The Efficacy of Cognitive-Behavioral Group Therapy on Depression, Anxiety, and Pain-Coping Strategies in Women With Breast Cancer.

ABSTRACT: Cognitive-behavioral group therapy is one of the most effective forms of intervention in therapy for women with breast cancer. The present study aimed to investigate the efficacy of cognitive-behavioral group therapy on depression, anxiety, and pain-coping strategies in women with breast cancer. The present study is a semiexperimental research with a pretest-posttest with the control group. For this purpose, 50 people of women with breast cancer were admitted to the medical university hospitals of Tehran to method purposive sampling and were randomly selected as experimental ( n = 25) and control ( n = 25) groups. The results showed that cognitive-behavioral group therapy significantly reduces depression and anxiety and increases the use of pain-coping strategies in women with breast cancer. Also in the field of pain-coping strategies between the experimental and control groups, there is a significant difference.

The effectiveness of adolescent-oriented mindfulness training on academic burnout and social anxiety symptoms in students: experimental research.

The aim of this study was to investigate the effectiveness of adolescent-oriented mindfulness training on academic burnout and social anxiety symptoms in students. The current study was a semi-experimental type with a pretest-posttest design with a control group with the measurement at baseline after the intervention and a 3-month follow-up. The statistical population included all high school students with symptoms of social anxiety who were studying in Tehran in the academic year 2022. Among the students, 100 students were selected as a sample by purpose-based sampling and randomly assigned to two experimental and control groups (50 people). The tools of this research were a researcher-made demographic questionnaire, social anxiety questionnaire, academic burnout questionnaire, and adolescent-oriented mindfulness protocol. Data analysis was performed using analysis of variance with repeated measures. The results showed that adolescent-oriented mindfulness training had a significant effect on reducing academic burnout and social anxiety symptoms of students (P<0.001). Based on the findings of the research, it can be said that adolescent-oriented mindfulness training is effective in reducing academic burnout and social anxiety symptoms of students.

Silver Trimolybdate (Ag2Mo3O10.2H2O) Nanorods: Synthesis, Characterization, and Photo-Induced Antibacterial Activity under Visible-Light Irradiation.

The present study reports the synthesis, characterization, and antibacterial properties of silver trimolybdate (Ag2Mo3O10.2H2O) nanorods. The synthesis was performed using a conventional hydrothermal method. The sample was characterised by scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, UV-Vis-NIR diffuse reflectance, thermogravimetric analysis (TGA), and differential scanning calorimeter (DSC). The direct antibacterial activity was evaluated using the microdilution method to determine the minimum inhibitory concentration (MIC). To assess the ability of Ag2Mo3O10.2H2O nanorods to modulate antibacterial resistance, the MIC of aminoglycosides was established in the presence of a subinhibitory concentration of this substance alone and associated with LED light exposure. The characterization of the sample indicated that the synthesis of silver trimolybdate generated nanometric crystals with rod-like morphology, without secondary phases. The treatment with Ag2Mo3O10.2H2O nanorods alone or combined with visible LED lights exhibited clinically relevant antibacterial activity against both Gram-negative and Gram-positive bacteria. This nanostructure presented a variable antibiotic-modulating action, which was not improved by visible LED light exposure. Nevertheless, LED lights showed promising antibiotic-enhancing activities in the absence of Ag2Mo3O10.2H2O nanorods. In conclusion, silver trimolybdate dihydrate nanorods have antibacterial properties that can be photocatalysed by visible-light exposure. While showing the potential use to combat antibacterial resistance, the simultaneous combination of silver trimolybdate, visible LED lights, and antibacterial drugs should be carefully analysed to avoid antagonist effects that could impair the effectiveness of antibiotic therapy.

Increased nurses' anxiety disorder during the COVID-19 outbreak.

BACKGROUND: The rapid outbreak of COVID-19 at the beginning of 2020 in the world has put severe physical and psychological pressure on the medical staff of hospitals involved in the care of patients with COVID-19 to the point of risk of PTSD. There was. The aim of this study was to investigate the relationship between the prevalence of COVID-19 and nurses' anxiety disorder. METHODS: This review study was conducted by library method. RESULTS: As is well known and mentioned everywhere in cyberspace, nurses have lost their mental health and become very anxious during the COVID-19. Serious spread of traumatic psychiatric symptoms in the current situation can lead to damage to the health system. CONCLUSIONS: The need to care for nurses to relieve fatigue for several months and inject hope and motivation into this group should be understood, But due to the economic situation of the country, unfortunately, the fulfillment of the promises has been delayed, which we hope will be fulfilled soon; Although the delay will certainly not prevent nurses from properly caring for patients, but resolving nurses 'livelihood problems should also be a priority on the authorities' agenda.

Phytochemistry and Biological Activities of Amburana cearensis (Allemão) ACSm.

Amburana cearensis (Allemão) ACSm. belongs to the Fabaceae family and occurs in the Brazilian semiarid, Argentina, Paraguay, Bolivia, and Peru. Numerous studies that portray its ethnobotany, use in popular medicine, chemical composition, and biological activities exist in the literature. This review aimed to provide an overview of the chemical composition, ethnopharmacology, and biological activities associated with A. cearensis and its isolated constituents. Information was collected from internet searches in the Scopus, Medline, PubMed, Google Scholar, and ScienceDirect databases were performed covering publications from 1997-2020. An ethnopharmacological literature analysis revealed that A. cearensis is used to treat a wide range of respiratory disorders in addition to intestinal, circulatory, and inflammatory problems. Coumarins, flavonoids, phenolic glycosides, phenolic acids, phenylpropanoid derivatives, and triterpenoids, among others, have been reported as active compounds, with High-Performance Liquid Chromatography (HPLC) being the main analytical technique used. The A. cearensis extracts and compounds presented several biological activities, including antimicrobial, antinociceptive, anti-inflammatory, antioxidant, neuroprotective, and myorelaxant activities, among others. This review provides a useful bibliography for future investigations and A. cearensis applications; however, future studies should focus on its toxic effects and the mechanisms of action of its extracts and isolated constituents to guide clinical applications.

Molecular identification and antifungal susceptibility testing of Candida species isolated from oral lesions in patients with head and neck cancer undergoing radiotherapy.

BACKGROUND AND PURPOSE: Radiation therapy in patients with head and neck malignancies predisposes them to oral Candida colonization and infection due to damage of oral mucosa and destruction of the salivary gland. This study aimed to determine the prevalence of oropharyngeal candidiasis (OPC) in patients with head and neck cancer (HNC) undergoing radiotherapy (RT), identify the yeasts isolated from them, and determine their antifungal susceptibility. MATERIALS AND METHODS: This cross-sectional study was conducted from December 2018 to June 2019 at two referral radiotherapy centers in northern Iran. Yeast strains that were isolated from patients with HNC were identified using conventional and molecular methods. The in vitro activities of eight common antifungal drugs against 55 isolates were investigated according to the guidelines of the Clinical and Laboratory Standard Institute (M27-A3 and M27-S4) broth microdilution document. RESULTS: Among 59 patients receiving RT, the prevalence of OPC was 21 (35.59%) and 15 (25.42%) patients were diagnosed with colonization. The mean age of the patients was 55.32±13.3 years (within the range of 27-87 years). In this study, the pseudomembranous form was reported as the most clinical type of OPC. Candida albicans with the frequency of 60% was the most common type of Candida spp. that was observed in this study, although non-albicans Candida spp., such as C. glabrata (27.27%), C. tropicalis (5.45%), C. parapsilosis (3.63%), C. krusei (1.83%), and C. kefyr (1.83%) were also isolated. Considering the low minimum inhibitory concentration range of amphotericin B, compared to fluconazole, administration of this agent is a more suitable antifungal drug for extensive oral candidiasis in these patients. Among azoles, clotrimazole had low efficacy and several studied isolates (65.5%) showed resistance. CONCLUSION: Correct diagnosis as well as determining drug sensitivity and risk factors are the effective steps in reducing the complications related to oral candidiasis in people undergoing RT.

A systematic literature review and meta-analysis on the global prevalence of Naegleria spp. in water sources.

Naegleria species (spp.) is a free-living amoeba whose pathogenic species such as N. fowleri pose a significant health risk to young people, and the most important source of infection is water source. This study aims to perform a systematic review and meta-analysis of the data on the prevalence of Naegleria spp. in water sources in the available literature. Included articles on the prevalence of Naegleria spp. in water sources in PubMed, Google Scholar, ProQuest, ScienceDirect, EMBASE, Scopus and Web of Science were systematically searched between January 1977 and September 2019. Regarding meta-analysis, the random-effect model was employed by forest plot with 95% of confidence interval (CI). The meta-analysis considered 103 articles surveying the prevalence of Naegleria spp. in various water sources. The pooled worldwide prevalence of Naegleria spp. across 35 countries was 26.42% (95% CI = 21.52-31.63). The subgroup analysis reported that the pooled worldwide prevalence of N. fowleri is 23.27%, N. australiensis 9.12%, N. lovaniensis 7.68%, N. pagei 5.95, N. polaris 5.17%, N. gruberi 3.95%, N. clarki 3.54%, N. americana 3.19%, N. philippinensis 1.99% and N. dobsoni 1.73%. This is the first systematic review on the prevalence of Naegleria spp. in water sources. Our findings suggest a wide distribution of Naegleria spp., including potential pathogenic species such as N. fowleri, in water sources all over the world. Therefore, it is of paramount importance to provide comprehensive data and systematic analysis regarding the prevalence of Naegleria spp. in water sources. Accordingly, further studies are highly recommended to investigate the presence of pathogenic N. fowleri in other countries.

A multi-centered study of Pneumocystis jirovecii colonization in patients with respiratory disorders: Is there a colonization trend in the elderly?

BACKGROUND AND PURPOSE: Pneumocystis jirovecii colonization plays a key role in the progression of pulmonary infection. However, there are limited data regarding the colonization of these fungi in the patients residing in different regions of Iran. Regarding this, the present study was conducted to evaluate the prevalence of P. jirovecii colonization in non-HIV-infected patients with respiratory failure introduced by physicians using nested polymerase chain reaction (PCR). MATERIALS AND METHODS: This study was conducted on 136 samples obtained from 136 patients with respiratory disorders referring to different hospitals in the capital and north of Iran during 2013-2015. The samples were collected using bronchoalveolar lavage (BAL; n=121) and sputum induction (n=15). Nested PCR method targeting mtLSU rRNA gene was used for the detection of P. jirovecii DNA in the specimens. RESULTS: The nested PCR analysis resulted in the detection of P. jirovecii DNA in 32 (23.5%) patients. The mean age of the participants was 49.04±11.94 years (age range: 14-90 years). The results revealed no correlation between Pneumocystis colonization and gender. The studied patients were divided into two groups of immunocompromised and immunocompetent patients. In the regard, 25.4% of the patients with detectable P. jirovecii DNA were immunocompromised and had cancer, organ transplantation, asthma, sarcoidosis, dermatomyositis, chronic obstructive pulmonary disease, bronchiectasis, and pulmonary vasculitis. On the other hand, Pneumocystis DNA was detected in 21.8% of the immunocompetent patients. Frequencies of P. jirovecii DNA detection in the patients with tuberculosis, hydatid cyst, and unknown underlying diseases were obtained as 20.8%, 25%, and 22%, respectively. The prevalence of Pneumocystis colonization varied based on age. In this regard, P. jirovecii colonization was more prevalent in patients aged above 70 years. CONCLUSION: As the findings indicated, non-HIV-infected patients, especially the elderly, had a high prevalence of P. jirovecii colonization. Therefore, these patients are probably a potential source of infection for others. Regarding this, it is of paramount importance to adopt monitoring and prophylactic measures to reduce this infection.

Fatal rhinocerebral mucormycosis in a patient with ulcerative colitis receiving azathioprine and corticosteroid.

BACKGROUND AND PURPOSE: Rhinocerebral mucormycosis is a rare fatal fungal infection which is on a growing trend, particularly among immunocompromised patients. Immunosuppressive drugs, including corticosteroids and antimetabolites, increase the risk of this infection. Herein, we reported the case of fulminant rhinocerebral mucormycosis in a patient with ulcerative colitis receiving azathioprine and corticosteroid. CASE REPORT: A 58-year-old woman was admitted to the hospital in a state of coma with an extensive necrosis in her nose. She was afflicted with intestinal bleeding after 1 month of fasting and was treated with azathioprine and a high dose of prednisolone for ulcerative colitis 2 months prior to hospital admission. The direct microscopic examination of the necrotic tissues of the paranasal sinuses showed several non-septate hyphae consistent with Mucorales. Culture media yielded Rhizopus species, which was identified as Rhizopus oryzae by internal transcribed spacer polymerase chain reaction sequencing. Despite the implementation of surgical and pharmaceutical (liposomal amphotericin B) treatments, the patient expired after 2 weeks of admission. CONCLUSION: The gastroenterologists should be aware of the adverse effect of immunosuppressive drugs they prescribe for the treatment of inflammatory bowel disease.

Identification of Mucorales in patients with proven invasive mucormycosis by polymerase chain reaction in tissue samples.

BACKGROUND: Accurate diagnosis of mucormycosis, a life-threatening fungal infection, remains a challenge for physicians. OBJECTIVES: To identify the causative Mucorales in fresh clinical samples and formalin-fixed paraffin-embedded (FFPE) samples of patients with proven mucormycosis by molecular method. PATIENTS/METHODS: Fresh clinical samples of patients with proven mucormycosis according to the EORTC/MSG criteria admitted between 2015 and 2017 and histopathologically proven FFPE archives collected during 2004-2007 and 2015-2017 from Mazandaran University-affiliated hospitals of northern Iran were included. Seminested PCR targeting the 18S rDNA of Mucorales and ITS region was performed, and PCR products were then sequenced. RESULTS: While culture was positive only in 5 of 9 (56%) of fresh specimen cases, PCR was positive in all 9 (100%) histologically proven mucormycosis. Ten of 18 (56%) FFPE samples were PCR-positive. Overall, Mucorales PCR was positive in 19 of 27 (70%) samples. Mucorales species were Rhizopus arrhizus in 16 (84%) cases, R. arrhizus/Amylomyces rouxii in 2 (10.5%) cases and Rhizopus stolonifer in one case (5.5%). Among 27 mucormycosis cases, 25 (93%) cases were rhinocerebral, and 2 (7%) cases were disseminated. Diabetes mellitus (74%) and neutropaenia (63%) were the main risk factors. CONCLUSIONS: Seminested PCR targeting 18S rDNA region of Mucorales is useful for identification of the causative agents of mucormycosis.

Effect of inhalation aromatherapy with lavender essential oil on stress and vital signs in patients undergoing coronary artery bypass surgery: A single-blinded randomized clinical trial.

OBJECTIVES: At present, aromatherapy is used widely in medical research. This study aimed to investigate the effects of inhalation aromatherapy using lavender essential oil to reduce mental stress and improve the vital signs of patients after coronary artery bypass surgery (CABG). DESIGN: A single-blinded randomized controlled trial was conducted with 60 patients who had undergone CABG in a 2-day intervention that targeted stress reduction. PARTICIPANTS: Sixty subjects following coronary artery bypass surgery in two aromatherapy and control groups. SETTING: The study was conducted in Ekbatan Therapeutic and Educational Center, Hamadan, Iran, in 2013. INTERVENTIONS: On the second and third days after surgery, the aromatherapy group patients received two drops of 2% lavender essential oil for 20min and the control group received two drops of distilled water as a placebo. MAIN OUTCOME MEASURES: The primary outcome was mental stress, which was measured before and after the intervention using the DASS-21 questionnaire. The secondary outcomes were vital signs, including the heart rate, respiratory rate, and systolic and diastolic blood pressure, which were measured before and after the intervention. RESULTS: The individual characteristics of the aromatherapy and control groups were the same. There were no significant difference in the mean mental stress scores and vital signs of the aromatherapy and control groups on the second or third days after surgery. CONCLUSION: Inhalation aromatherapy with lavender essential oil had no significant effects on mental stress and vital signs in patients following CABG, except the systolic blood pressure.

Extracellular enzymes and susceptibility to fluconazole in Candida strains isolated from patients with vaginitis and healthy individuals.

BACKGROUND: Extracellular phospholipase, proteinase, and coagulase are accounted as the major virulence factors in Candida albicans. Several reports showed that the incidence of resistance to fluconazole has risen during last two decades. OBJECTIVES: The present study has investigated the extracellular enzymes of C. albicans and non-albicans species isolated from both patients with vaginitis and healthy women. In addition, susceptibility of the isolates was evaluated against fluconazole. PATIENTS AND METHODS: Vaginal samples were collected using sterile cotton swabs and inoculated on CHROMagar Candida. Routine morphological tests and ID 32C and API 20C AUX Kits were used to identify species. Phospholipase, proteinase, and coagulase activity were determined by standard methods. Susceptibility to fluconazole was also evaluated using ATB Fungus 3 Kits. RESULTS: The phospholipase activity was detected in 66.7% of the tested isolates recovered from patients with vaginitis. In the present study, phospholipase activity with higher Pz values (< 0.70) was more common in patients with vaginitis (28 of 66 isolates) whereas this rate in the normal individual was 13 of 42. Proteinase activity was detected in 74.2% and 61.9% of tested isolates recovered from patients and normal individuals, respectively. All tested isolates were negative for coagulase activity. In the present study, resistance to fluconazole was found in 34.8% of isolates. C. dubliniensis was the most common isolate (6 out of 11 isolates) that showed resistance to fluconazole. CONCLUSIONS: Our results showed that C. albicans was the most frequently isolated from both patients with vaginitis and normal individual. In the present study, we could not find any correlation between extracellular activities and sources of isolates (patients and normal flora) and sensitivity or resistance to fluconazole.

Otomycosis in iran: a review.

Fungal infection of the external auditory canal (otitis externa and otomycosis) is a chronic, acute, or subacute superficial mycotic infection that rarely involves middle ear. Otomycosis (swimmer's ear) is usually unilateral infection and affects more females than males. The infection is usually symptomatic and main symptoms are pruritus, otalgia, aural fullness, hearing impairment, otorrhea, and tinnitus. Fungal species such as yeasts, molds, dermatophytes, and Malassezia species are agents for otitis externa. Among molds, Aspergillus niger was described as the most common agent in the literature. Candida albicans was more prevalent than other yeast species. Otomycosis has a worldwide distribution, but the prevalence of infection is related to the geographical location, areas with tropical and subtropical climate showing higher prevalence rates. Otomycosis is a secondary infection and is more prevalent among swimmers. As a result, a higher incidence is reported in summer season, when more people interested in swimming. Incidence of otomycosis in our review ranged from 5.7 to 81 %, with a mean value of 51.3 %. Our results showed that 78.59 % of otomycosis agents were Aspergillus, 16.76 % were Candida species, and the rest (4.65 %) were other saprophytic fungi. Among Iranian patients, incidence of infection was highest in summer, followed by autumn, winter, and spring. In Iran, otomycosis was most prevalent at the age of 20-40 years and the lowest prevalence was associated with being <10 years old. The sex ratio of otomycosis in our study was (M/F) 1:1.53.

The effect of lavender essential oil on anxiety level in patients undergoing coronary artery bypass graft surgery: A double-blinded randomized clinical trial.

BACKGROUND: Open heart surgery can cause high levels of anxiety in patients. Nowadays, lavender essential oil is widely used in medical research. This study was conducted with an aim to investigate the effects of lavender essential oil to reduce the anxiety of patients after coronary artery bypass surgery. MATERIALS AND METHODS: This research is double-blinded randomized controlled trial on 60 patients who had undergone coronary artery bypass surgery in a 2-day intervention targeting reduction of anxiety. This study was conducted in Ekbatan Therapeutic and Educational Center, Hamadan city, Iran, in 2013. The patients in the inhalation aromatherapy group inhaled two drops of 2% lavender essential oil and those in the control group inhaled two drops of distilled water as placebo for 20 min on the 2(nd) and 3(rd) days after surgery. The level of anxiety was evaluated by Spielberger's State Anxiety questionnaire before and after intervention and the vital signs were documented as well. Data were analyzed using Stata 11 (Stata Corp., College Station, TX, USA) by independent t-test for continuous variables and Chi-square test for categorical variables. RESULTS: The mean score of anxiety in the aromatherapy group was 48.73 ± 5.08 and in the control group was 48 ± 6.98 before the intervention (P = 0.64), which reduced after the intervention to 42.6 ± 5.44 and 42.73 ± 7.30, respectively. On the 3(rd) day after surgery, the mean score of anxiety in the aromatherapy group was 46.76 ± 4.07 and in the control group was 46.53 ± 7.05 before the intervention, which reduced to 41.33 ± 3.65 and 41.56 ± 6.18, respectively, after the intervention. However, there was no statistically significant difference in the mean scores of anxiety between the aromatherapy and control groups. CONCLUSIONS: Lavender essential oil has no significant effect on anxiety in patients after coronary artery bypass surgery, although it decreased the level of anxiety in the patients.

Lamisil versus clotrimazole in the treatment of vulvovaginal candidiasis.

BACKGROUND AND OBJECTIVES: Vaginal candidiasis is a common disease in women during their lifetime and occurs in diabetes patients, during pregnancy and oral contraceptives users. Although several antifungals are routinely used for treatment; however, vaginal candidiasis is a challenge for patients and gynecologists. The aim of the present study was to evaluate terbinafine (Lamisil) on Candida vaginitis versus clotrimazole. MATERIALS AND METHODS: In the present study women suspected to have vulvovaginal candidiasis were sampled and disease confirmed using direct smear and culture examination from vaginal discharge. Then, patients were randomly divided into two groups, the first group (32 cases) was treated with clotrimazole and the next (25 cases) with Lamisil. All patients were followed-up to three weeks of treatment and therapeutic effects of both antifungal were compared. RESULTS: Our results shows that 12 (37.5%) patients were completely treated with clotrimazole during two weeks and, 6(18.8%) patients did not respond to drugs and were refereed for fluconazole therapy. Fourteen (43.8%) patients showed moderate response and clotrimazole therapy was extended for one more week. When Lamisil was administrated, 19 (76.0%) patients were completely treated with Lamisil in two weeks, and 1 (4.0%) of the patients did not respond to the drug and was refereed for fluconazole therapy. Five (20.0%) of our patients showed moderate response and Lamisil therapy was extended for one more week. CONCLUSION: Our results show that vaginal cream, 1% Lamisil, could be suggested as a first-line treatment in vulvovaginal candidiasis.

Candiduria in children and susceptibility patterns of recovered Candida species to antifungal drugs in Ahvaz.

BACKGROUND: Candiduria presents as an increasingly common nosocomial infection, which may involves urinary tract. Spectrum of disease is varying from asymptomatic candiduria to clinical sepsis. Disease is most commonly caused by Candida albicans. OBJECTIVES: The aim of the present study was to determine the frequency of candiduria in children attending Abuzar Pediatrics Hospital. PATIENTS AND METHODS: Urine samples were collected from 402 patients attending to the Abuzar Pediatrics Hospital, Ahvaz. 10µl of each urine sample was cultured on CHROMagar Candida plates and incubated at 37°C. Ketoconazole, amphotericine B, clotrimazole, fluconazole, miconazole and nystatin disks were used for determination of susceptibility. RESULTS: In the present study, 402 patients with the age range <1-14 years were sampled (59.2% males and 40.8% females). Prevalence of Candida among enrolled patients was found to be 5.2% (71.4% males and 28.6% females). In our study C. albicans was identified in 19 cases as the most common yeast followed by nine C. glabrata and one C. krusei. Urine cultures were yielded more than 10000 CFU/ml in 14.3% of the cases followed by 600-10000 CFU/ml (28.5%) and 100-600 CFU/ml (57.2%). Antifungal susceptibility testing revealed that only one isolate of C. glabrata and seven isolates of C. albicans were resistant to nystatin and ketoconazole, respectively.  However, all tested isolates were resistance to fluconazole. CONCLUSION: Asymptomatic candiduria is relatively more prevalent among children in Ahvaz and the most common agent is C. albicans. In addition, isolated Candida species were sensitive to use antifungals, with exception to fluconazole.