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Background: Bipolar disorder is considered a psychiatric disease without any effective screening questionnaire to monitor and manage Iranian patients. This study aims to implement a researcher-made questionnaire in the form of educational interactive software for better management of patients with bipolar disorder and prevent further complications. Methods: The present cross-sectional study evaluated the efficacy of psychoeducational-interactive-therapeutic software for patients with bipolar disorder, which is a network-based software providing a researcher-made questionnaire in a planned manner. This software can predict the occurrence of future bipolar episodes for each patient by using artificial intelligence algorithms after the occurrence of two mood episodes as the training phase. The patients with bipolar disorder were asked to use the software for a year and their mood episodes were compared before and after using the software. We evaluate the reliability of the questionnaires in the software with internal consistency using alpha Cronbach test and test-retest analysis. Face validity and content validity were also evaluated. Results: The content validity index of the instrument was 93%, and the Cronbach's alpha coefficient of the whole questionnaire was 0.955. Also, the ICC coefficient for this questionnaire is above 0.70, and the correlation coefficient of the answers in all constructs of the questionnaire is more than 0.8. Thirty male patients with bipolar disorder who experienced four episodes of mood swings per year experienced an average of 2 mood episodes per year following the use of this software. Conclusion: Our Psychoeducational-interactive-therapeutic software is the first Persian language software based on artificial intelligence to monitor clinical symptoms in patients with bipolar disorder, which uses a standard questionnaire to predict the incidence of episodes of depression and mania in these patients.
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Methotrexate as a single agent chemotherapy in most women with low risk gestational trophoblastic neoplasia (GTN) has been associated with high treatment rate. Combination of methotrexate with Vitamin A due to reduced number of chemotherapy regime courses is one of the treatment options for patients with low-risk GTN. Therefore, this study was performed with aim to determine the efficacy of combination therapy of Methotrexate with Vitamin A in low risk GTN treatment. This randomized clinical trial was performed on 49 patients with low risk gestational trophoblastic neoplasia. The treatment group (Group A = 19 cases) weekly received Methotrexate 50 mg/m2, and Vitamin A 200000 IU, intra-muscular, and the control group (Group B = 30 cases) only received Methotrexate 50 mg/m2 weekly. All patients were followed up for 8 weeks. Then, treatment outcomes were compared between two groups, and response to therapy was assessed in two groups by evaluation of HCG serum level. P < 0.05 was considered significant.Mean of B-HCG serum level after 4 weeks in Group A and Group B was 68.5 mIu/mL and 360 mIu/mL, respectively (P = 0.018), and after 8 weeks was 1 mIu/mL and 12 mIu/mL, respectively (P = 0.074). Combination therapy of Methotrexate and Vitamin A in low risk GTN is associated with shorter duration of chemotherapy.
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BACKGROUND AND AIM: Obesity is one of the greatest public health concerns worldwide. Weight loss surgeries have been increased in recent decades due to the world's epidemic of obesity. The aim of this prospective study is investigating metabolic factors of morbid obese patients following Roux-en-Y gastric bypass surgery. METHODS: This was a nonrandomized prospective cohort study conducted from 2010 to 2013 on 60 consecutive patients who had body mass index (BMI) of more than 40 kg/m(2) and met the surgical indication criteria of bariatric surgery. Upon discharge, patients were followed in outpatient clinic of Qaem Hospital, Mashhad, Iran, each 3 months for 12 months. Measurement of anthropometric and metabolic indices was done in each postoperative visit. RESULTS: Mean BMI reduction was 15.26 ± 3.45 kg/m(2) in the patients with an average value of 28.84 ± 3.94 (range from 22 to 40 kg/m(2)), which was significantly lower than the base value (p < 0.001). After a 12-month follow up, patients had lower low-density lipoprotein, triglycerides, and total cholesterol (p < 0.001 for all the variables), while achieving a greater high-density lipoprotein (p = 0.004). An improvement was seen in all of hypertensive patients after a 3-month follow up and blood pressure remained within normal limit in further follow ups. Complete remission was observed in all the patients with obstructive sleep apnea. CONCLUSION: It appears reasonable that multidisciplinary treatment including surgical alternatives should be concerned for all morbidly obese patients, considering high rate of failure of conservative medical therapy in this setting.