Comorbidity of asthma in patients with attention-deficit/hyperactivity disorder (ADHD) aged 4-12 years in Iran: a cross-sectional study.

Attention-deficit/hyperactivity disorder (ADHD) is defined as a stable pattern of attention deficits or impulsive hyperactivity that can interfere with the functioning, growth, and development of individuals. It is believed that both the type of asthma and the medications used to treat it exacerbate the symptoms of ADHD. Methods and Materials: The present study was a cross-sectional analytical study conducted to investigate the incidence of asthma in ADHD patients aged 4-12 years who were referred to Urmia University of Medical Sciences clinics and hospitals. In this study, ADHD patients were diagnosed through a psychiatric interview and based on a paediatric asthma questionnaire (approved by asthma and allergy organizations and scientific institutions), and individuals with suspected asthma were selected. All 101 ADHD patients referred to these clinics during the specified period were examined. Five patients were excluded from the study because of lack of cooperation or incomplete information. Then, the selected subjects were divided into two age groups of less than 5 years and between 5 and 12 years. The final diagnosis of asthma was made by clinical findings and demographic questionnaire in subjects younger than 5 years, while it was made by spirometry in subjects between 5 and 12 years. Data analysis was conducted using SPSS software. Results: The mean age of the 96 samples included in the study was 7.67 years with a standard deviation of 7.214. Sixteen of them (16.7%) were under 5 years of age and eighty of them (83.3%) were between 5 and 12 years of age. Asthma was diagnosed in 7 children under 5 years of age (7.3%) and in 14 children (14.6%) between 5 and 12 years of age. A total of 21 (21.9%) were diagnosed as having asthma after screening. On the basis of these results, the frequency of asthma according to classified age was significant (P=0.020). The frequency of asthma based on sex and birth rank was also examined, and none of these factors showed a significant association with asthma. Medications taken by the ADHD patients were also examined in this study. The most commonly used medications in both groups of patients with asthma and no asthmatic patients were a combination of risperidone and atomoxetine or risperidone alone. The prevalence of asthma in the target population was also assessed in terms of parental smoking. Conclusions: According to the results of this study, the incidence of asthma in ADHD patients aged 4-12 years is high, and this case is more frequent in subjects younger than 5 years than in subjects aged 5-12 years. It should be noted that according to the results of the present study, there was no significant association between birth rank, parental smoking, ADHD medication, and the frequency of asthma.

Healing refractory diabetic foot ulcers (DFUs) by ozone therapy and silver dressing: A case report.

INTRODUCTION AND IMPORTANCE: Refractory diabetic foot ulcers (DFUs) are still a major health problem and can lead to death. CASE PRESENTATION: The present case reports a 45-year-old man with an 8-year history of type 2 diabetes who has had left refractory DFU for a year on the left heel with a size of 6 × 3 × 1 cm. The patient's ulcers were infected with Staphylococcus aureus. Despite the routine DFU care (normal saline dressing twice a day and intravenous antibiotic therapy), the patient did not recover from DFU using standard methods. The patient was referred to our wound management team. In the first step, the necrotic tissues of his foot ulcer were irrigated and debrided using mechanical debridement and saline. Next, the patient underwent a 70 µg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After two months, the patient's DFUs healed, and he was discharged from our service in good condition. CLINICAL DISCUSSION: DFU can lead to infection, amputation, and even patient death. Therefore, effective treatment methods are very important for managing DFUs. CONCLUSION: This case report study was shown that the ozone therapy is an effective approach to improve the healing of refractory DFUs and prevent foot amputation. Therefore, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.

Social Capital of Parents of Children and Adolescents and Its Relation to Psychiatric Disorders; A Population-Based Study.

Social capital is a complex concept that is considered an effective factor in the development of societies. Considering the importance of burdens of psychiatric disorders in Iran, we studied the relationship between various dimensions of social capital of parents of children and adolescents and psychiatric disorders among them. In this cross-sectional study, 18,940 parents of children and adolescents aged 6 to 18 years old were randomly selected from all provinces of Iran and were evaluated by the Millon clinical multiaxial inventory-III (MCMI-III) and a modified version of Nahapiet and Ghoshal questionnaire. MCMI-III was designed as a self-report tool for investigating psychiatric clinical disorders and personality traits in the general population. Modified Nahapiet and ghoshal questionnaire has 20 items and measures four components of social capital included trust, values, communication, and collaboration. Validity and reliability of both questionnaires have been approved in Iran. In the regression model, the relationship between social capital components and clinical and sever clinical syndromes, in the form of regression weight and standard weight for trust was - 0.558 and - 0.062 with p value less than 0.0001, and for values was - 0.466 and - 0.057, respectively, with p value less than 0.0001. There was a reverse correlation between social capital components of parents of children and adolescents and psychiatric disorders in Iran. In regression statistical models, the two components of values and trust were negative predictors of psychiatric disorders. Considering the high prevalence of psychiatric disorders in Iran, it seems that the strengthening of cognitive and structural aspects of social capital of parents of children and adolescents is one of the effective factors in reducing the prevalence of these disorders among them.

Association between Dietary Patterns and Major Depression in Adult Females: A Case-Control Study.

BACKGROUND: Depression is one of the most common mental disorders. This study aimed to determine the association between dietary patterns and major depression in adult females. STUDY DESIGN: A case-control study. . METHODS: This study was conducted on adult females suffering from major depression within the age range from 19 to 65 years. The total participants of this study included 170 cases and 340 controls. Dietary intakes were collected using a 168-item validated semi-quantitative food-frequency questionnaire. Household food security was measured using a locally adapted Household Food Insecurity Access Scale. Moreover, the depression status of the adult females was assessed through a validated "Beck" questionnaire. Logistic regression was utilized to assess the association between dietary pattern scores and depression. RESULTS: The mean ±SD ages of the participants were 36.97 ±11.28 and 36.07 ±10.58 years in the case and control groups, respectively (P=0.374), and five major dietary patterns were extracted in this study. The odds ratio (OR) in the last adjusted model was (OR: 0.61; 95% CI: 0.46, 0.81); therefore, the "Healthy pattern" was significantly inversely associated with the odds of depression. Adherence to the "Western pattern" significantly increased depression by 29% (OR: 1.29; 95% CI: 1.06, 1.59). Furthermore, the "Traditional pattern" was positively associated with depression (OR: 1.16; 95% CI: 0.94, 1.43). There was no significant association between "Sugar and fast food" and "red meat and oils" dietary pattern and depression. CONCLUSION: Healthy dietary pattern reduces the risk of depression in adult females; however, the western and traditional dietary patterns increases this risk.

Autonomy-supportive exercise behaviors promote breast cancer survivors' well-being.

Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors. Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions. Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions. Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.

Study of the role of regular physical activity on promoting hedonism and eudaimonia in breast cancer survivors.

BACKGROUND: Individuals who have completed cancer treatment may have psychological and physical challenges. Participating in regular physical activity is considered as one of the most important factors for improving postcancer experience. AIMS: The aim of this study was to examine the effect of participating in physical activities on hedonism and eudaimonia among breast cancer survivors. METHODS: The research method was a semi-experimental design in the form of time-series using two experimental and control groups. 42 breast cancer survivors participated in this study in Urmia. Data using motives for activation of hedonism and eudiamonia (HEMA) were gathered before the intervention program (pre-test), at the end of intervention (the first post-test), and two weeks after the first post-test (the second post-test). For data analysis, descriptive and inferential statistics (T-test, Chi-square, and repeated measures ANOVA) were used. RESULT: Repeated measures ANOVA analysis in the three different periods of pre-test, post-test, and a month later post-test showed that changes in the mean score of hedonism and eudaimonia motivation were not similar in the two groups and indicated the improvement of dialysis adequacy in the intervention group compared with the control group. CONCLUSION: Generally, the results showed that participating in regular physical activity is an effective intervention on enhancing the motives for hedonism and eduaimonia in breast cancer survivors.

Lifetime prevalence, sociodemographic predictors, and comorbidities of oppositional defiant disorder: the National Epidemiology of Iranian Child and Adolescent Psychiatric disorders (IRCAP)

Objective: This was the first national epidemiological study on oppositional defiant disorder (ODD) in Iran, which provided new information about the prevalence, comorbidities, and sociodemographic predictors of ODD. Methods: Data from a face-to-face household survey of 30,532 children and adolescents aged 6-18 years were collected from across all 31 provinces of Iran using a multistage cluster sampling design. The Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version (K-SADS-PL) was used in this study. Results: The lifetime prevalence of ODD was found to be 3.9%. ODD was significantly more common in boys than girls and appeared in late adolescence more frequently than in childhood. A lower prevalence of ODD was found among participants who lived in rural areas. ODD is highly likely to co-occur with attention deficit hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, and depressive disorders. Conclusions: The findings of this national population-based study confirm and extend previous findings on the prevalence, comorbidities, and sociodemographic predictors of ODD.

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.

Gender Determines the Pattern of Correlation between Body Mass Index and Major Depressive Disorder among Children and Adolescents: Results from Iranian Children and Adolescents' Psychiatric Disorders Study.

Background: We aimed to determine the correlation of BMI with depression and to determine the role of gender in this association, in a large study sample. Methods: We used the data of participants in the Iranian Children and Adolescents' Psychiatric Disorders (IRCAP) Study, conducted in 2017. This study was a national community-based, cross-sectional study in which the urban and rural areas of all provinces of Iran were covered. Overall 30,532 children and adolescents, ages 6-18, were randomly selected with the stratified cluster sampling method. Results: Of a total of 30,532 participants, 25,321, whose BMI had been measured and who had been interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), entered the study (12,455 boys and 12,866 girls). We categorized the participants according to the national cutoff points for BMI classification. After controlling for age, father's and mother's job and education, and place of residence, the odds ratio (OR) of depression in underweight, healthy weight, and overweight boys compared with obese boys was 2.19 [95% confidence interval (95% CI): 1.00-4.81], 1.06 (95% CI: 0.73-1.55), and 0.80 (95% CI: 0.49-1.32), respectively. In the girls' subgroup, after controlling for the aforementioned covariates, the OR of depression in healthy weight, overweight, and obese participants compared with underweight subjects was 1.29 (95% CI: 0.52-3.19), 1.54 (95% CI: 0.59-3.98), and 1.79 (95% CI: 0.68-4.69), respectively. Conclusions: Underweight boys were more likely diagnosed with depression than normal weight and overweight boys. While in girls, the probability of depression increased by increased BMI.

The prevalence, comorbidity and socio-demographic factors of depressive disorder among Iranian children and adolescents: To identify the main predictors of depression.

BACKGROUND: Depressive disorders are a major public health problem in developed and developing countries. Recently, several risk factors have been described for depressive disorders in children and adolescents. The aim of the present study was to identify the main risk factors that can affect the incidence of depression in Iranian children and adolescents. METHODS: A total of 30,546 children and adolescents (between 6 and 18 years of age) participated in a cross-sectional study to identify the predictors of depressive disorders. Depressive disorders were assessed using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). In addition, a demographic characteristics questionnaire was completed by parents of the participants. The data was analyzed using the SPSS22 software via performing the descriptive analysis and the multiple logistic regression analysis methods. P-values less than 0.05 were considered statistically significant. RESULTS: Results showed that a higher age (15-18), being female, and the father's unemployment were associated with an increased odds ratio for depressive disorders. The age of 10-14 (OR = 2.1; 95% CI, 1.57-2.81), the age of 15-18 (OR = 4.44; 95% CI, 3.38-5.83), female gender (OR = 1.44; 95% CI, 1.2-1.73) and the father's unemployment (OR = 1.59; 95% CI, 1.01-2.5) were significant positive predictors, whereas, the mother's job (as a housewife) (OR = 0.66; 95% CI, 0.45-0.96) and a history of psychiatric hospitalization of the father and mother (OR = 0.34; 95% CI, 0.15-0.78 and OR = 0.34; 95% CI, 0.14-0.84) were negative predictors for depressive symptoms. CONCLUSION: Depressive symptoms are common in children and adolescents and are correlated with age and gender. The assessment of the prevalence of psychiatric disorders, especially the depressive disorders and their comorbidities, may help to prevent mood disorders in children and adolescents.

Hypnosis for reduction of background pain and pain anxiety in men with burns: A blinded, randomised, placebo-controlled study.

INTRODUCTION: 'Background pain' and 'pain anxiety' are among the numerous problems of patients with burns. Non-pharmacological and pharmacological interventions have been used to reduce background pain and pain anxiety. This study compared the effectiveness of hypnosis and 'neutral hypnosis' (as a placebo in the control group) in decreasing the background burn pain and pain anxiety of adult male survivors with burns. DESIGN: This is a blinded, randomised, placebo-controlled study. METHODS: Sixty men with burns were included in the minimisation method (30 individuals in the intervention group and 30 individuals in the control group). Four hypnotherapy sessions were performed every other day for each participant in the intervention group. Four neutral hypnosis sessions were performed every other day in the control group. Burn pain and pain anxiety of the patients in both groups were measured at the end of the second and fourth sessions. Repeated measures ANOVA was used for data analysis. RESULTS: There was no significant difference between the groups in the reduction in background pain intensity. There was a significant reduction in background pain quality and pain anxiety in the intervention group during the four hypnosis sessions. After two hypnotherapy sessions, a significant reduction was observed in the level of background pain quality and pain anxiety of participants. CONCLUSION: Hypnosis is effective in reducing background pain quality and pain anxiety of men with burns.