Persian Translation and Cultural Adaptation of Mini International Neuropsychiatric Interview and its Psychometric Properties.

BACKGROUND: The main objectives of this study were the translation, cultural adaptation, and assessment of the psychometric properties of the Persian version of Mini International Neuropsychiatric Interview (MINI). METHODS: All processes of linguistic methodology were conducted according to the published guidelines. A total of 180 patients with psychiatric problems were interviewed using MINI and Structured Clinical Interview for DSM-5(R) - Clinician Version (SCID-5-CV) by different interviewers. Another 30 patients were selected for examining the test-retest reliability. The study sample was recruited from a psychiatric hospital and a general hospital in Tehran, Iran. Face validity, feasibility, time of the interview, test-retest reliability, and concurrent validity were evaluated. RESULTS: Mean interview time was 19.76±10.30 minutes, indicating satisfactory feasibility. The test-retest reliability was very good (phi=2, Cramer's V=0.89, P<0.0001). The kappa values showed good or excellent agreement between MINI and SCID-5-CV for psychotic disorders (0.88), substance-related disorders (0.86), bipolar disorder (0.85), major depressive disorder (0.84), obsessive-compulsive disorder (0.74), and mental disorder due to other medical disorders (0.7). However, the kappa values were found to be lower for generalized anxiety disorder (0.44) and posttraumatic stress disorder (0.32) diagnoses. CONCLUSION: The Persian version of MINI is a feasible, reliable, and valid instrument for diagnosing some mental disorders. Further research is needed to evaluate the validity of this instrument in other categories of psychiatric diagnoses in the general population.

Diabetes-related distress and its association with the complications of diabetes in Iran.

Purpose: Diabetes-related distress (DRD) has negative emotional effects on the patients' quality of life. This is while the condition often goes undiagnosed despite it being common among diabetic patients. This study investigated the prevalence of DRD and its association with diabetes complications among a group of Iranian type 2 diabetic patients (T2DM). Methods: This descriptive-analytical cross-sectional study was conducted on 186 T2DM patients referred to a diabetes clinic in a teaching hospital from the beginning of May 2019 to the end of April 2020. Two questionnaires on disease-related information and diabetes distress screening scale (DDS) were filled out for each patient. The latter was divided into four domains, emotional burden (EB), diabetes-related interpersonal distress (ID), physician-related distress (PD), and regimen-related distress (RD). In addition to the frequency of DRD and its association with age, sex, body mass index (BMI), hypertension, hemoglobin A1C, duration of disease, and type of medication regimen (oral, insulin, or mix) along with the history of cardiovascular disease (CVDs), retinopathy, nephropathy, and diabetic foot were assessed. Results: DRD was reported in 47% of the patients. Being female, old age, hypertension, high hemoglobin A1C levels, nephropathy, and retinopathy were significantly associated with DRD (P-value = < 0.001, 0.013, 0.014, 0.007, 0.001, and 0.004, respectively). The history of the diabetic foot had a significant relationship with PD and ID (P-value = 0.007 and < 0.001, respectively). Multivariate regression showed gender and the existence of complications to have a direct effect on the development of DRD. Conclusion: DRD prevalence is relatively high and requires screening to identify and treat high-risk patients. Further studies are needed to study diabetes, its complications and their relation with DRD to help reduce such conditions and improve the patient's quality of life.

Transcranial Direct Current Stimulation for Treatment-Resistant Major Depression: A Double-Blind Randomized Sham-Controlled Trial.

In the current study, we tried to evaluate the effect of transcranial direct current stimulation (tDCS) on treatment-resistant major depression. We carried out a double-blind randomized sham-controlled trial was conducted in University Hospitals. Individuals with less than 50% decrease in the intensity of depression after 8 weeks of treatment with selective serotonin reuptake inhibitors were recruited. Thirty patients (16 women) with a mean (SD) age of 47.2 (12.0) years were randomly allocated to 2 groups. For the active group we administered 2-mA stimulation 20 minutes for each session, with 30 seconds ramp-up from 0 and 30 seconds ramp-down. For the sham group we administered 30 seconds ramp-up to 2 mA, 10 seconds stimulation, 30 seconds ramp-down, and 20 minutes no current. The anode was fixed on the center of F3, and the cathode on F4, over the dorsolateral prefrontal cortex. We assessed the Hamilton Depression Rating Scale at the baseline (mean difference = 1.0, P = .630), at the last session of tDCS, and at 1-month postintervention. There were statistically significant differences in the mean Hamilton scores after the intervention, and 1 month later in favor of active group; P < .001, and P = .003, respectively. Mixed analysis of variance showed a significant difference in the mean scores for active group P = .010 and pattern of change during the study P < .001 in favor of active intervention. We concluded that tDCS is an efficient therapy for patients with resistant major depression, and the benefits would remain at least for 1 month.

A concise rehabilitation protocol for sub-acute and chronic non-specific neck pain.

There is increasing evidence in support of multidisciplinary approaches for management of chronic neck pain. Although presence of different team members is one of the strengths of these approaches, it can limit the access to these treatments. The main objective of this study is designing and investigating the efficacy of a concise rehabilitation program. Thirty-nine patients with sub-acute and chronic non-specific neck pain underwent an 8-week rehabilitation program. Baseline and 8 weeks' follow-up data regarding neck pain (visual analog scale, neck disability index and quality of life) were compared using paired T test. After eight weeks of study, pain and disability significantly decreased: -3.8 of 10 (95% CI: -4.6 to -3.0) (p-value < 0.001) for pain and -18.4 of 100 (95% CI: -23.7 to -13.2) (p-value < 0.001) for disability. Also, all SF-36 domain scales improved significantly. By using this concise rehabilitation approach, pain, disability, and quality of life improved significantly in patients with sub-acute and chronic non-specific neck pain.

Serological Evaluation of Celiac Disease in Children with Congenital Heart Defect; A Case Control Study.

BACKGROUND Due to the increased prevalence of celiac disease in chromosomal anomalies and other congenital anomalies, this study was conducted to evaluate the seroprevalence of celiac disease (CD) in patients with congenital heart defects (CHD). METHODS This case-control study was done on 1002 children in two groups of CHD patients (n=402) and controls (n=600). The serum tissue transglutamianse (TTG) levels were investigated. The two groups were compared in terms of TTG IgA levels and p<0.05 was considered as the significant level. RESULTS The means of serum TTG IgA levels in children with CHD and the control groups were 19.17±46.67 and 7.77±10.02 u/mL respectively (p=0.001). After ANOVA analysis a significant difference between two cyanotic and acyanotic subgroups of cases and control groups was observed (p=0.000). The follow up tukey test showed only non-significant difference between the cyanotic and acyanotic cases. The frequency of TTG IgA with the consideration of 20 u/mL as cut-off point showed a significant association with groups (X2=28.31 and p=0.000). CONCLUSION According to the results the serum TTG IgA levels were significantly higher in patients with CHD than normal children and screening for CD in children with CHD is recommended.

Serologic evaluation of celiac disease in patients with beta thalassemia major and control.

AIM: This study reports evaluated prevalence of CD in patients with Beta-thalassemia major. BACKGROUND: Celiac Disease (CD) is an autoimmune disorder triggered by ingestion of gluten in genetically predisposed individuals. PATIENTS AND METHODS: In this case-control study in a period of 3 years, which was performed on 620 children in two groups of Beta-thalassemia major patients (n=200) and control (n=420), serum tissue transglutamianse (tTG) IgA levels were measured. The two groups were compared together in terms of tTG IgA levels, and p<0.05 was considered significant. RESULTS: The means of serum tTG IgA levels in patients with Beta-thalassemia major and control groups were 28.81±68.44 and 6.94±6.68 U/mL, respectively. There was a significant difference in favor of the case group (p=0.000). Body mass index in the two case and control groups had a significant difference (t=3.859, p=0.001). Belonging to each group will change the probability of having less than 20 in tTG IgA (odds=0.285) and it means that belonging to the control group has a protective role. There is only a significant association in the case of all population (r=0.102, p=0.011). Body mass index in the two case and control groups had a significant difference (t=3.859, p=0.001). CONCLUSION: Probability of CD should be considered since the prevalence of CD is high in patients with and Beta-thalassemia major. Patients with thalassemia major are recommended for screening for CD.

Validation of the Persian version of the fear avoidance belief questionnaire in patients with low back pain.

OBJECTIVES: Fear of pain or re-injury and avoidance attitudes have a great impact on maintenance of chronic low back pain (CLBP) and disability. Fear-Avoidance Beliefs Questionnaire (FABQ) is developed to assess these psychosocial factors. The aim of this study was to provide a translated and validated version of the FABQ for Persian speaking population. METHODS: Forward and backward translation techniques were carried out for translation and cultural adaptation of the questionnaire into Persian. Internal consistency and test-retest reliability were used to assess the reliability of the Persian questionnaire. Construct validity of the scale was assessed by divergent validity (using Spearman correlation coefficient) and exploratory factor analysis. Principle component analysis with varimax rotation method was applied for assessment of factor analysis. RESULTS: The test-retest reliability was excellent with the Intra-class Correlation (ICC) value of 0.802 and 0.808 for the physical activity and work subscales of the questionnaire, respectively. The Chronbach's alpha coefficient value of 0.89, demonstrated adequate internal consistency of the questionnaire. Factor analysis revealed two factors which could explain 57.9% of the total variance. Items 7, 10 and 11 of the questionnaire were used in both major factors of the final Persian version. Regarding the divergent validity of the questionnaire, data demonstrated no correlation (r< 0.3) between factor 2 (which is about physical activity) and measured clinical variables (pain intensity and level of dysfunction), while factor 1 (which is about work) was fairly correlated with both pain intensity and disability level of the subjects. CONCLUSION: The provided Persian version of FABQ is a reliable and valid measurement and further research into its use as a diagnostic and prognostic tool is warranted. Development of this questionnaire will be useful for comparability between Persian and English language studies and facilitates an international collaboration in this field.

The rate of addiction in parents of toddlers with congenital heart disease.

BACKGROUND: Opium abuse is one of the widespread social problems, and one of the most worrying aspects of it is the effect of parents' drug abuse on the fetus. OBJECTIVES: The present study has investigated the correlation between opium abuse during pregnancy in mothers with congenital heart defects in their children. MATERIALS AND METHODS: From early 2009 to late 2011, for two consecutive years in specialized pediatric center of Zahedan Medical University, 225 of children suffering from congenital heart defects were examined and compared with 480 healthy ones for mother opium dependency. The final data were analyzed by student t-test and χ(2) in SPSS software and the two groups were compared in terms of their parents' addiction to opium. RESULTS: From 225 children under study 23.5% had addicted parents based on the variables of the study but the rate was only 2.3 for the control group. The difference between these two groups was significant and the most common form of heart disease was congenital ventricular septal defect. CONCLUSIONS: Opium has teratogenic effect on cardiovascular system.

A study of serum levels of leptin, ghrelin and tumour necrosis factor-alpha in child patients with cyanotic and acyanotic, congenital heart disease.

OBJECTIVE: To investigate the serum levels of leptin, ghrelin and tumour necrosis factor-alpha in children with cyanotic and acyanotic congenital heart disease. METHODS: The prospective cohort study, was conducted at imam Ali Hospital, Zahedan University of Medical Sciences, Iran, in 2009-10 and comprised 64 subjects, including patients and controls. Using enzyme-linked immunosorpent assay kits, serum levels of ghrelin, leptin and tumour necrosis factor-alpha were measured and compared among patients (both cyanotic and acyanotic) and the controls, SPSS version 20 was used for statistical analysis. RESULTS: Of the 64 subjects, 24 (37.5%) were cyanotic, 21 (32.8%) were acynotic and 19 (29.68%) were healthy controls. The three groups were homogenous in terms of age and gender characteristics. There was no significant difference among the groups leptin, ghrelin and tumour necrosis factor-alpha serum levels (p > 0.05). There were also no significant differences in terms of weight, height and body mass index (P > 0.05). CONCLUSION: Serum levels of ghrelin, leptin and tumour necrosis factor-alpha did not change in acyanotic and cyanotic patients with congenital heart disease, suggesting that other crucial factors may regulate individuals' nutrient intake, growth, weight and energy intake and output.