Effect of l-arginine compared to placebo on sexual function in women with major depressive disorder: a randomized controlled trial.

BACKGROUND: While some evidence suggests that l-arginine may improve sexual function and alleviate depression, it has not been investigated in women with depression to assess both its effects on the depression and sexual function concurrently. METHODS: Patients who had received a diagnosis of major depressive disorder, as determined by predetermined inclusion and exclusion criteria, were enrolled in this triple-blind clinical trial. Patients were divided into two groups: group A, received L-arginine 1 gram twice daily, and group B, received a placebo for four weeks. They were evaluated at baseline, after four and eight weeks with the Hamilton Depression Rating Scale (HDRS), and Rosen's questionnaire or Female Sexual Function Index (FSFI). RESULTS: A decrease in the severity of depression was observed in all patients, which was determined due to Hamilton's questionnaire (P-value < 0.001). During the time in group A, FSFI increased. Based on the FSFI questionnaire, they had improvement in some domains, including the lubrication index and orgasm index, which significantly changed in the eighth week compared to the baseline (P-value < 0.05). However, these two indicators did not change statistically significantly compared to the placebo group. CONCLUSION: L-arginine supplementation can improve sexual function, particularly lubrication and orgasm, and mood in women with depression, with minimal side effects observed. Additional research is necessary to validate these results by examining the effects of higher dosages, extended durations, and larger populations of depressed patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trial: IRCT20100127003210N26.

Effect of low-level laser therapy (LLLT) on cognitive impairment among patients with chronic schizophrenia: a double-blind randomized placebo-controlled clinical trial.

Low-level laser therapy (LLLT) is a noninvasive technique used in different medical fields. It has been applied in different medical areas such as wound healing, traumatic brain injuries, neurological disorders, cognitive disorders, Alzheimer's disease, pain, and arthritis, with different results. We studied the effectiveness of LLLT on cognitive impairment in patients with chronic schizophrenia. A randomized controlled double-blind clinical trial was performed in a men's chronic treatment center, in Razi Psychiatric Hospital, in Tehran, Iran. We screened the cognitive impairment by Mini-Mental State Examination (MMSE). Positive And Negative Syndrome Scale (PANSS) was also used to assess the patients' positive and negative symptoms. Seventeen consenting patients were randomly allocated to the treatment arm, and 15 to the sham treatment control arm. The mean age of the control and treated patients was 49.47 ± 6.99 and 50.24 ± 7.69, respectively. No significant difference in PANSS and MMSE test scores was detected in both groups after the 6th session and after 2 months of follow-up after laser therapy. The positive and negative scales and agitation and excitement levels did not change significantly in either group. Nevertheless, the depression/anxiety subscale in the PANSS test showed a significant reduction after 6 sessions but did not persist after 2 months. No improvement in cognitive impairment or the positive and negative symptoms was detected after LLLT in patients with chronic schizophrenia. Trial registration: IRCT 20210520051349N1.

Emotional states of different obesity phenotypes: a sex-specific study in a west-Asian population.

BACKGROUND: The present study aimed to investigate the associations of obesity phenotypes with depression, anxiety, and stress symptoms among adults in the Tehran Lipid and Glucose Study (TLGS). METHODS: Depression, anxiety, and stress levels of participants from the TLGS were examined among different obesity phenotypes in this cross-sectional study. Obesity was defined as body mass index (BMI) ≥30 kg/m2, and metabolically unhealthy status based on having metabolic syndrome (MetS) or type 2 diabetes. Four obesity phenotypes were defined: 1) Metabolically Healthy Non-Obese (MHNO), 2) Metabolically Healthy Obese (MHO) 3) Metabolically Unhealthy Non-Obese (MUNO), and 4) Metabolically Unhealthy Obese (MUO). Emotional states of different obesity phenotypes were assessed by the Persian version of depression, anxiety, and stress scale-21 items (DASS-21). Ordinal logistic regression analysis was used to compare sex-specific odds ratios of depression, anxiety, and stress in different obesity phenotypes. RESULTS: The mean age of 2469 men and women was 46.2 ± 15.9 and 45.6 ± 14.7, respectively. In total, women were more likely to experience higher levels of depression (30.5%), anxiety (44.2%), and stress (43.5%) symptoms compared to men. After adjusting for potential confounders, compared to MHNO men, the odds of experiencing higher anxiety levels were significantly greater in metabolically unhealthy men whether they were obese (OR: 1.78, 95% CI: 1.25-2.54; P = < 0.001) or non-obese (OR: 1.61, 95% CI: 1.17-2.21; P = < 0.001), and also in MUO women (OR: 1.73, 95% CI: 1.28-2.34; P = < 0.001) compared to MHNO women. Moreover, the odds of experiencing higher stress levels were significantly greater in MUNO men (OR: 1.40, 95% CI: 1.02-1.90; P = 0.04) compared to MHNO men and in MUO women (OR: 1.45, 95% CI: 1.07-1.96; P = 0.02) compared to MHNO women. No difference in depression levels was observed in either sex. CONCLUSIONS: Our results showed that men and women with various obesity phenotypes experienced different anxiety and stress levels. While MUO women and all metabolically unhealthy men experienced more anxiety and stress levels than MHNO individuals, none of the obesity phenotypes were associated with depression. These findings provide insight into recognizing the psychological consequences of different phenotypes of obesity in both sexes and utilizing future health promotion planning.

Assessing the Anatomical Variability of Deep Circumflex Iliac Vessels in Harvesting of Iliac Crest-Free Flap for Mandibular Reconstruction.

In this study, the authors' aims were to measure the length and location of branching of the pedicle from iliac artery, to describe the anatomical variability of iliac crest free flap with deep circumflex iliac (DCI) artery pedicle. Fourteen patients with ameloblastoma, osteosarcoma, and squamous cell carcinoma underwent mandibular resection and iliac crest-free flap reconstruction in one-step surgery. During surgery and before harvesting the deep circumflex iliac artery vascular pedicle, the location, origin, and the branching pattern of the pedicles were studied. Then, the pedicle length was measured and the data was analyzed using χ and independent samples t test. In all patients, the DCI vascular pedicles were separated with a common trunk from the external iliac artery and vein and the DCI arteries were posterior and lateral to the veins. Also after branching from the external iliac artery, all vascular DCI pedicles traveled upward and medially along the Iliacus muscle and the iliac fascia. The mean pedicle length was 21.78 mm for men and 19 mm for women. No statistically significant relationship was observed between the patient's age and the vascular pedicle length or number of branches. There are great variations in the anatomy of this vascular pedicle. According to the finding of this study, the length of the vascular pedicle is 2.78 mm higher in men which might help to increase the feasibility and success rate of this operation. No significant correlation was found between other variables.

Ventral tongue myomucosal flap: a suitable choice for shaved lower vermilion border reconstruction.

Squamous cell carcinoma (SCC) or verrocous carcinoma (VC) occurs frequently on the border of the lower lip and surgical excision is the mainstay of treatment. The vermilion border area is difficult to reconstruct and is very complex both morphologically and anatomically. Various reconstructive approaches for defects of the vermilion border have been described. However, for esthetics, reconstruction of the vermilion border defect by tissue of normal texture and color is paramount.We used a ventral myomucosal tongue flap for reconstruction of the vermilion border after radical excision of squamous cell carcinomas of the lip in 15 patients with labial carcinoma. The tumor was resected with a safe margin (1 cm in SCC and 0.5 cm in VC) in an approximately rectangular shape. Free-border confirmation was done using frozen section. A longitudinal strip of the free border of the tongue nonkeratinized mucosal layer with submucosal muscular layers of the tongue including the terminal branch of the lingual artery was raised. This strip extended to the angles of the mouth to cover the defect. The mucosal or myomucosal flap of the ventral tongue is designed according to the shape and size of a vermilion defect. The vermilion and subcutaneous tissue are incised, and the specimen is sent for histopathological free-border confirmation by frozen section. The flap is sutured in 2 layers, joining the mucosal border of the tongue and the upper border of the skin. The tongue flap pedicle was cut off after 3 weeks, and the oral side of the vermilion was sutured. The donor site of the tongue was closed primarily. Application of moisturizing cream for at least 2 months after surgery would be continued. In all 15 cases, the reconstructed vermilion with a tongue flap was ideal and with almost no disturbance in the patients' speaking, swallowing or taste with satisfactory cosmetic results. The ventral tongue flap is a suitable choice for vermilion border reconstruction. This flap is useful because the procedure does not require complicated surgery, and preservation of the orbicularis oris muscle and mental artery and nerve is possible.

Personality traits of university students with smartphone addiction.

Background: Nowadays smartphone use is increasing drastically. There is a higher prevalence of smartphone addiction in some specific personality traits. Objectives: The goal of this study is to evaluate the association of smartphone addiction with personality traits. Methods: This study is correlational research. Three hundred and eighty two students of Tehran universities were asked to answer the smartphone addiction scale (SAS) questionnaire and the Persian version of the Cloninger temperament and character inventory (TCI) questionnaire. After the smartphone addiction questionnaire assessment, individuals with smartphone addiction were identified and compared to the non-smartphone addicted group in terms of personality traits. Results: One hundred and ten individuals (28.8%) were prone to smartphone addiction. Mean scores of people with smartphone addiction were higher in novelty-seeking, harm avoidance, and self-transcendence than the non-addicts and were statistically significant. In persistence and self-directedness, the mean scores of the smartphone addiction group were lower than the non-addicts and were statistically significant. Individuals with smartphone addiction had higher reward dependence and lower cooperativeness however they were not statistically significant. Conclusions: high novelty seeking, harm avoidance, self-transcendence, low persistence, and self-directedness which indicate narcissistic personality disorder, could have a role in smartphone addiction.

Health-Related Quality of Life in Those with Persistent or Transient Obesity Phenotypes during Two Decades: Tehran Lipid and Glucose Study.

INTRODUCTION: The current study aimed to investigate the association of three stable obesity phenotypes (persistent metabolically healthy normal weight [P MHNW], persistent metabolically healthy obese [P MHO], persistent metabolically unhealthy obese [P MUO]), and one transient (MHO to MUO) obesity phenotype throughout 18 years with health-related quality of life (HRQoL). METHODS: 1,932 participants (649 men and 1,283 women) who completed the HRQoL questionnaire during 2016-2019 were recruited in the current investigation. Based on the body mass index and metabolic status, participants were classified into four obesity phenotypes, including (1) P MHNW, (2) P MHO, (3) P MUO, and (4) transient from MHO to MUO. The HRQoL was compared between groups using analysis of covariance. Participants' age, marital status, occupation status, education level, physical activity, and smoking were adjusted. RESULTS: After adjustment for confounder variables, a significant difference among obesity phenotypes was indicated in (physical component summary) PCS scores of both sexes and (mental component summary) MCS scores just in women (p value = <0.001). The P MUO had the lowest scores in PCS and MCS, and P MHO had the highest MCS scores compared to other obesity phenotypes in either sex. CONCLUSION: The results of the present study indicate the negative effect of long-term concurrence of obesity and metabolic disorders on the HRQoL of adults. However, long-term obesity alone or loss of metabolic health in the short term did not affect individuals' assessment of their physical and mental health. These findings highlight the importance of preventive interventions in people with obesity; also indicate the need for awareness-raising strategies about healthy lifestyles to improve the quality of life in society.

Comparison between cytisine and Nicotine Replacement Therapy in smoking cessation among inpatient psychiatric patients.

Introduction: Smoking is more common among people with mental disorders and is associated with adverse effects. Some compounds, including nicotine and cytisine, have been used in many individuals to increase success in smoking cessation. In this study, the effect of cytisine on the smoking status of patients hospitalized in the psychiatry department was investigated.Method: Forty-seven patients, hospitalized in the psychiatry ward, motivated to quit smoking, participated in this open-label randomized trial. Thirty patients used nicotine gums 2 mg (Nicolife®) for eight weeks, and the remaining took cytisine pills (Tabex®) according to the manufacturer's instructions for 25 days. All patients were followed up for six months. The primary outcome was smoking cessation, measured by the mood and physical symptoms scale (MPSS), the AUDIT alcohol consumption questions (AUDIT-C), confirmatory factor analyses, and reliability of the modified cigarette evaluation questionnaire at the end of the 1st week and at 1st, 2nd and 6th months after quit day.Findings: Only two out of 30 patients (6.66%) in the group taking Nicotine Replacement Therapy (NRT) could quit smoking entirely (no cigarettes after six months). In contrast, three out of 17 patients (17.64%) managed to do so in the cytisine group. The number of cigarettes smoked by the patients in both groups decreased, but the reduction was significant in the cytisine group.Conclusion: Cytisine is an effective and suitable agent for smoking cessation in patients with psychological problems, with fewer adverse effects and more success rate compared to NRT.

Physical fitness in patients with bipolar disorder compared with a population-based sample.

BACKGROUND: This study aimed to evaluate physical fitness and body composition in a sample including hospitalized patients with bipolar disorder and to compare them with a population-based sample. METHODS: In this comparative observational study, 40 bipolar patients and 40 healthy subjects in Taleghani Hospital, Tehran, Iran, in 2019 were assessed. The physical fitness items such as body mass index (BMI), body fat, push-up test, curl-up test, VO2 peak, and sit and reach test were compared across the groups. Young Mania Rating Scale for assessing the severity of bipolar disease and WHODAS2.0 for the estimation of global performance were done in the case group. RESULTS: The results of this study demonstrate that sit and reach test, body mass index (BMI), and body fat percent were similar across the studied groups. The push-up test, curl-up test, and VO2 peak (P = .001) were significantly lower in the case group. In the case group, only the push-up test was associated with the severity of bipolar disorder and decreased performance. CONCLUSION: Lower push-up and curl-up can indicate an increase in both back and neck pains in these patients. Low VO2 peak in these patients increases the risk of heart disease and mortality rates in bipolar patients. The push-up test can be used as a screen test to estimate the severity of the bipolar disorder.

Experiences of parents of children with psychiatric disorder from Covid-19 pandemic and its related quarantine: A qualitative study.

Introduction: Owing to the considerable mortality caused by Covid-19, different countries have made some decisions for dealing with this virus, one of which was quarantine. It was shown that a range of behavioral and emotional changes may exacerbate in children while staying more at home, and parents may then experience these positive or negative behavioral changes. The present study was conducted to examine the experiences of families with children with psychiatric disorders in a psychiatric outpatient clinic in Iran. Method: The phenomenological method, which is a qualitative approach, was used in this study. The population was the parents of children with psychiatric disorders referred to the pediatric psychiatric clinic of Imam Hossein Hospital. Sampling was purposeful, which continued until data saturation. Finally, the number of included participants reached 14. As well, the Colaizzi method was used for data analysis. Results: The results of this study included 12 secondary codes and 10 tertiary codes, which were divided into three main thematic groups as follows: effective factors for improving behavior, effective factors for worsening behavior, and affective factors on creating a new behavior during quarantine. Conclusion: In conclusion, quarantine, social restrictions, closure of schools, and online classes can affect the mental health status of children and adolescents in different ways, especially in children with a history of psychiatric disorders.

Therapeutic Effects of Low-Level Laser Therapy on Cognitive Symptoms of Patients with Dementia: A Double-Blinded Randomized Clinical Trial.

Objective: To investigate the effects of low-level laser therapy (LLLT) as a new nonpharmaceutical approach to improve cognitive symptoms in patients with dementia. Background: Routine pharmacological treatment of dementia patients is inefficient and has considerable adverse effects. Recent attempts to develop nonpharmaceutical approaches are considered favorable for patients with dementia. Methods: Thirty-two patients with dementia were randomly divided into the same population of LLLT and sham groups. The LLLT group underwent transcranial LLLT, and the sham group received the same protocol with a zero-intensity laser. All patients in the two groups were evaluated using the minimental state examination (MMSE) and clinical dementia rating (CDR) tests at the time of admission as baseline at 2 and 6 weeks postintervention. Results: The rate of change of MMSE scores in sham and LLLT groups was 0.13 ± 0.96 and 2.31 ± 1.81 in week 2 (p = 0.00005) and also -0.25 ± 0.86 and 2.53 ± 1.73 in week 8 (p = 0.000003). In the LLLT group, the mean scores of CDR were 1.28 ± 0.71, 1.28 ± 0.71, and 1.25 ± 0.80 at baseline, week 2, and week 8 (p = 0.605 and p = 0.742), respectively. The mean scores of CDR in the sham group were 1.69 ± 0.73, 1.75 ± 0.68, and 1.72 ± 0.82 at baseline, week 2, and week 8, respectively. Conclusions: These findings suggest that laser therapy could be a promising treatment modality and an adjunct to pharmacotherapy in dementia patients. Clinical Trial Registration: IRCT20191018045148N1 was obtained from the Iranian Registry of Clinical Trials (IRCT.ir).

Tele-medicine and improvement of mental health problems in COVID-19 pandemic: A systematic review.

INTRODUCTION: Tele-medicine services have been developed in response to the COVID-19 pandemic, which disrupts mental health services. The present study investigates the effectiveness of telephone-delivered services for psychological disorders in the COVID-19 pandemic. METHODS: We searched PubMed/Medline, Embase and Cochrane Controlled Register of Trials for relevant clinical studies up to February 1, 2022. Following terms were used: "severe acute respiratory syndrome", "Coronavirus", "Coronavirus infection", "SARS-CoV-2", "COVID-19", "mental disorder", "mental health", "mental health program", "mental health service", "psychiatric service", "telemedicine", "Telehealth", "Tele-health", "Telecare", "Mobile health". RESULTS: Twelve relevant clinical articles were included in our study. Eight articles were parallel randomized controlled trials (RCTs), two were Quasi-experimental, and one was a multicenter retrospective cohort study. A total of 1900 adults (18 years old or above that) were included. Online telecommunication methods like online apps and videoconference were the most common interventions. The most prevalent measured outcome was levels of anxiety and depression among participants. Eleven out of 12 articles showed a significant association between telemedicine and mental health improvement. CONCLUSIONS: The included studies in the current systematic review reported the probable efficacy of telemedicine in improving mental health disorders during the COVID-19 pandemic. But it is not possible to determine the best telecommunication method for each mental disorder in different populations and the preference of patients is still face to face therapy. So RCTs in different populations with previous mental disorders or chronic diseases are required to investigate the further telemedicine's efficacy on managing mental problems.

Prevalence of substance use among Iranian male adolescents: Systematic review and meta-analysis.

Background and aims: Substance use among adolescents is one of the most challenging behavioral disorders with direct consequences. It is of the essence (that) the prevalence of substance use is investigated among Iranian male adolescents. Methods: The present study is a systematic review and meta-analysis. All published articles titled "prevalence of substance use among Iranian adolescents" authored in Persian and English from 2004 to 2020 on Pub Med, Scopus, SID, and Google Scholar, a top list of academic research databases, were reviewed. Thirty-three out of 805 articles, hinge on the inclusion and exclusion criteria, were eligible. Statistical analysis carried out in STATA 14.0.Q index, I2 index, and χ 2 test were applied. Results: Overall prevalence reported with (95% confidence interval) for substance use 7% (4%-11%), methamphetamine 4% (3%-6%), tobacco 10% (3%-19%), and any addictive substances 4% (2%-7%) among male adolescents respectively. Besides, overall prevalence of alcohol consumption reported 10% (8%-11%). Conclusion: The prevalence of substance use among male adolescents is high, so it is indispensable for researchers to pay special attention to this issue.

Nasal reconstruction: experience using tissue expansion and forehead flap.

PURPOSE: The forehead is acknowledged to be one of the best, if not the best, donor sites for reconstruction of postoperative nasal defects after ablation in cancer patients. The versatility, color match, and texture are among the benefits of this flap. However, it has 2 major disadvantages: 1) it is stiff, flat, and thicker than normal nasal skin, and thus molding from a 2-dimensional to a 3-dimensional shape is difficult, and 2) there is a donor-site defect that requires coverage using a split-thickness skin graft. PATIENTS AND METHODS: In this 5-year study (2004-2009), we modified the 2-stage technique and added an operation before tissue transfer and pedicle division in 48 patients with nasal defects. During the first stage, the tumor was completely excised, and a tissue expander was inserted in the subgaleal plane. After 3 weeks, expansion was initiated. The second operation was performed 12 weeks later. A full-thickness forehead flap was elevated and transposed with primary closure of the donor site. In a third or final stage 3 weeks later, the pedicle was divided. Patient satisfaction and donor site scar was evaluated. RESULTS: Over the past 5 years, 48 reconstructions for nasal defects were performed using this technique. Nasal defects of the dorsum, alar, tip, columella, and septum were successfully treated. Graft take was successful in all patients. CONCLUSIONS: The forehead flap technique, in conjunction with tissue expander for nasal repair, has both advantages and disadvantages. The esthetic benefits of this technique must be weighed against the disadvantages.

Mental Health Status among Hospitalized Patients with COVID-19 in Iran.

Objective: The recent escalated numbers of subjected COVID-19 patients and mortality rates have alerted the general population and authorities to its effects not only on physical health but also on different aspects of the society such as mental health. This study assesses the general mental health and immediate psychological impacts in hospitalized patients with COVID-19. Method : In this cross-sectional study, 88 patients from two tertiary hospitals in Tehran agreed to complete the surveys. The Impact of Event Scale-Revised (IES-R) and 12 item General Health questionnaire (GHQ-12) were used to evaluate mental health and impact of disease. Epidemiological and sociodemographic information entailing underlying diseases was assess by a researcher-made questionnaire. Results: We found that the psychological impact of the current pandemic is mild to moderate. During the initial phase of the pandemic, the intellectual engagements, inducing post event stress is not yet entirely developed. However, patients had a moderate to high probability of psychiatric morbidity with 63.6% and 28.4%, respectively. Conclusion: The effect of such viral pandemic on mental health is inevitable. As we conducted the study in the dire times of the outbreak, patients showed a high probability of psychiatric morbidity. On the other hand, since the study was done in the initial phase of the epidemic, we detected mild effects of the epidemic on PTSD in COVID-19 patients. Furthermore, several psychosocial protective programs should be implicated to address the mental complications.

OPRM1 and CYP3A4 association with methadone dose in Iranian patients undergoing methadone maintenance therapy.

BACKGROUND: Investigations proposed that genetic polymorphisms within proteins in methadone pharmacokinetic and pharmacodynamics are critical factors in determination of methadone dose in methadone maintenance therapy (MMT). OBJECTIVE: This study aimed to assess the associations between two polymorphisms, CYP3A4 (rs2740574) and OPRM1 (rs1799971), with dose of methadone in Iranian patients undergoing MMT. METHODS: A total of 124 Iranian male subjects aged 18-65 years old who were confirmed to be addicted by the addiction diagnostic tests and underwent MMT were assessed. Patients were divided into three groups of low (less than 40 mg/day), moderate (more than 40 mg/day and less than 110 mg/day) and high (more than 110 mg/day) methadone dose consumption. DNAs of included patients were extracted from their blood samples and were assessed for CYP3A4 and OPRM1 polymorphisms. RESULTS: Results showed that there was no significant association between the studied polymorphisms and methadone dose in Iranian addicted patients underwent MMT (P > 0.05). CONCLUSIONS: CYP3A4 and OPRM1 single variations cannot explain variability in methadone dosage in MMT. Studying the interactions of more genetic factors in larger samples may elucidate factors influencing the required dose of methadone and better individualized therapy.

A retrospective study on mandibular reconstruction using iliac crest free flap.

PURPOSE: To assess the availability, success rate and complications of microvascular iliac crest free flap for reconstruction of mandibular segmental defects. METHODS: In this retrospective-descriptive study, we report patients who had undergone segmental mandibular resection for pathologic lesions and received reconstruction with iliac crest microvascular free flap between 2016 and 2019. Clinical and demographic data of all the cases were collected. Success was regarded as complete consolidation of the bone graft in panoramic radiograph. Postoperative complications were defined as major or minor based on the need for intervention. T-test, Kolomogorov_Smirnov, and multivariate analysis were used and the p-value<0.05 was considered to be statistically significant. RESULTS: Of all 30 patients, 16 were women and 14 were men with an average age of 27.2 years (range 14-40). Patients were followed for 12-60 month (mean: 38.4). One flap was lost due to unsalvageable venous thrombosis. Six other cases had post-op complications while smoking and diabetes were associated with more complications (P = 0.036). Twenty-three patients received primary reconstruction which was more successful than secondary ones (P = 0.003). Osteogenic sarcoma was associated with greater risk of complications (P < 0.01). CONCLUSIONS: The results of this study suggest that iliac crest microvascular free flap serves as a promising option for the reconstruction of mandibular defects, providing excellent contour and acceptable success rate with low donor site morbidity. Future studies will focus on the role of systemic diseases in post-op complications and flap failures.

Cognitive function in methadone maintenance patients compared with abstinent opioid users.

BACKGROUND: Opioid is the second most prevalent illicit drug worldwide, whose consumption is very high in Iran, due to Iran's geographical proximity to producing countries. Methadone maintenance therapy is one of the most prevalent and accepted methods of substance abuse treatment. Nevertheless, cognitive disorders have been reported as one of its complications. AIM: This study was conducted to evaluate cognitive impairment in methadone maintenance patients (MMPs) and to compare it with abstinent opioid users (AOUs). MATERIALS AND METHODS: This cross-sectional analytical study was performed on 25 MMPs and 25 AOUs. Samples were selected through convenience sampling method whereby a self-made questionnaire was distributed among them to assess demographic information, clinical variables such as methadone and opioid use history, underlying disease and medication history, as well as 13-item Beck depression inventory. Then, they were interviewed using the Montreal Cognitive Assessment (MoCA) questionnaire. RESULTS: Significant differences were found in MoCA questionnaire total scores (p = 0.018) and orientation to time and place dimension (p = 0.008) between the two groups, with the mean scores being higher in AOU group. Duration of opioid use was the only factor influencing cognitive assessment score in both Groups. (p = 0.029). CONCLUSION: We suggest monitoring and assessing cognition function in patients receiving methadone especially for those with a long history of opioid use.

Psychiatric Adverse Drug Reactions and Potential Anti-COVID-19 Drug Interactions with Psychotropic Medications.

Coronavirus disease 2019 (COVID-19) management in patients with predisposing psychiatric disorders would be challenging due to potential drug-drug interactions (PDDIs) and precipitation of their disease severity. Furthermore, COVID-19 itself might precipitate or induce unpredicted psychiatry and neuropsychiatry complications in these patients. In this literature review study, the psychological impacts of COVID-19 and major psychiatric adverse drug reactions (ADRs) of COVID-19 treatment options have been discussed. A detailed Table has been provided to assess potential drug-drug interactions of COVID-19 treatment options with psychotropic medications to avoid unwanted major drug-drug interactions. Finally, potential mechanisms of these major drug-drug interactions and possible management of them have been summarized. The most common type of major PDDIs is pharmacokinetics. Hydroxychloroquine/chloroquine and lopinavir/ritonavir were the most involved anti-COVID-19 agents in these major PDDIs.

Mental Health Status among Healthcare Workers during COVID-19 Pandemic.

Objective: COVID-19, which is an international concern by far, had fundamental impacts on mental health of medical staff. Healthcare workers are the high-risk group to endure the emotional outcomes brought about by the outbreak. This study assesses the mental consequences of healthcare workers during the acute phase of COVID-19 pandemic in Tehran. Method : We conducted a cross-sectional study on healthcare workers from two tertiary referral hospitals in Tehran province. A total of 222 of the staff participated in the study. Our questionnaires comprised Impact of Event Scale-Revised (IES-R) and 12-item General Health Questionnaire (GHQ-12), which were handed to participants to obtain data on their general mental problems in addition to the psychological impacts of the evolving virus on this particular group. Epidemiologic and sociodemographic information of participants, level of perceiving exposure to disease, and underlying diseases of each of them were gathered during the recruitment period. Results: Results showed high probabilities (98.2%) in mental disorders among healthcare workers. Since our study was done during the initial phase of the pandemic, development of mental issues due to the newly emerged infectious virus was expected. However, we recorded mild (41.4%) to moderate (31.5%) impact of this novel virus. The possibility of having mental problems was much higher in females, assistant nurses, individuals with lower education, and those who provided care for COVID-19 patients. Conclusion: COVID-19 has brought about increased distress among healthcare workers. Noticeably, the forefront group in combating this virus bear the most emotional complications. Thus, efforts should be taken into practice to provide proper psychological support for this vulnerable group.