Journal of Analytical Research in Clinical Medicine
Volume:4 Issue: 4, Autumn 2016

One of the most important duties of a family physician is to provide primary health care. This is completely considered in the Family Physician Program for a target population. The aim of this study was to systematically review the Family Physician and Referral System strength and weakness in rural area of Iran.
In this systematic review, Scientific Information Database (SID), Science Direct, and PubMed databases were searched and Google search engine was employed using key words such as family medicine, family physician, and referral system for the period of January 2005 to June 2013, both in English and Persian. For identifying duplicated references, Endnote Software was used and for summarizing results of fully assessed articles extraction table was employed.
Strengths and weaknesses of Family Physician Program and referral system in rural areas of Iran were extracted from 28 studies. In total, 115 weaknesses (3.96 per study) and 103 strengths (3.55 per study) were obtained. Content analysis was used and 218 items were summarized into 29 items. Strengths of Family Physician Program were: access of villagers to health services, filling health document for clients, improving services for pregnant mothers, and family planning; while its obvious weaknesses included repeated unnecessary referral of clients as well as lack of providing job stability.
Results of studies conducted in Iran showed that Family Physician and Referral System in rural area of Iran could not be successful enough and has many shortcomings. Therefore, a growing body of effective changes must be made for a better performance and to obtain better outcomes.

The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on positive reappraisal in patients suffering from obsessive compulsive disorder (OCD).
The research design was quasi-experimental of pre-test and post-test type with control group. The statistical population of present study involved all patients referring to psychiatry clinics of Tabriz University of Medical Sciences who received obsessive-compulsive disorders diagnosis. Thirty available patients were selected that filled cognitive emotion regulation questionnaire (CERQ) after being randomly assigned to experimental and control groups. The experimental group attended 8 sessions of MBCT. The cognitive emotional regulation questioner was administered after completion of the sessions and data of both states (before and after sessions) were collected and analyzed using covariance analysis test.
The MBCT was effective in increasing positive strategies (positive reappraisal, positive refocusing, planning, putting into perspective) and decreasing negative strategies (self-blame, blaming others, catastrophizing, rumination, and acceptance) in patients with obsessive-compulsive disorder (P This study indicated that it is possible to increase positive strategies of emotion regulation through training MBCT.

Abdominal penetrating trauma is still a serious problem in the world, due to its high prevalence in young people that impose a heavy economic burden on our country, we decided to evaluate the epidemiologic and demographic status and patients prognosis.
This is a descriptive cross-sectional study; all patients with abdominal penetrating trauma referred to the emergency department of Imam Reza Hospital between March 2012 and March 2014 were enrolled to study. Age, sex, injured organs, mechanism of trauma and the prognosis was documented in the checklist. Data was analyzed by SPSS 15.0, and descriptive analysis was run.
In this study, 137 patients were enrolled; 103 patients (75.20%) did not have visceral damage. In visceral injury, the spleen was most commonly injured abdominal organs (8.03%). the damage to small intestine seen in 8 patients (5.84%), kidney and liver damage seen in 6 patients (4.38%) and 5 patients, respectively, and finally diaphragm and colon injury was seen in 2 patients (1.46%).
According to a recent study, abdominal penetrating trauma mostly occurred in men. The most common cause of abdominal penetrating trauma was related to knife damage; spleen was commonly damaged organ caused by knives and other sharp objects.

This study aimed to examine the role of prenatal stressful events in mothers of children and adolescents with autistic disorder (AD).
This case-control study was conducted in 2014. A total number of 115 children and adolescents with AD were selected by convenience method from the autism rehabilitation centers in Tabriz, Iran. Moreover, 112 typically developing (TD) children and adolescents were selected from public schools using a random clustering method. Two groups were matched in terms of mother's and child's age and mother's educational level. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured diagnostic interview was used to evaluate the presence of psychiatric disorders. The diagnosis of AD was made based on the DSM-IV criteria during separate diagnostic interviews by two child and adolescent psychiatrists. The life stressful events inventory was used to assess the presence of stressful events during pregnancy.
According to Fisher's exact test, the frequency of stressful life events including failure to achieve life goals, high debt, frequent marital conflict, conflict with spouse's family, changes in sleeping habits, and sexual difficulties in the mothers of AD children during pregnancy was significantly higher than the mothers of TD children. Also, mothers of AD children reported significantly higher frequency for the positive stressful life events including the major job progress, starting or finishing education, change of education, location, and summer vacation during pregnancy.
Some stressful life events in mothers during pregnancy may be considered as risk factors for developing AD in their children. Further researches are needed to establish the results of this study.

Job-burnout is a psychological expression for describing the experiment of negative attitude, morale and behavior when people face work-related stressors. It affects the physical, emotional and mental exhaustion, associate with suspicions about individuals competence and the value of their work.
A total number of 40 librarians working in the libraries of Tabriz University of Medical Sciences, Iran, were chosen as the population of study. Two types of questionnaires were distributed among participants. First, the factors affecting the job-burnout; second the Maslach Burnout Inventory (MBI) for measuring the job-burnout scales among librarians.
The study showed that the highest frequencies of job-burnout dimensions among librarians were from the high level of emotional-exhaustion and depersonalization and low level of personal-performance and involvement.
Analysis of data concluded that the university librarians believe, the low level of wages and benefits, the low status of librarians profession in the society, the deficiency of promotion and occupation advancement, and incorrect assessment of the librarian's job performance, has the most influence on the job-burnout among librarians.

Selective serotonin reuptake inhibitors (SSRIs) are among the selected medication to treat depression, panic disorder and many other psychiatric disorders. The most common undesirable effects of SSRIs are sexual dysfunctions that may lead to discontinuation of treatment in some patients. This study was conducted to compare sexual side-effects of two common drugs, citalopram and fluoxetine in male patients.
This cross-sectional study was carried out on 60 male patients referred to the psychiatric clinics of Tabriz University of Medical Sciences, Iran, in 2013. They were candidates for SSRIs treatment and the clinic physicians prescribed citalopram or fluoxetine for them. The patients were examined in two groups after taking written informed consent and initial completion of the International Index of Erectile Function (IIEF) questionnaire and no history of sexual dysfunction, considering the inclusion and exclusion criteria. Both citalopram and fluoxetine groups completed IIEF questionnaire again at the end of the first and second months after treatment and statistical analysis was done using SPSS.
Sexual dysfunction was observed in both groups in the all sexual function indices and its components. Although there was no significant difference in terms of sexual function components between the two groups, general sexual dysfunction was significantly higher in the fluoxetine group. In both groups, age was inversely related to the general sexual function index.
Unlike many other studies suggesting no difference on SSRI sexual side-effects, the present study showed a reduction in sexual function of men taking citalopram and fluoxetine and the reduction was more prominent with fluoxetine.

Trauma is the first cause of death in the young population and imposes large costs on the health system. Due to high rates of trauma and its associated mortality in developing countries, it seems to be necessary to study epidemiological and demographic characteristics of the damage caused by blunt abdominal trauma and common organs involved and the prognosis.
All patients with blunt trauma of the abdomen who referred to Imam Reza Hospital, Tabriz, Iran, from March 2012 up to March 2014 were enrolled, the data were collected by a questionnaire for each patient separately; then all data was analyzed by SPSS.
From March 2012 to March 2014, 332 patients with blunt abdominal trauma came to the emergency department, mean age was 34.15 ± 1.6 years and 63.9% of them were men. In 290 cases (83.3%) there was not any damage to any organ. The most common injured organs were spleen and liver, equally 10 cases (3.0%). Kidney (2.4%) bladder (1.8%) and intestine (1.2%) were also involved. In this study, the most common cause of blunt abdominal trauma was a car crash.
According to this study, men consisted 63.9% cases of blunt abdominal trauma and the mean age of patients was 34.15 ± 1.6 years. The most common cause of blunt abdominal trauma was car crash. In this study, 87.3% cases did not have any intra-abdominal organ damage. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved with equal incidence. About 79.5% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

Solitary neurofibroma is a benign tumor originating from Schwann cells in peripheral nerves. In an investigation of 430000 pathologic samples, only 6 cases of neurofibroma had been reported in nose and paranasal sinuses. Present patient was a 15-year-old girl with left-sided nasal and malar mass, whose CT scan and MRI showed a non-circumscribed solid mass with total thickness affecting outer part of nose in left side as well as surface and deep soft tissue. The mentioned mass underwent excision by sub-labial incision and open rhinoplasty keeping infra-orbit nerve intact. Pathologic investigation of samples showed adipose fibroblast and skeletal muscle fibers with proliferation of spindle-shaped cells and staining was negative for GFAP and positive for S-100 which represents diagnosis of neurofibroma. Main differential diagnoses of benign tumors of paranasal sinuses and nasal cavity include neurofibroma, fibroma, leiomyomas, papilloma, and schwannoma. After resection tumor should be precisely monitored, since there is malignant transformation possibility in solitary neurofibromas.