency of hospitalization. Children who had been hospitalized more than 3 times in the last year, experienced more severe levels of depression. We also found a significant correlation between pubertal age and severity of depressionin patients with cancers and chronic renal failure.ConclusionChildren who are hospitalized due to chronic conditions are at a higher risk for mood disorders in comparison with the ones with acute conditions. It is therefore advisable to consider more practical plans to improve the care for hospitalizedchildren’s mental health.ReferencesKessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-ofonset distributions of dsm-iv disorders in the national comorbidity survey replication. Arch Gen Psychiatry 2005;62(6):593-602.Rutter M. Relationship between mental disorders in children and adulthood. Acta Psychiatr Scand 1995;91(2):73-85.Naerde A, Tambs K, Mathiesen KS Dalgard OS. Symptoms of anxiety and depression among mothers of pre-school children: effect of chronic strain related to children and child care-taking. J affect Discord 2000;58(3):181-99Ernest J, Weissflog G, Brahler E, Romer G, Götze H. Depression in children of cancer patients over time and dependence of parental distress. Prax Kinderpsychol Kinderpsychiatr 2012;61(6):432-46.Gordijn MS, van Listenburg RR, Gemke RJ, Huisman J. Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2013;60(3):479-85.De Sousa A. Psychiatric issues in renal failure and dialysis. Indian J Nephrol 2008;18(2):47-50Bakr A, Amr M, Sarhan A, Hammad A. Psychiatric disorders in children with chronic renal failure. Pediatr Nephrol 2007;22(1):128-31.Goldstein SL, Rosburg NM, Warady BA, Seikaly M, McDonald R, Limbers C, et al. Pediatric end stage renal disease health-related quality of life differs by modality: a PedsQL ESRD analysis. Pediatr Nephrol 2009;24(8):1553-60.Thomalla G, Barkmann C, Romer G. Psychosocial symptoms in children of hemodialysis patients. Prax Kinderpsychol Kinderpsychiatr 2005;54(5):399-416.Laffond C, Dellatolas G, Alapetite C, Puget S, Grill J, Habrand JL, et al. Quality of life, mood and executive functioning after childhood craniopharyngioma treated with surgery and proton beam therapy. Brain Inj 2012;26(3):270-81.Chung TK, Lynch ER, Fiser CJ, Nelson DA, Agricola K, Tudor C, et al. Psychiatric coomorbidity and treatment response in patients with tuberous sclerosis complex. Ann Clin Psychiatry 2011;23(4):263-9.Kinahan KE, Sharp LK, Seidel K, Leisenring W, Didwania A, Lacouture ME, et al. Scarring, disfigurement, and quality of life in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor study. J Clin Oncol 2012;30(20):2466-74.Adduci A, Jankovic M, Strazzer S, Massimino M, Clerici C, Poggi G. Parent-child communication and psychological adjustment in children with a brain tumor. Pediatr Blood Cancer 2012;59(2):290-4Szabo A, Mezei G, Kovari E, Cserhati E. Depressive symptoms amongst asthmatic children caregivers. Peditr Allergy Immunol 2012;21(4 Pt 2):e667-73.Arabiat DH, Elliot B, Draper P. The prevalence of depression in pediatric oncology patients undergoing chemotherapy treatment in Jordan. Pediatr Oncol Nurs 2012;29(5):283-8.Li HC, Williams PD, Lopez V, Chung JO. Relationships among therapy-related symptoms, depressive symptoms, and quality of life in Chinese children hospitalized with cancer: an exploratory study. 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Mizaj assessment and data analysis methods in Amirkola health and aging project (AHAP cohort)

Background: One of the principles of Persian medicine (PM) is the individualized approach that is presented with the concept of Mizaj. In this viewpoint, Mizaj is determined for every person based on 10 criteria, which is a result of the Mizaj of the main organs, including the brain, liver, and heart. There is no standard diagnostic tool for Mizaj assessment in the elderly. The purpose of this study is to explain the method of Mizaj assessment and data analysis in the elderly in the second phase of the Amirkola health and aging project (AHAP) in Iran. Methods: In this study, a novel Mizaj assessment method in two phases is presented. In the first phase, 1541 elderly were assessed by a PM expert and typical diagnoses were determined. At the second phase, an expert panel including 5 PM experts evaluated the cases. The paraclinical and metric data of the elderly whose Mizaj agreed in the expert panel was used to assess its correlation with Mizaj. Conclusion: In the lack of valid and reliable questionnaires to assess the personalized viewpoint of PM, a new expert-based method has been introduced that can be used in similar studies. The result of the Mizaj assessment in this way will be used to obtain objective values for the Mizaj assessment

Effective medical plants extracts on bloating in traditional Persian medicine

نفخ شکم یکی از شایع‌ترین شکایات عمومی و از جمله شایع‌ترین بیماری‌های گوارشی محسوب می‌شود. با توجه به اثرات متناقص درمان‌های ارائه‌شده جهت درمان نفخ در طب رایج و اهمیت تجارب سنتی در ساخت داروهای مؤثر، این مقاله به معرفی مفردات مؤثر بر نفخ شکم از دیدگاه طب سنتی ایران پرداخته است. این تحقیق یک مطالعه کتابخانه‌ای و بر اساس بررسی متون طب سنتی می‌باشد. در این مطالعه مفردات دارویی مؤثر در درمان نفخ شکم در شش کتاب مرجع داروشناسی طب سنتی (الابنیه عن حقایق الادویه، قانون فی الطب، اختیارات بدیعی، تذکره داوود انطاکی، تحفه حکیم مؤمن، مخزن الادویه) جستجو شد. این کار در ده مرحله (یافتن کلیدواژه، یافتن مفرده، جستجو در منابع، تهیه لیست واحد، یافتن مترادف‌ها، دسته‌بندی، بازبینی، خروج مفردات از ترکیبات، جمع‌بندی، نمره‌دهی، مرتب‌سازی) انجام شد. در پایان این مراحل، بر حسب نمره کسب‌شده، 302 مفرده داروییِ مطرح در درمان نفخ شکم یافت شد. بیشترین نمره کسب‌شده (امتیاز 10) برای سه مفرده (اگیر ترکی، زنیان، سیاه‌دانه) در درمان نفخ شکم به‌ دست آمد و بیشترین تعداد مفردات مؤثر بر نفخ، در کتاب مخزن الادویه می‌باشد. لیست مفردات دارویی حاصل‌شده در این مطالعه می‌تواند مبنای انجام مطالعات بالینی برای ساخت داروهای جدید در درمان نفخ شکم قرار گیرد.Abdominal bloating is one of the most common general symptoms and digestive complaint. In addition to contradictory effects of bloating treatment and importance of traditional experiments on product of effective drugs, this study presents effective plants in traditional medicine. This study is a review and searched effective medical plants on abdominal bloating on 6 books (Al Abnieh Anhaghayegh Al Advieh, Canon fe Teb, Ekhtiarat Badiei, Tazkere Davod Antaki, Tofat ol moeminin, Makhzak ol Advieh). This plan was done on 10 steps (finding key words, finding materia medica, searching on references, taking same list, finding equivalents, grouping, reseeding, extract of singular of complexes, adding, scoring, ranking). The last of study was detected 302 effective medical plants on abdominal bloating. Maximum score was 10 (Acorus Calamus, Carum Copticum, Nigella Sativa) and Makhzan Al Advieh had maximum effective plants. List of medical plants can be base of clinical studies for producing new drugs on abdominal bloating treatment in this study

Does abstinence resolve poor sleep quality in former methamphetamine dependents?

Background and objective: Among substances that have a significant effect on sleep are stimulants, including amphetamines. As there are few studies assessing sleep quality in methamphetamine withdrawal this study aims to evaluate changes in sleep quality of methamphetamine dependent patients during early remission period by controlling depression and anxiety as confounding variables. Methods: This study was conducted in Mashhad, Iran. Ninety amphetamine dependent patients, who were admitted in residential centers during 2012–2014 and met our inclusion criteria, were chosen by purposive nonprobability sampling method. Sleep quality was assessed by Pittsburg sleep questionnaire, in the first, second, and after the fourth week of abstinence. Additionally all participants were assessed by Beck Depression Inventory-2 and Beck Anxiety Inventory for controlling depressive and anxiety symptoms. Results: The prevalence of improper quality of sleep was very high (97.8%) within the first week of withdrawal, but it reduced considerably four weeks after abstinence (52.2%), which was statistically significant (P=0.00). The variations of depression and anxiety levels within four weeks after quitting methamphetamine, have low impact on variation of patients' sleep quality (adjusted R2<0.5). Furthermore, the effectiveness of these two intervening variables on patients' quality of sleep was dwindled over time after abstinence. Conclusions: This study showed that the patients' quality of sleep improved significantly four weeks after abstinence and its variation was independent from variations in anxiety and depressive symptoms

An unusual salvage technique for posterior tracheal membranous laceration associated with transhiatal esophagectomy: A transcervical–transsternal approach

Various surgical approaches may be employed for esophageal resection. Major airway injuries due to transhiatal esophagectomy include vertical tears in the membranous trachea. Tracheal injury is an uncommon but potentially fatal complication. This article describes the technique to repair the posterior membranous tracheal tear, extended just over the carina through a transcervical–transsternal approach, thereby avoiding a second thoracotomy. Six patients with posterior membranous tracheal injury underwent this procedure. The laceration ranged from 3 cm to 5 cm in length. Four patients had received neoadjuvant chemoradiation. The management of tracheal laceration added approximately 60 minutes to the total operation time. There was no mortality related to tracheal injury. Patients were followed up for 6 months after surgery, and both posterior tracheal wall and transverse tracheotomy remained intact without stenosis. The transcervical–transsternal approach decreases the need of thoracotomy and its complications in patients with tracheal laceration in any stage, even in cases of an extended tear down to the carina

Dramatic Response of Resistant Obsessive Compulsive Disorder to Repeated Transcranial Magnetic Stimulation on Right Supplementary Motor Area

The response rate to the treatment of obsessive compulsivedisorder (OCD) is 21.6% to 61.3%, which shows a relativeresistance to current treatments and a need for noveltherapeutic approaches. Here we report a case of resistantOCD with fast and dramatic response to a relatively newmethod of repeated transcranial magnetic stimulation. In thismethod a pulse magnetic field emits from a coil over thesurface of the scalp to induce a localized electrical current inthe cortex below. Cortical activity can then be either inhibitedor stimulated. The patient was a 40-year-old woman withsevere OCD who admitted to our psychiatric hospital. She wastreated with 10 sessions of rTMS (110% intensity, 1 Hzfrequency and duration of 30 minutes per day / a total of 1200pulses per day) on right supplementary motor area. Herimprovement evaluated serially with Yale Brown Scale. Bythe end of the 2nd day she reported a major improvement ofsymptoms. Dramatic improvement was observed in herobsessive and compulsive behaviors, and avoidance recoveredcompletely. She also reported significant improvement inability to control obsessive thoughts and impulses, and anxietysymptoms. Since repeated transcranial magnetic stimulation isa low risk method with almost no interaction with the commonmedications, as well as the faster response obtained by usingthis method, it can be used as an add-on treatment in resistantcases of OCD and even in the initial stages of this disorder

Comparison of the Effect of Face-to-Face and Multimedia Education on the Anxiety Caused by Electroconvulsive Therapy in Patients with Mood Disorders

Background: Training methods to reduce the anxiety caused by the electroconvulsive therapy (ECT) should match the necessity of communicating with the patients suffering from mood disorders. Aim: This study aimed to compare the effects of face-to-face and multimedia education on the anxiety induced by the ECT. Method: This randomized controlled clinical trial was conducted on 75 patients with mood disorders undergoing ECT in the Ebn-e-Sina Psychiatric Hospital in Mashhad, Iran within 2013-2014 in three groups of face-to-face education (i.e., individual training), multimedia education (i.e., training through CD), and control (i.e., usual training), Receiving training for half an hour to get familiar with the ECT department, nursing care, and self-care one day before performing the ECT. The Spielberger's State-Trait Anxiety Inventory was completed prior to the intervention and before the first, middle, and final sessions of the ECT. The data were analyzed using the one-way and repeated measures ANOVA in the SPSS version 11.5. Results: According to the results of the study, 56% (n=14), 56% (n=14), and 48% (n=12) of the participants in the face-to-face, multimedia, and control groups were male, respectively. The post-hoc Tukey's test demonstrated that the control group had a significant difference with the face-to-face and (P=0.01) multimedia education groups (P=0.03) before the first session of the ECT. In addition, there was a significant difference between the face-to-face and multimedia education groups in this regard (P=0.07). Implications for Practice: Considering the conditions and facilities of the psychiatric hospitals, it is possible to use different methods of face-to-face or multimedia education to reduce the anxiety caused by the ECT

Assessment of life skills of medical students in Mashhad, Iran, in 2015

Background: Developing social skills and mental health is a crucial part of the psychosocial health status of medical students. Objective: The aim of this study was to assess the life skills of medical students in Mashhad University of Medical Sciences (MUMS). Methods: This cross-sectional study was performed in Mashhad University of Medical Sciences, Iran in 2015. By census method, 146 interns were entered into the study. The life skill questionnaire, consisting of 144 questions, was used as the measurement tool. Over 3 months, all the medical students in internship period were asked to complete the questionnaire. Data were analyzed by independent-samples t-test, one-way ANOVA, and Mann-Whitney with SPSS version 11.5 software. Results: Women were shown to have higher decision-making ability than men (p=0.046). It was also shown in the study that social behavior (p=0.018), participation in activities that improve benefits (p=0.006), critical thinking (p=0.007), observing and using safety points (p=0.005), and mental health status (p=0.034) were significantly lower in men than in women. The data also suggests that men (13.97±4.7249) are more likely to become global citizens than women (12.15±3.6298) (p=0.010). Furthermore, there was a significant difference when comparing smoking and non-smoking in freedom and justice (p=0.003) and becoming a global citizen (p=0.012). Conclusion: Our study provides helpful information about medical students’ life skills for policy makers and university authorities. We suggest that gender differences should be considered during life skill trainin