The Effect of Ticlopidine on Early Arteriovenous Fistula Thrombosis: A Randomized Clinical Trial

Background: Arteriovenous (AV) fistula is the first choice of a long-term vascular access for hemodialysis, but there is a 20-30% probability of thrombosis in the 1st month after its creation. Ticlopidine is a potent drug, which inhibits both primary and secondary platelet aggregation. This study is performed to evaluate the effect of ticlopidine in the prevention of AV fistula.Methods: Totally 124 patients in need of an AV fistula were divided into two groups after creation of their fistula. In the first group, we prescribed ticlopidine for 62 patients, and in the second group, 62 patients received placebo. The two groups were compared to see if their fistulas are patent or thrombotic after 1 and 3 months.Results: Of the 62 patients who received ticlopidine, four had fistula thrombosis, while in 62 patients who received placebo, 16 had fistula thrombosis (P = 0.003). This shows the significant effect of ticlopidine in the prevention of thrombosis in AV fistulas. Also, we compared age, sex, and the fistula location in the ticlopidine and placebo groups, and these attributes had no significant difference between the two groups (P > 0.050).Conclusions: Considering the significant value of ticlopidine in the prevention of AV fistula thrombosis, it can be recommended after the surgery if there is no contraindication for its use

Comparison of the effects of lecture and booklet methods on awareness and attention of parents of children with Thalassemia major

چکیده: زمینه و هدف: تالاسمی از مهمترین بیماریهای ژنتیک است که مشکلات زیادی برای بیماران مبتلا ایجاد کرده است. با آموزش والدین می توان از بروز مشکلات جبران ناپذیر و عوارض خطرناک این بیماری پیشگیری و یا آنها را به حداقل رساند. این مطالعه با هدف مقایسه تاثیر روش سخنرانی و خود آموزی بر میزان آگاهی والدین کودکان مبتلا به تالاسمی ماژور بر نحوه مراقبت از کودکان خود انجام شده است. روش بررسی: در این مطالعه مداخله ای والدین 90 نفر از بیماران مبتلا به تالاسمی ماژور که به منظور گرفتن خدمات پزشکی به بیمارستان هاجر شهرکرد مراجعه نموده بودند بصورت نمونه گیری آسان انتخاب و بصورت تصادفی به سه گروه آموزش سخنرانی، خود آموزی و شاهد تقسیم شدند. در گروه آموزش سخنرانی چهار جلسه کلاس به مدت 30 دقیقه و در فاصله 3 هفته برای والدین برگزار شد. در گروه آموزش خود آموزی جزوه ای که حاوی همان مطالب در روش سخنرانی بود به زبان ساده در اختیار والدین قرارداده شد و در گروه شاهد هیچگونه مداخله ای انجام نشد. آگاهی والدین نسبت به بیماری در هر سه گروه، قبل و بعد از مداخله با استفاده از پرسشنامه محقق ساخته جمع آوری گردید. جهت تجزیه و تحلیل داده ها از آزمون های t زوجی وضریب همبستگی اسپیرمن و آنالیز واریانس یکراهه استفاده شد. یافته ها: بین سه گروه از نظر میانگین سنی، جنس، مدرک تحصیلی، شغل، تعداد فرزندان مبتلا، سن کودک مبتلا و میزان آگاهی قبل از آموزش اختلاف معنی دار وجود نداشت. یافته ها نشان داد که میانگین میزان آگاهی به ترتیب قبل و پس از آموزش در گروه سخنرانی 73/4±53/10 و 14/4±5/16 (05/0

Modulation of Drug Craving in Crystalline-Heroin Users by Transcranial Direct Current Stimulation of Dorsolateral Prefrontal Cortex

Background: Drug craving, the main cause of relapse and a major motivator for drug use, is a challenging obstacle in substance use treatment. Transcranial direct current stimulation (tDCS), a non-invasive neuromodulatory technique, has shown promising outcomes in treating different neuropsychiatric disorders such as drug addiction, more specifically on drug craving. The aim in the current study was to examine the effects of applying tDCS on dorsolateral prefrontal cortex (DLPFC) in reducing drug cravings in former crystalline-heroin users enrolled in methadone maintenance (MMT) programs. Methods: The present study was a semi-experimental, crossover study with pre/post-test, and a control group. 40 right-handed men were selected from former crystalline-heroin users enrolled in MMT programs in Tehran, Iran. They were then divided into two matched groups based on age, education, and age of onset crystalline-heroin abuse. Desire for Drug Questionnaire (DDQ) was administered two times to all of the subjects, before first brain stimulation, and at the end of the last session. Experimental group received TDCS on DLPFC, and sham stimulation was applied on control subjects. The data were analyzed by analysis of covariance (ANCOVA) method using SPSS software. Findings: The study results indicated anodal tDCS over right and cathodal TDCS over left DLPFC, and in parallel with sham, significantly decreased drug cravings among former crystalline-heroin users (P < 0.050). Conclusion: This study showed that applying TDCS on DLPFC of former crystalline-heroin users reduces drug craving. The findings of this study expanded the results of previous studies on effects of this neuromodulatory technique for drug craving reduction in other drug type settings

Randomized Controlled Trial of a Peer Based Intervention on Cardiac Self-efficacy in Patients Undergoing Coronary Artery Bypass Graft Surgery: a 3-year Follow-up Results

Background: Self-efficacy is one's belief in ability to succeed in specific situations and considerable factor to maintaining healthy behaviors. It has an important role in person-centred care and significantly improves after effects of heart attacks. This study aimed to investigate the effects of a peer based intervention on cardiac self-efficacy of the patients after bypass surgery.Methods: In this clinical trial study, 60 patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups. The patients were assigned into two groups by block randomization. While routine education was presented to the patients in the control group, intervention group were taught using the peer education in two sessions. Cardiac self-efficacy of all the selected patients was assessed orderly in 36-month (3 years) follow-up after surgery. Inclusion criteria used to choose the suitable patients were as the following: no record of CABG surgery, understanding and talking Persian language, willingness to participate in the research, age between 40 and 70 years, no dementia, confusion, mental and psychological problems which might hinder their participation. In addition, exclusion criteria in this study were patient’s death, serious physical problems after CABG surgery, emergency and unexpected surgeries, or cancellation the CABG surgery due to patient’s situation. Data was collected using cardiac self-efficacy scale and analyzed using chi-square, independent t-test and Kolmogorov-Smirnov tests. Results: The patients in both groups were homogenous in terms of demographic data. The mean score of cardiac self-efficacy in the intervention group was significantly different from control group in 3- year follow-up after surgery (P&lt;0.038).Conclusions: Based on this study, accomplishment of peer based intervention can be a beneficial educative-supportive approach in cardiac surgery fields.

Randomized Controlled Trial of a Peer Based Intervention on Cardiac Self-efficacy in Patients Undergoing Coronary Artery Bypass Graft Surgery: a 3-year Follow-up Results

Background: Self-efficacy is one's belief in ability to succeed in specific situations and considerable factor to maintaining healthy behaviors. It has an important role in person-centred care and significantly improves after effects of heart attacks. This study aimed to investigate the effects of a peer based intervention on cardiac self-efficacy of the patients after bypass surgery.Methods: In this clinical trial study, 60 patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups. The patients were assigned into two groups by block randomization. While routine education was presented to the patients in the control group, intervention group were taught using the peer education in two sessions. Cardiac self-efficacy of all the selected patients was assessed orderly in 36-month (3 years) follow-up after surgery. Inclusion criteria used to choose the suitable patients were as the following: no record of CABG surgery, understanding and talking Persian language, willingness to participate in the research, age between 40 and 70 years, no dementia, confusion, mental and psychological problems which might hinder their participation. In addition, exclusion criteria in this study were patient’s death, serious physical problems after CABG surgery, emergency and unexpected surgeries, or cancellation the CABG surgery due to patient’s situation. Data was collected using cardiac self-efficacy scale and analyzed using chi-square, independent t-test and Kolmogorov-Smirnov tests. Results: The patients in both groups were homogenous in terms of demographic data. The mean score of cardiac self-efficacy in the intervention group was significantly different from control group in 3- year follow-up after surgery (P&lt;0.038).Conclusions: Based on this study, accomplishment of peer based intervention can be a beneficial educative-supportive approach in cardiac surgery fields.

Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study

Background Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults. Methods The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed the E to identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran. Results The estimated E for poor mental health was - 0.012 (95% CI: - 0.0144, - 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status. Conclusion There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions. Keywords:Mental health; Socioeconomic inequality; Concentration index; Decompositio

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

A Hybrid Algorithm for Simultaneous Retrieval of Thermal Conductivity and Time-Dependent Heat Flux

Abstract: This paper presents a hybrid technique for simultaneous estimation of parameter and function in inverse heat conduction problems. No prior information is used for the functional form of the heat flux in the present study. The scheme presented here is a combination of two different classical methods: The Variable Metric Method (VMM) and Gauss Method (GM). The determination of the unknown thermal coefficients includes two steps per iteration of the estimation algorithm: the function estimation step; and the parameter estimation step. VMM and GM are used to handle function estimation and parameter estimation problems, respectively. It is shown via simulated experiment that unknown quantities can be obtained with reasonable accuracy using this method despite existing noise in the measurement data

Estimation of Boundary Conditions in the Presence of Unknown Moving Boundary Caused by Ablation

Ablative materials can sustain very high temperatures in which surface thermochemical processes are significant enough to cause surface recession. Existence of moving boundary over a wide range of temperatures, temperature-dependent thermophysical properties of ablators, and no prior knowledge about the location of the moving surface augment the difficulty for predicting the exposed heat flux at the receding surface of ablators. In this paper, the conjugate gradient method is proposed to estimate the unknown surface recession and time-varying net surface heat flux for these kinds of problems. The first order Tikhonov regularization is employed to stabilize the inverse solution. Considering the complicated phenomena that are taking place, it is shown via simulated experiment that unknown quantities can be obtained with reasonable accuracy using this method despite existing noises in the measurement data

A study of the application of teaching organization indices in Iranian public universities

Abstract   The purpose of this article is to survey the amount of application and desirability of teaching organization's indices in public universities of Iran. The paper determines the indices of teaching organization in five domains, teachable point of view, ideas, values, emotional energy and edge. In this study the method is descriptive- survey. The statistical population of this research are all the faculty members of public medical and non medical universities in 1385- 1386. The sample consist of 345 managers and faculty members who were selected through random cluster multi stages sampling, but 315 took part in the research. In order to gather the data, a 74 item researcher made questionnaire on the basis of Tichy's teaching organization theory in the form of Lykert's 5 degree scale with a reliability of 0.87 is used. One sample t test is used to analyze the data. The findings of this research indicates that the mean scores of the subjects about the application of teaching organization indices are all less than the mean of criterion (3) and there is a significant difference between all the means of indices. But the examinees' responses regarding desirability in applying the teaching organization indices in universities with score mean of 4.25 is much more than the mean criterion. The observed t revealed that the differences of means in regarding all indices were significant