Razavi International Journal of Medicine
Volume:8 Issue: 1, Autumn 2020

Coronary no-reflow phenomenon (CNRP) is one of the leading catastrophic consequences of percutaneous coronary intervention (PCI). Although several preventive strategies have been advised, yet CNRP is not entirely controlled with pharmacological agents after diagnosis. This study is a review of therapeutic pharmacological agents used in various studies for post-PCI-CNRP. Several pharmacological agents have been introduced for reducing the burden of adverse outcome, before or during PCI. Although most of these agents have shown a remarkable effect on post-PCI CNRP incidence reduction, and it seems more powerful are still needed for a better validation of the results. It appears that intra lesion and distal intracoronary administrations would have a less systemic effect, and therefore may be safer than catheter injection. Moreover, adenosine, sodium nitroprusside, and calcium channel blockers are among the most routinely used methods. However, we believe that the best approach in treating or preventing no-reflow post-STMI might be combinational therapy. By the way, although there have been numerous studies on different agents capable of lessening the noreflow phenomenon, yet there is no exact guideline for choosing the most appropriate drug. A systematic review and meta-analysis on all available or practiced combinational pharmacotherapies to prevent PCI-related no-reflow are needed to suggest the most appropriate therapy.

Considering the prevalence of this disease and the high mortality rate of gastric cancer in the country, it is necessary to investigate the causes and factors affecting this disease's incidence. This study aimed to analyze the structural equations of biological stress indices in patients with gastrointestinal cancer based on perceived stress mediated by rumination. This research was a descriptive-correlational study of structural equation modeling. The statistical population of this study included all patients with gastrointestinal cancer referred to Reza-Mashhad hospital and Avicenna Hospital in Tehran in 2020, of which 250 patients were selected by convenience sampling method. Data were collected using the perceived stress scale (PSS), Nolen and Hoxma rumination questionnaire, and biological stress indices. Data were analyzed using structural equation modeling and Pearson correlation statistical methods using SPSS.22 and AMOS.22 software. The results showed that perceived stress (β=0.45, P0>0.001) directly affected rumination. Also, rumination (β=0.30, P=0.001) had a direct effect on biological stress indices. Rumination played a mediating role in the relationship between perceived stress and biological stress indices (RMSEA: 0.001; AGFI: 0.93). Considering that perceived stress and rumination are effective on biological stress of gastrointestinal patients, it is necessary for therapists to pay attention to modifying beliefs related to stress and rumination in the psychological health of gastrointestinal patients in order to improve the quality of life of patients.

Implantation of prosthetic valve requires a life time consumption of anticoagulation. Thrombotic and embolism complications as well as bleeding associated with anticoagulants are the leading cause of mortality and morbidity after heart valve surgery. Accordingly, this study is designed to explore and report the complications and factors related to usage of warfarin and constant check of prothrombin time and international normalized ratio.

This is an observational study in which the medical records of 100 patients with an average age of 47.9 ± 13.4 years undergoing surgery for replacement of heart valves were studied. All factors related to mortality and postoperative complications were extracted, and the patients were followed up for one year.

The results suggested that tricuspid valve insufficiency was significantly correlated other valvular defects. Nine patients died; one patient in the operating room, one patient in the ICU, one patient in the ward and six patients during the first year died after the surgery. Two of the patients needed redo-surgery in the first year. It should be noted that among patients receiving warfarin on a regular basis (n=81), no mortality was reported in a one-year fallow-up.

In this study, out- of-hospital mortality only occurred in patients' irregular usage of warfarin and without follow-up coagulation tests. So, we conclude that in developing country, if we cannot follow and train the patients constantly for warfarin usage and blood tests, mechanical valve utilization would be concomitant with high risk complications.

This study aims to investigate the role of coronary artery bypass graft (CABG) surgery by off-pump and on-pump methods in the severity of postoperative inflammation based on serum levels of interleukin 6 (IL6) and interleukin 17 (IL17). This is a cross-sectional study in which 39 patients’ candidate for CABG were evaluated in terms of serum levels of IL17 and IL6 before and after surgery in two groups of off-pump and on-pump CABG. Thirty-nine patients with an average age of 63±8.9 in the on-pump group and 59±7.74 in the off-pump group were evaluated. There was no significant difference between the two groups in terms of baseline information and underlying diseases. IL6 serum level (p=0.249) was not significantly difference between the two groups. However, IL17 serum level (p=0.012) demonstrated a significant difference between the two groups. In general, the results of this study showed that increased IL6 serum level following coronary artery bypass was not different between the two methods of CABG surgery. Besides, IL17 exhibited a significant difference between the two groupsi that it was reduced in on-pump group in after surgery. It can be due to special condition’s patients or low sample size of study. Moreover, the postoperative complications were not significantly different between the two groups. This valuable outcome contradicts the popular belief that the use of the CARDIO PULMONARY BYPASS (CPB) system stimulates the immune system and hence its application should be limited.

Health in families is rooted in sustenance and health of relationships between husbands and wives; and marital relationship is the core of families, disorders of which are threats to family survival. The present study was aimed to examine the effectiveness of CBT on sexual self-esteem and marital commitment of couples' with troubled relationships in Tehran in 2017. It was semi-experimental with a pre-test, post-test design as well as an experiment and a control group. The statistical population of the present research consisted of all couples with troubled relationships in Tehran, who were selected using a convenience sampling method and Cohen table for the sample size , and they were randomly divided into two groups: an experiment group (15 individuals) and a control group (15 individuals).The experiment group received ten 90-minute sessions of group CBT interventions, and the control group remained on a waitlist. The measurement tools of the research included Dobel Naha and Schwarz's sexual self-esteem questionnaire and Adams and Jones' marital commitment questionnaire. The analysis of the data obtained from implementing the questionnaires was done through SPSS-V22 software in two sections: descriptive and inferential . Results showed that CBT leads to an increase in sexual self-esteem in couples with troubled relationships. Therefore, it can be stated that group CBT is an effective method for improving self-esteem and marital commitment in couples. It can be stated that CBT helps family members to face problems effectively by resolving conflicts among family members and improving interpersonal relationships

Family cohesion affects health, mental and physical well-being, academic achievement, and emotional health of the family with disturbance of family environment and feelings of depression, aggressive behaviors and delinquency, and disruption of family members' self-concept. This study aimed to investigate the effectiveness of psychological education based on Olson's model on family cohesion of schizophrenic patients in Bushehr. The research method was semi-experimental with a pretest-posttest and follow-up design. The statistical population consisted of 425 patients in all families of schizophrenic patients who were treated in the province's medical centers (both governmental and non-governmental) in Bushehr in 2019. The sample size in this study will be 30 parents of schizophrenic patients. All of them had inclusion criteria and were selected by convenience sampling method and randomly assigned to the experimental and control group. Data obtained by Faces-III Scale (Olson et al., 1983)and analyzed using multivariate analysis of covariance and post-test by Spss.22. The results showed that psychological training based on the Olson model effectively improved family cohesion of schizophrenic patients (p <0.001). Providing psychological services is necessary to promote and cohere the families of schizophrenic patients, so it can be said that psychological training based on family cohesion and flexibility can be used to promote and cohere the families of schizophrenic patients and provide the ground for their psychological care.

Bereavement is a person's response to loss that has a physical, psychological, or social aspect. This study aimed to determine the effect of distress tolerance and emotional self-regulation on complicated grief with the mediating role of social support. The research method was descriptive and the research design was a structural equation modeling. The statistical population consisted of all survivors of the Kermanshah earthquake who are suffering from complicated grief in 2019 and are selected by convenience sampling method. Data obtained by Grief Experience Questionnaire (GEQ), Social Support Scale (MOS-SSS), Emotional self-regulation questionnaire and Distress Tolerance Questionnaire. Data were analyzed by the Pearson correlation coefficient and structural equation modeling using SPSS.22 and PLS2-SMART software. The results of this study showed that the relationship between the variables of the study was significant, and distress tolerance, self-regulation, and social support have the ability to predict complicated grief (p <0.001). Also, social support has the mediating variable between distress tolerance and emotional self-regulation on complicated grief (p <0.001). According to the results of this study, earthquake survivors should be able to control the tolerance of grief after the earthquake by increasing their distress tolerance and emotional self-regulation and with social support from others.