مجله دانشکده پزشکی اصفهان
پیاپی 639 (هفته سوم آبان 1400)

Alexithymia and lack of understanding and expression of emotions are very common in patients with epileptic seizures. Psychiatric non-epileptic seizures are among the disorders that have epilepsy-like symptoms, and are often confused with epilepsy. The aim of this research was to study the effectiveness of partner-assisted emotional disclosure therapy on alexithymia in patients with psychogenic non-epileptic seizures (PNES).

In this research, a single case experimental design with multiple asynchronous baseline was used. The research population was all patients with non-epileptic psychiatric seizures who referred to psychology and neurology clinics in Ahvaz City, Iran, in 2018. The effectiveness of 6 sessions of partner-assisted emotional disclosure therapy on alexithymia was evaluated at three stages of baseline, posttest, and follow-up. Three patients were purposefully selected based on inclusion and exclusion criteria. Data gathering tool was Toronto Alexithymia Scale (TAS). For data analysis, the Reliable Change Index (RCI), clinical significances and visual inspection were used.

The RCI for the alexithymia variable in the first to third patients was 4.46, 2.72, and 4.83, respectively. According to RCI > 1.96, the reliable change index was significant. Moreover, the recovery rates for the first to third patient were 50%, 29%, and 52%, respectively, which indicated the success of treatment in the first and third patients, and relative success in the second patient.

The partner-assisted emotional disclosure therapy is effective in reducing alexithymia in patients with non-epileptic seizures.

This study aimed to assess the trends in management and in-hospital mortality of patients admitted with cardiogenic shock complicating ST-segment elevation myocardial infarction (STEMI-CS) between 2009 and 2018, and its association with new therapeutic modalities.

In this retrospective study, all patients with STEMI-CS from 2009 to 2018 in Shahid Madani Heart Center in northwest of Iran were enrolled (n = 410). Patients were classified into two five-year periods based on the year of admission, 162 patients in the first period (2009-2013) and 248 patients in the second period (2014-2018) were included in this study. Demographic data, risk factors, clinical symptoms, treatment strategies, and in-hospital mortality were compared between the two periods.

Therapeutic approaches including thrombolysis, percutaneous coronary intervention (PTI), coronary artery bypass grafting (CABG), and intra-aortic balloon pump were similar between two periods, and the only significant difference in treatment was the higher rate of using glycoprotein IIb/IIIa inhibitor in the second period (20.2% vs. 43.9%, respectively; P = 0.001). However, higher in-hospital mortality rate was found in 2009-2013 period compared to 2014-2018 period (80.8% vs. 69.7%, respectively; P = 0.010). Multivariate regression analysis showed that only coronary revascularization, either percutaneous or CABG, were independently associated with a lower mortality risk (Odds ratio of 0.26 and 0.21, respectively; P < 0.001 for both).

The results of this study showed that the therapeutic approaches in patients with STEMI-CS did not improve significantly over one decade, and most patients did not undergo coronary revascularization.

Measuring body temperature is one of the most important and oldest diagnostic methods in the diseases. According to several studies in domestic and foreign databases, there are different results about tympanic temperature of the right and left ears. Therefore, the present study was designed to measure the temperature of the right and left ears by tympanic method, during and after fever, and compare it with rectal temperature in children with fever.

The present cross-sectional study was performed on 140 children aged 3 months to 5 years admitted to the pediatric ward of Allameh Behlool hospital in Gonabadi City, Iran, who were eligible for inclusion in the study. Samples were selected using convenience sampling method. Data collection tools were demographic questionnaire, temperature registration form, tympanic thermometer and rectal thermometer. Participant's temperature was measured consecutively with tympanic thermometer from both right and left ears, and compared with the temperature taken with a rectal mercury thermometer.

There was a difference between the temperature of the right ear and the left ear with each other and also with the rectal temperature. The temperature of the left ear was lower than the right ear and was closer to rectal temperature.

According to the results of the present study, the temperature of the left ear is closer to the rectal temperature; measuring of the left tympanic temperature is recommended for children.