Frequency of bipolar spectrum disorders in those who are managing as a case of anxiety disorder in outpatient clinics of Isfahan (Iran)

Background and aims: Recent evidence showed significant rate of anxiety co-morbidity in patients with a diagnosed bipolar disorder. In this research we tried to study the rate of bipolar spectrum disorder (soft bipolarity) in those who are treating with anxiety disorder diagnosis. Methods: In this descriptive-analytic study, 210 patients with a diagnosed anxiety disorder were selected from out patient's clinics and clinic of Noor general hospital in Isfahan (Iran). 210 persons from general population were selected as control. Bipolar spectrum diagnostic scale (BSDS) was used as screening tool of bipolar disorder. Data were analyzed using X square and logistic regression. Results: Considering the homologizing between 2 groups, there was no significant difference regarding age, genders and educational level between 2 groups. Bipolar spectrum disorder was 15.8% in patients with anxiety disorders (case group) and 5.4% in the control group (P<0.001, OR=3.38, CI95%=1.65-6.94). This finding means that the probability of bipolar spectrum disorder in patients with anxiety disorders was about 3 times the control group. Conclusion: Co-morbidity of bipolar spectrum disorder (soft bipolarity) is significantly more prevalent in those with a diagnosed anxiety disorders than control group and needs to be considered in prognostication and treatment of the patients with anxiety disorder

The Effect of Add-on Memantine in New Onset Combat-Related Posttraumatic Stress Disorder Core Symptoms: A Pilot Study

Objective: Studies using standard neuropsychological instrumentation have shown memory deficits in posttraumatic stress disorder (PTSD) patients. We examined the efficacy and safety of memantine in new cases of combat-related PTSD in the military by conducting a 16-week prospective double-blind randomized controlled trial. Method: Twenty-six new combat-related PTSD cases were recruited from among the military personnel based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Patients were assigned to memantine and Placebo groups. They were monitored at baseline, week eight, and week 16. Memantine was added to each patient's current medication with an initial dosage of 5 mg/day, raised by 5 mg/day every week until it reached the maintenance level of 20 mg/day. The concurrent drugs were essentially kept unchanged during the trial. The primary outcome was PTSD severity as assessed by the Clinician-administered PTSD Scale (CAPS). The CAPS is a valid and reliable tool for the diagnosis of PTSD and measurement of its severity according to the DSM–4. Results: CAPS mean score in baseline (P = 0.811) and weeks eight (P = 0.389) and 16 (P = 0.066) did not show any significant differences between the two groups. The mean CAPS score in the memantine group significantly (P = 0.006) decreased (Mean differences = -8.79) compared to the placebo group, showing that intervention with memantine was effective. The mean total CAPS in weeks eight (Mean differences = -14.21) and 16 (Mean differences = -27) were less than the baseline, which was significantly meaningful (P < 0.001). Conclusion: Findings of this study suggest that add-on memantine can be effective in veteran patients with PTSD. So our data provide useful insight into the management of new cases of combat-related PTSD

Designing and validation a visual fatigue questionnaire for video display terminals operators

Background: Along with the rapid growth of technology its related tools such as computer, monitors and video display terminals (VDTs) grow as well. Based on the studies, the most common complaint reported is of the VDT users. Methods: This study attempts to design a proper tool to assess the visual fatigue of the VDT users. First draft of the questionnaire was prepared after a thorough study on the books, papers and similar questionnaires. The validity and reliability of the questionnaire was confirmed using the content validity index (CVI) beside that of the Cronbach's Coefficient Alpha. Then, a cross-sectional study was carried out on 248 of the VDT users in different professions. A theoretical model with four categories of symptoms of visual fatigue was derived from the previous studies and questionnaires. Having used the AMOS16 software, the construct validity of the questionnaire was evaluated using the confirmatory factor analysis. The correlation co-efficiency of the internal domains was calculated using the SPSS 11.5 software. To assess the quality check index and determining the visual fatigue levels, visual fatigue of the VDT users was measured by the questionnaire and visual fatigue meter (VFM) device. Cut-off points were identified by receiver operating characteristic curves. Results: CVI and reliability co-efficiency were both equal to 0.75. Model fit indices including root mean of squared error approximation, goodness of fit index and adjusted goodness of fit index were obtained 0.026, 0.96 and 0.92 respectfully. The correlation between the results measured with the questionnaire and VFM-90.1 device was-0.87. Cut-off points of the questionnaire were 0.65, 2.36 and 3.88. The confirmed questionnaire consists of four main areas: Eye strain (4 questions), visual impairment (5 questions) and the surface impairment of the eye (3 questions) and the out of eye problems (3 questions). Conclusions: The visual fatigue questionnaire contains 15 questions and has a very remarkable validity and reliability. Usingthis questionnaire and its findings, one will be able to identify, assess and finally prevent the effective factors of VDT users' visual fatigue

Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

Objective: Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods: A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results: Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (

perinatal depression in a cohort study of Iranian women

Introduction: Childbearing years in the women’s life are associated with the highest risk of depression. Despite the results of some studies that suggested, depression during pregnancy has been associated with poor prenatal care, substance abuse, low birth weight, and preterm delivery and introduced antenatal depression and anxiety as predictors of postnatal depression, researches during past 25 years have focused mostly on postpartum depression so depression during pregnancy is relatively neglected. &#13; Materials and methods: We studied depression during third trimester of pregnancy and after delivery, using prospectively gathered data from a cohort of 1898 women. We compared depressive symptom score and the proportion of mothers above a threshold, to indicate probable depressive disorder at each stage. &#13; Results: Point prevalence of depressed pregnant women (clinical depression) based on BDI score greater than 20 in last trimester of pregnancy, was 22.8% and postnatal rate of depression based on EPD score greater than 12 between 6 to 8 weeks after delivery, was 26.3%. Incidence of PPD in 6 to 8 weeks after delivery in those who were not clinically depressed during pregnancy was, 20.1%.&#13; Discussion: We found that history of depression, unplanned pregnancy; being housewife and having 3 or more children were variables with significant relation to ante partum depression. Two main risk factors for post partum depression in this cohort study, were previous history of depression and depression during current pregnancy that highlight the importance of these two variables assessment during pregnancy in order to facilitate timely identification of women at risk

Major dietary patterns and their associations with overweight and obesity among Iranian children

Background: Increasing prevalence of obesity is a major health concern. Lifestyle behaviors and diet play an important role in developing childhood obesity. The aim of this study was to determine the association between major dietary patterns and overweight/obesity in a group of Iranian school-aged children. Methods: This cross-sectional study was conducted in Isfahan, Iran with 637 elementary school-aged children. A semi-quantitative food-frequency questionnaire was used to assess usual dietary intakes. Data on socio-demographic, physical activity and other lifestyle habits were collected using standard questionnaires. Obesity was determined based on national cut-offs. Factor analysis was used for identifying major dietary patterns. Results: Three major dietary patterns were extracted; "Healthy," "Western," and "Sweet-Dairy." After adjusting for confounders, girls in the second quartile of healthy pattern, were more likely to be overweight (odds ratio [OR] =2.23, Confidence intervals [CI] =1.003, 4.96) compared to those in the highest quartile. Likelihood of being overweight was lower for girls in the second quartile of western dietary pattern versus the fourth quartile (OR = 0.46, CI = 0.21, 1.01). Accordingly, lower adherence to sweet and dairy pattern was associated with lower body mass index (BMI) among girls (OR = 0.42, CI = 0.21, 0.85). There was no significant relationship between western and sweet-dairy pattern with BMI among boys, however, significant association was observed between lowest and highest quartiles of healthy pattern (OR = 0.36, CI = 0.15, 0.84). Conclusions: We found significant associations between the three dietary patterns and obesity among girls. Only healthy pattern was related to weight status of schoolboys. Longitudinal studies will be needed to confirm these associations

Parenting Styles and Psychiatric Disorders in Children of Bipolar Parents

Background: Bipolar disorders (BD) in parents can have different effects on children and perhaps as a reason of the incidence of various psychiatric disorders in them and they may show a particular parenting style due to features of their disease. Given a crucial role of parenting style in upbringing children, this study aimed to evaluate different styles of parenting and its relationship with psychiatric disorders in children of parents with bipolar disorder (PBD) compared with controls. Materials and Methods: In this case–control study, 500 parents with children aged 6–17 years were included that 250 of them with BD were selected as the case group and 250 of them were healthy as control group. The parents were selected according to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) by a physician. Psychiatric disorders in children were assessed by The Kiddie Schedule for Affective Disorders and Schizophrenia for school-age children (KSADS). The collected data were analyzed with SPSS (version 20). Results: According to KSADS, there was significant difference between two groups of children in depression, mania, attention-deficit hyperactivity disorder, and posttraumatic stress disorder (P < 0.05). In authoritative dimension, parenting styles were effective in the incidence of psychosis (odds ratio [OR] [95% confidence interval (CI)]: 0.775 [0.63–0.95]) and led to a decrease of 0.320 times in the chance of oppositional defiant disorder incidence (OR [95% CI]: 0.320 [0.21–0.74]; P = 0.043) but an increase of 1.129 times in the chance of cigarette/tobacco use (OR [95% CI]: 1.129 [1.02–1.25]; P = 0.016). Conclusion: The chance of psychiatric disorder's incidence in children of PBD was so far more than children of healthy parents. Hence, the incidence of some psychiatric disorders in children can be associated with parenting styles

Life expectancy after HIV diagnosis based on data from the counseling center for behavioral diseases

Background: Predicting life expectancy is an important component of public health, in that, it may affect policy making in fields such as social security and medical care., To estimate the life expectancy and the average years of life lost (AYLL) of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)-infected population, compared with that of the general population, and also to assess the impact of the CD4 count, risk factors of transmission, marital status, and employment status on life expectancy. Material and Methods: This study is a population-based cohort study. The sample consisted of HIV/AIDS-infected patients receiving care from 2001-2011. The patients were all adults (20-64 years) who were recruited from the Counseling Center of Behavioral Diseases. Life expectancy was measured based on an abridged life table, according to age-specific mortality rates and average years of life lost (AYLL) during the study period. Results: Forty-three of the 205 eligible patients died during 853 person-years follow-up. Compared to the general population, the life expectancy for patients with HIV infection at age 20 is about 36 years less. We have found that out a total of 1597 years of life lost during 2001-2011, compared to an overall AYLL for all HIV/AIDS, the deaths had occurred 36 years earlier than the life expectancy. Conclusion: Life expectancy in HIV/AIDS-infected patients is about 38 years less than that of the general population at the exact age of 20. The deaths caused by HIV/AIDS occurred about 36 years before what was expected in the general population at ages 20-64, and many of these years of life lost could be saved if the health care system was implemented against the risk factors of HIV/AIDS