Journal of Arak University of Medical Sciences

Parent-mediated Behavioral Intervention for Treatment Behavioral Excesses in Children With Autism Spectrum Disorder

Hamidreza Pouratemad

Background and Aim: One of the problems of children with Autism Spectrum Disorder (ASD) is behavioral excesses resistance to many educational and rehabilitation programs. Parent-mediated behavioral interventions seem to be effective in overcoming these problems. However, these methods are not well-introduced. The purpose of this study is to systematically review these studies and their primary and secondary outcomes, and finally analyze the components.
Methods & Materials: This study was a systematic review. The search included SID, Magiran, Medline, PubMed, Springer, Science Direct, Online Library, and PsycINFO. We reviewed The articles published between 2000 and 2017 about parent-mediated behavioral interventions on behavioral excesses in autistic children.
Ethical Considerations: This study with ethical code IR.SBU.ICBS.97/1013 was approved by the Biological Research Department of Shahid Beheshti University.
Results: The findings of 9 studies indicated positive effects of parent-mediated behavioral intervention on behavioral excesses, including repetitive behaviors, irritability (including tantrums, aggression, and self-injurious behaviors), echolalia, and destructive behaviors (preliminary results). Also, these interventions improved the adaptive behaviors in autistic children, and parental functions such as self-efficacy, parental style, psychological problems (secondary results). Components of the therapeutic program included the type of consequence-based interventions (such as response interruption and redirection), antecedent-based interventions A (visual cue and daily schedules), antecedent-based interventions B (such as enriching environment with play). Three articles had medium certainty of the evidence, and 6 had high certainty of evidence.
Conclusion: The results of this study indicated the positive effect of parent-mediated behavioral intervention on behavioral excesses in children with ASD. Future studies should emphasize the comprehensiveness of all the effective components in the parent-mediated behavioral intervention and the feasibility of the intervention in various contexts. It is suggested that parent-mediated interventions be implemented on behavioral excesses in children with ASD in Iran.

The Effectiveness of Resilience Training on Positive and Negative Affect and Reduction of Psychological Distress in Mothers of Children With Attention Deficit Hyperactivity Disorder

Seyed Mahmoud Tabatabaei

Background and Aim: This study aimed to investigate the effectiveness of resiliency training on positive and negative affect and reduce the psychological distress in mothers of children with Attention Deficit Hyperactivity Disorder (ADHD).
Methods & Materials: The research method was semi-experimental with and pre-test, post-test design with the control group. The statistical population of this study included all mothers of children with ADHD in Tabriz in 2020, among which 30 were selected by convenience sampling method, were randomly assigned to experimental, and control groups. The research tools included the Positive and Negative Affect Scale and Anxiety, Depression, and Stress Questionnaires.
Ethical Considerations: The Ethics Committee of the Islamic Azad University of Tabriz Branch approved this study (Code: IR.IAU.TABRIZ.REC.1398.062).
Results: The results of 9 sessions with 90 minutes of group resilience training (taken from Henderson & Milstein, 2003) showed that resiliency training leads to an increase in positive affect and a decrease in negative affect, as well as a decrease in psychological distress in mothers of children with ADHD.
Conclusion: These results suggest that resiliency education can be effective as an educational-therapeutic approach to increase positive emotions and decrease negative emotions and mental disorders in mothers of children with childhood disorders.

Comparison of the Effectiveness of Chelleh Daghi Herbal Ointment and Piroxicam Gel on Ankle Sprains

Bahman Sadeghi

Background and Aim: Ankle injuries are among the most common musculoskeletal injuries in sports, accounting for 10% to 15% of all injuries. Since controlling pain and inflammation in ankle sprains is one of the main goals of treatment, we decided to compare the therapeutic effects of Cheleh daghi Herbal ointment with a common therapeutic gel such as piroxicam.
Methods & Materials: This study was performed as a double-blinded clinical trial for 6 months from January 2019 to August 2019. After referral, all patients completed the consent form, and the patient's details and study variables were recorded by the evaluator in the research form. To measure joint inflammation, we measured the ankle with a meter tape in the ankle area (cm) and recorded. A goniometer was also used to measure the degree of ankle movements. The symptoms of ankle ecchymosis were also checked by physical examination and observation and recorded in the checklist. Statistical analysis was performed in SPSS V. 18 using statistical tests (the Mann-Whitney U test, the Chi-square, and the independent t-test).
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved the study (Code: IR.ARAKMU.REC.1396.55) and registered by the Clinical Trial (Code: IRCT2017071720258N53).
Results: The Mean±SD age in the control group was 34.2±8.6 years, and in the case group was 35.4±8.9 years. There was no statistically significant difference according to the Mann-Whitney U test (P<0.05). Also, the Mean±SD height in the control group was 1.7±0.12 m and in the case group was 1.72±0.11 m. The results also showed a statistically significant difference between the two groups studied before and after the intervention regarding the mean indicators of pain, swelling, and inflammation around the joints (P<0.05).
Conclusion: The results of our study showed that Cheleh daghi Herbal ointment for 3 weeks could be more effective in reducing local pain and inflammation than piroxicam gel treatment.

Prevalence of Musculoskeletal Pains Among Rehabilitation, Dentistry and Nursing Students

Hamid Dalvand

Background and Aim: Musculoskeletal disorders are mainly prevalent among college students who experience direct contact with patients. This study aimed to determine the prevalence of musculoskeletal pains among Rehabilitation, Dentistry, and Nursing students at Arak University of Medical Sciences in 2017-2018.
Methods & Materials: In this cross-sectional descriptive study, 538 students of Arak University of Medical Sciences were recruited using the convenience sampling approach. Variables included age, sex, body mass index, study field, hours of using smartphone per day, and nine symptom sites being neck, shoulders, upper back, elbows, low back, wrist/hands, hips/thighs, knees, and ankles/feet. The researchers assessed the musculoskeletal pain by using the Nordic questionnaire and demographic questionnaire. Statistical analysis was performed using SPSS V. 18.
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved this study (Code: IR.ARAKMU.REC.1397.253).
Results: In this study, 538 students (205 males and 333 females) were studied with Mean±SD age of 22.04±2.53 years old. The results showed that the prevalence of musculoskeletal pain in the spine (neck 29.4%, upper 24.3%, and lower back 37.2%) was higher than in upper and lower extremities. Musculoskeletal pain in the shoulder, upper, lower back, and thigh were significantly different based on sex. Also, musculoskeletal pain in the neck and ankle, and foot were significantly different based on age (P<0.05). There was a significant difference between musculoskeletal pain of back and ankle based on smartphone use hours per day.
Conclusion: This study suggested that rehabilitation, nursing, and dentistry students are at risk for musculoskeletal pain, especially in the lumbar, cervical, and upper back.

Evaluation of Factor Structure of the Persian Scale of Coping With Carver Shortened Stress

Hamid Reza Agha Mohammadian Sharbaf

Background and Aim: Coping with stress is one of the most important research areas in health psychology. Researching in this regard requires a tool with strong psychometric properties and validation in Iranian culture. The purpose of this study was to investigate the most commonly used short-scale factor structure, the Carver’s Brief Cope.
Methods & Materials: This study was a cross-sectional and methodological study of test type. The statistical population consisted of all students studying at Birjand University in 1977-98. Sampling was available by the method. The condition for entry into the study was the experience of a stressor for at least 6 months. After receiving a medium or high score on the perceived stress level, 629 students completed the 28-question form. Data was analyzed using SPSS V. 15 and laser software V. 8.8. Exploratory factor analysis was performed to determine the factor structure of the questionnaire. A confirmatory factor analysis was used to confirming the factors. Reliability was established through retesting and internal consistency.
Ethical Considerations: This study is part of a PhD. thesis, registered (Code: IR.UM.REC. 3/50099) at Ferdowsi University of Mashhad. Before entering the study, an informed consent was obtained from the subjects.
Results: After confirming the face and content validity quantitatively and qualitatively, the exploratory factor analysis results after varimax rotation showed 55.139% of the total variance explained by the first eight factors with a higher than one specific value. However, in confirmatory factor analysis, the first two factors, 4 and 7, were omitted due to insufficient power to explain the present variables. Finally, the goodness-of-fit indices of the RMFIA, PFI, GFI, IFI, IFI, CFI, AGFI confirmed the fit of the six-factor structure with the data. Reliability of the instrument was also confirmed by internal consistency (α=0.73) and test-retest reliability (r=0.59).
Conclusion: The highly abbreviated 6-item form of Carver’s Brief Cope showed good validity and reliability in the student sample and can be used in health psychology studies.

The Effectiveness of Mindfulness-based Cognitive Therapy on Marital Self-regulation, Marital Burnout and Self-criticism of Infertile Women

Taher Tizdast

Background and Aim: The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy on marital self-regulation, marital burnout, and self-criticism of infertile women.
Methods & Materials: This experimental study was conducted with a pretest-posttest design with the control group. The statistical population of this study included all the infertile women of Mazandaran Province, Iran, in 2018-2019. In this study, 30 infertile women were considered the sample size in the experimental group mindfulness-based cognitive therapy (of 15 infertile women) and control (15 infertile women). The experimental group underwent mindfulness-based cognitive therapy (10 sessions 60 minutes), but the control group received no training. To collect data, we used the marital self-regulation scale of Wilson and et al., the marital burnout scale of Pines, and the self-criticism scale of Thompson and Zuroff. Data analysis was performed in SPSS V. 24 with descriptive and inferential statistics (multivariable analysis of covariance).
Ethical Considerations: This study with research ethical code IR.IAU.TON.REC.1397.030 was approved by the Research Ethics Committee at Islamic Azad University Tonekabon Branch.
Results: The results showed that the scores of marital self-regulation of infertile women after mindfulness-based cognitive therapy in the experimental group significantly increased in comparison with the control group, and also marital burnout, and self-criticism scores were decreased (P<0.01).
Conclusion: Therefore, it is suggested that counselors and therapists use mindfulness-based cognitive therapy to improve marital self-regulation, marital burnout, and self-criticism of infertile women.

The Effect of Cardiac Rehabilitation on Endostatin Levels in Patients With Atherosclerosis After Coronary Artery Bypass Grafting

Rambod Khajei

Background and Aim: Coronary Artery Disease (CAD) is one of the leading causes of death and mortality in today's societies. Physical activity increases some of the influential factors for this disease. The purpose of this study was to investigate the effect of 8 weeks of aerobic and resistance training on endostatin in patients with Coronary Artery Bypass Graft (CABG).
Methods & Materials: The study participants were 24 male patients who were randomly divided into the experimental (n=12) and control (n=12) groups with Mean±SD age of 55.37±6.90 years, weight 75.45±5.87 kg, height 173.27±3.36 cm and body mass index of 25.11±1.55 kg/m2. The experimental group performed 8 weeks of aerobic and resistance training (3 sessions per week and 1.5 hours per session) based on the measurements, while the control group did not exercise during this period. To measure endostatin concentrations, blood samples were taken 48 hours before and 48 hours after the last training session while all subjects were fasting. Data were analyzed using the Shapiro-Wilk test to normalize the data and Student t-test in independent and correlated groups at the significant level of 0.05.
Ethical Considerations: This article was ethically approved by Azad University of Neyshabur (Ethics Code IR.IAU.NEYSHABUR.REC.1398.018) and with the Clinical Trial Code IRCT20191228045916N1 in the Iranian Registry of Clinical Trials.
Results: The present study showed that the aerobic and resistance training group significantly decreased endostatin concentrations (P=0.001) (t=1.672) compared with the control group.
Conclusion: Based on the findings, aerobic and resistance training decreases endostatin concentrations, known as an anti-angiogenic factor.

Evaluation of Demographic and Clinical Characteristics of the Patients Undergoing Surgery With Ultrasound in Internal Jugular Vein Cannulation Requiring Central Venous Catheter

Hossein Hemmati

Background and Aim This study aimed to investigate the demographic and clinical information of patients undergoing surgery with ultrasound in internal jugular vein cannulation.
Methods & Materials After the approval of the plan in the ethics committee of Guilan University of Medical Sciences, this study was performed in the general surgery department of Razi Hospital in 2018 on 100 patients in need of central venous catheter implantation. The neck type (distance between the two designated areas) was entered in a special form made by the researcher and after the completion of the design, it was examined and statistically analyzed.
Ethical Considerations This research ethically approved by the Ethics Committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1396.20)
Results The mean age of the studied patients was 58.72±16.09 years. The anatomical and sonographic margins between the two Land Mark areas were higher in men VS women, but there was no statistically significant difference (P>0.05). However, there was no statistically significant difference between the other variables. (P>0.05).
Conclusion The findings of this study show that catheterization of the internal jugular vein under the guidance of ultrasound was less access time and fewer complications.

Effect of Donepezil and Hyoscyamoside on Improving Spatial Memory in Rats With Alzheimer's Disease

Majid Kheirollahi

Background and Aim: Alzheimer's Disease (AD) is a neurodegenerative brain disease that gradually destroys memory and cognitive skills. The disease is caused by the formation of beta-amyloid plaques, oxidative stress, dysfunctions in the cholinergic system, neuronal killing inflammation, and ultimately brain atrophy. Donepezil and hyoscyamoside have inhibitory effects on these pathogens; therefore, their impact on the learning process of Alzheimer’s rats in the Morris Water Maze was investigated.
Methods & Materials: In the present experimental study, 60 male rats of Wistar breed with approximately 7 weeks age within the control group (rats that received normal water and food), the PBS group (underwent surgery), PBS group (received solvent Aβ), the first Alzheimer›s group (animals that received beta-amyloid by Alzheimer’s surgery, second Alzheimer’s group (after Alzheimer’s surgery, they received 1 cc of normal saline daily, and treatment groups that treated the rats with beta-amyloid after Alzheimer. In the hyoscyamoside group, they received 10 mg/kg daily of hyoscyamoside for 28 days. The donepezil group received it 4 mg/kg daily for 28 days by gavage. The Morris Water Maze test was used to evaluate learning and memory. Data were analyzed by ANOVA statistical analysis and Post Hoc test.
Ethical Considerations: The Ethics Committee in Biomedical Research, Islamic Azad University, Science and Research Branch approved the research (Code: IR.IAU.SRB.REC 1397.057)
Results: Beta-amyloid injection caused extensive damage to memory. The treatment groups with hyoscyamoside and donepezil spent less time and distance with a significant level (P<0.001) than the group of Alzheimer’s patients to find the hidden platform. In the reminder phase, where the previously hidden platform was located, they spent more time, with a significant level (P<0.001) in the local quarter.
Conclusion: Treatment of rats with hyoscyamoside and donepezil improved spatial memory in Alzheimer’s rats. They appear to play a significant role in the prevention and treatment of Alzheimer’s disease.

Relationship Between ZAP-70 Gene (rs104893674 "A/C") Polymorphism With Risk for Acute Myeloid Leukemia

Siroos Naeimi

Background and Aim: In acute myeloid leukemia, a large number of immature cells develop, which can related to some single nucleotide polymorphisms presence in positions of genes that encodes enzymes involved in cell activation and evolution signaling pathways. In this study, the association of rs104893674 (A / C) polymorphism with the risk of Acute Myeloid Leukemia (AML) in samples obtained from Fars and Isfahan Province hospitals was investigated.
Methods & Materials: In the present case-control study conducted at Islamic Azad University of Kazerun in 2019, 94 AML patients and 99 age and sex-matched healthy individuals were enrolled. The rs104893674 (A / C) polymorphism was determined by Tetra Primer ARMS PCR method. Data were analyzed by SPSS (version23) software using Chi-square statistical test.
Ethical Considerations: This study with research ethics code IR.IAU.KAU.REC.1398.051 has been approved by Research Ethics Committee of Islamic Azad University of Kazerun.
Results: The results of this study showed a significant, allele and genotype-specific Association between rs104893674 (A / C) polymorphism with risk of AML. Thus, there are more likely to develop AML in AC genotype, individuals with A allele at this polymorphic site (P=0.000).
Conclusion: The association of acute myeloid leukemia with the genetic polymorphism of the ZAP-70 protein can be considered as an option for prognosis of this complication in susceptible individuals.

Identifying Qualitative Factors Affecting the Quality of Clinical Education

Ghohamreza Sharifirad

Background and Aim: Training clinical students who learn the theoretical lessons in hospitals in practice will play an important role in improving treatment processes and providing better services to patients. Therefore, the purpose of this study is to identify the factors affecting the quality of clinical education in hospitals in Saveh City.
Methods & Materials: This research is a combination of exploratory studies and exploratory projects. In the qualitative stage, the qualitative method of Grand Strauss and Corbyn 1998 was used to explain the quality of clinical training. Since the students who have taken clinical courses in the Faculty of Medical Sciences of Saveh Hospitals in 1398-1397 are about 200 people and the professors and educators who teach these people are about 20 people, which according to Karajsi and Morgan, the sample size should be 140, of which 20 were interviewed and 120 were filled out with paper and electronic questionnaires. In this study, semi-structured interviews, and a researcher-made questionnaire with Cronbach’s alpha coefficient of 0.598 were selected as the data collection method. This research was performed using the qualitative method and using MAZQDA 10 and SPSS 26 software, the items obtained from qualitative research were collected and exploratory factor analysis was used to identify the factors.
Ethical Considerations: Considering that this study is one of the research priorities of Saveh School of Medical Sciences, it has a research license letter (No. 24.127. D.99).
Results: The results showed that the factors affecting the quality of clinical education include five factors. The first factor is space and facilities, the second factor is the improvement of educational processes, the third factor is educational and managerial deficiencies, the fourth factor is the evaluation of the teacher and the fifth factor is the qualitative improvement of education.
Conclusion: According to the quantitative and qualitative results of this study and by interviewing twenty experienced professors and student representatives, the factors affecting the quality of clinical education in Saveh hospitals were identified.

Effect of a Lower Limb Restless Period on Expression of Mir-1 and Mir-206 Neural Muscle Genes in Endurance Training Rats

Mohammad Reza Kordi

Background and Aim: Several microRNAs are involved in regulating muscle mass, which plays an essential role in hypertrophy and atrophy of skeletal muscle, The present study examined the expression of some genes as regulators of muscular atrophy following a period of inertia in rats.
Methods & Materials: For this purpose, 18 male Sprague-Dawley rats were divided into three groups (Control, Exercise+inactivity, and Inactivity). The exercise+inactivity group run on the treadmill for 18 weeks and five times per week. The hindlimb of the animal was immobilized for seven days with the casting method. Soleus muscle was extracted and the expression of the genes was measured by the RT-PCR method. Univariate ANOVA and Tukey post hoc test was used to determine the differences (α=0.05).
Ethical Considerations: The Ethics Committee of the Tehran University of Medical Sciences Research approved this study (Code: IR.SUMS.REC.1396.S 463).
Results: Results showed that immobilization in both Exercise+ inactivity and inactivity groups, compare to the control group, increased expression of miR-1 genes (P<0.10), FOXO3a (P<0.001) and decreased expression of miR-206 (P<0.007) and IGF-1 (P<0.001). This difference was statistically significant.
Conclusion: According to the results of this study, it can be said that changes in the expression of RNAs by chromatography cause changes in the expression of muscle regulating genes, and although endurance exercises have protective effects, they cannot prevent these changes.