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

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

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