فهرست مطالب shakeri j

Having depression is common in patients with headache, but research on this issue in Iran is limited. Investigating depression and Primary headache symptoms comorbidity Study of depression and headache comorbidity and some influential factors such as age, gender and type of headache is the goal of this case-observation study. 131client patients of nerves and mental clinic of Kermanshah Farabi Hospital, and 131 people as a control group were selected among general population of Kermanshah city randomly. Data were collected by clinical interview and based on criteria of International Headache Society (IHS) and with Beck Depression Inventory. We found comorbidity of depression and headache in 58.8% of cases, with the average depression score larger than that in the control group (p<0.001). 3.8 times of depression raises the risk of primary headaches. The relationship between depression and headaches in all age groups except the 45-64 year age group was significant (p<0.05). Data analysis indicated a correlation between depression and headaches

Ulcerative colitis is an inflammatory chronic disease which is believed to be a multi organ condition. The prevalence of ulcerative colitis is reportedly increasing in Iran presenting with the same clinical characteristics as in developing countries. Pulmonary manifestations of ulcerative colitis are increasingly reported. In this study, we investigated the incidence of bronchial hyper-responsiveness (BHR) in ulcerative colitis (UC) patients. Fifty-one UC patients with definite diagnosis referred to Shariati Hospital, Tehran, Iran, were selected to be evaluated with methacholine challenge test from October 2010 to October 2011. Patients were compared for their methacholine test outcome and its association with age, sex, diagnosis time, and disease activity. The median age was 41 (range 15 to 65) years. The median time of diagnosis was 7 (range <1 to 16) years. Forty-five percent were females, 18% had active disease and 13% had comorbidity. Nine percent of patients with UC had abnormal PFT in our study. Three cases (5%) had bronchial hyper-responsiveness that was not correlated with sex, age, time of diagnosis, or disease activity. A small number of ulcerative colitis patients in our study had disturbed pulmonary function test which is in concord with the findings of other studies. However, higher rates of bronchial hyper-responsiveness have been reported in other studies. Confounding factors like cigarette smoking and medications, which were negative or minimal in our study, may influence the results.

Using peak expiratory flow (PEF) as an alternative to spirometry parameters (FEV1 and FVC), for detection of airway reversibility in diseases with airflow limitation is challenging. We developed logistic regression (LR) model to discriminate bronchodilator responsiveness (BDR) and then compared the results of models with a performance of >18%, >20%, and >22% increase in ΔPEF% (PEF change relative to baseline), as a predictor for bronchodilator responsiveness (BDR). PEF measurements of pre-bronchodilator, post-bronchodilator and ΔPEF% of 90 patients with asthma (44) and chronic obstructive pulmonary disease (46) were used as inputs of model and the output was presence or absence of the BDR. Although ΔPEF% was a poor discriminator, LR model could improve the accuracy of BDR. Sensitivity, specificity, positive predictive value, and negative predictive value of LR were 68.89%, 67.27%, 71.43%, and 78.72%, respectively. The LR is a reliable method that can be used clinically to predict BDR based on PEF measurements.

CD4 count is the most important indicator of the degree of immune deficiency in HIV-positive patients. The goal of this research was to study the relationship between CD4 count and psychological disorders in these patients.

In this cross-sectional study, subjects were studied from June 2004 for one year in Sina hospital in Kermanshah. HIV infection was confirmed with positive double ELISA and Western Blot, CD4 counts by flow-cytometery. SCL-90-R questionnaire was used for selection of patients. In the second stage diagnostic symptom checklist based on DSM-IV criteria was used for patients with unconfirmed diagnosis of psychological disorders. All data were then analyzed.

From 59 studied patients, 58 patients were males all being addicts with prison records. Mean age of patients was 34.26±7.4, (range 23 to 50), years. Mean CD4 count was 312±216 per micro liter. The incidence of psychological disorders was 62.7% multiple disorders 22%, mood disorder %22, anxiety disorder %8.5, psychotic disorder 5.1%, cognitive disorder 3.4%, and personality disorder 1.7%. The least CD4 count was found in single cognitive disorder (129cells/ul). There was a significant statistical relationship between cognitive disorder, (apart from it combination with other disorders), and CD4 count of lower than 200 per micro liter (p=0.021) and CD4 percent lower than 15 (p=0.032). Also, relation between single anxiety disorder and CD4 count of lower than 200 per micro liter was significant, (p=0.033). In addition, there was a significant relationship between pneumonia syndrome and mood disorder (p=0.009), and between soft tissue infection and psychotic disorder (p=0.017). Prison settlement of over 60 months was related to anxiety disorder (p=0.045).

In this research psychiatric disorder incidence was higher than other studies that could be due to the high rate of addiction and imprisonment. Relation between CD4 count with cognitive and anxiety disorders indicated that with the progression of HIV infection, there is an increase in the occurrence psychological disorders with social problems having additional adverse effects on the psychological status.