Archives of Iranian Medicine
Volume:25 Issue: 5, May 2022

Disruptions in sleep related to mealtime may contribute to gut microbial imbalances, and put individuals at higher risk for metabolic diseases. The aim of this pilot study was to investigate the relationships between late-night eating habits and sleep quality and duration, with gut microbiota (GM) profiles.

In this cross-sectional study, 36 men referred to a clinic were enrolled. In addition to demographic information, each participant completed questionnaires regarding medical history, physical activity, late-night eating habits, sleep quality and sleep duration. The scores from these questionnaires were used to categorize study participants into the following groups: sleep quality (good or poor), late-night eating (yes or no) and sleep duration (<7 or ≥7 hours). Five grams of stool was also obtained from each participant for GM profiling analysis by sequencing.

The mean age of the study population was 42.1 ± 1.6 years. Firmicutes and Actinobacteria were the two dominant phyla present in all participant samples. Differences in the relative abundance of GM at each taxonomic rank between study groups were insignificant. Only Erysipelotrichales at the order level were found to be significantly different between individuals who had late-night eating habits and those who did not (P & q < 0.05). No other parameter demonstrated a significant difference in GM profiles of participants.

In this pilot study, we found Erysipelotrichales to be more abundant in individuals with late-night eating habits. Studies with higher sample sizes are warranted to better delineate the possible effects of time of eating on microbial composition.

Nowadays, some treatments such as neurofeedback and Vitamin D Supplementation are of great importance in the treatment of attention-deficit/hyperactivity disorder (ADHD). To determine the efficacy of the combined treatment, the present trial was conducted to investigate the effectiveness of each one of them with combined neurofeedback and vitamin D supplementation in the reduction of ADHD symptom in children suffering from this disorder.

In this study from March 2020 to June 2020, we enrolled a total of 120 patients (6-15 years old) who were referred to the Mehr psychiatric hospital (affiliated to Lorestan University of Medical Sciences). Patients were then randomly categorized into three experimental groups and one control group. The first, the second, and the third experimental groups consumed vitamin D pearl, neurofeedback combined with vitamin D, and neurofeedback for 12 weeks, respectively. The control group was given no treatment. Vitamin D serum level was evaluated at baseline, 4, 8, and 12 weeks in all participants. For data collection, the Parent Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) was applied. The obtained information was analyzed using repeated measure variance analysis.

The mean scores were significantly different across the groups. Repeated measure variance analysis showed that the mean score was lower in the combined group in comparison with the other three groups (P<0.05).

Combined treatment could be considered as more effective compared to separate treatments. In addition, in this study, by applying the combined intervention, the duration of treatment decreased significantly.

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).

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.

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.

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.

Breast cancer is now the most significant health issue in women, threatening diverse aspects of human health, including mental health and cognitive function. This research aimed to validate the Persian version of Mindful Attention Awareness Scale (MAAS) in Iranian women with breast cancer.

We gathered data on 229 women with breast cancer in Tehran through convenience sampling. They completed a demographic questionnaire, the Persian version of MAAS, the General Self-Efficacy Scale, and DASS-21. SPSS-22 analyzed the Pearson correlation between the Persian version of MAAS, general self-efficacy, and DASS-21. Also, LISREL 8.8 was used to analyze the internal structure of the MAAS.

Findings from the confirmatory factor analysis (CFA) showed that the model with one factor fits well with the data (sbχ2=4.29 (P=0.36); SRMR=0.058; CFI=1.0; NFI=0.91; IFI=0.95; RFI=0.97; GFI=0.90; RMSEA=0.069). Significant negative correlations were found between MAAS and DASS-21 scores for anxiety (r=-0.51), depression (r=-0.48) and stress (r=-0.49), indicating an acceptable divergent validity. There was also a positive relationship between MAAS and general self-efficacy (r=0.37; P<0.01).

The Persian version of MAAS seems to be a valid scale for evaluating the extent of mindfulness of Iranian women with breast cancer.

Foreign body aspiration from tracheostomy is very rare, and materials related to tracheostomy are usually aspirated. This condition, which can lead to serious complications, can be treated using bronchoscopic procedures. In this study, we aimed to present our clinical experience in foreign body aspiration via tracheostomy.

Data from 26 patients who presented to our hospital for foreign body aspiration via tracheostomy from 2006 to 2020 were analyzed retrospectively.

Foreign bodies were removed by fiber optic bronchoscopy in 15 (57.7%) cases, by rigid bronchoscopy in 9 (34.6%) cases and both methods were used in 2 (7.7%) cases. During bronchoscopy, local anesthetic procedures were used in 13 (50%) cases and general anesthesia was used in 11 (42.3%) cases. No anesthesia was used in two (7.7%) patients who underwent bronchoscopy under intensive care conditions. While the mean operative time for flexible bronchoscopy was 8.77±0.83 (CI: 26.03–29.43) minutes, the mean operative time for rigid bronchoscopy was 27.73±2.53 (CI: 26.03–29.43) minutes.

Both rigid bronchoscopy and fiberoptic bronchoscopy (FOB) have advantages and disadvantages in foreign body removal. In our opinion, it is more reasonable to perform fiber optic bronchoscopy first in patients with a tracheostoma. In the light of our experiences, fiber optic bronchoscopy does not require general anesthesia and the operation time is shorter than rigid bronchoscopy. This feature makes fiber optic bronchoscopy advantageous.

Any surgery has some complications, and septorhinoplasty is not an exception. The aim of this study was to highlight the relationship between satisfaction with nasal appearance and olfactory function in patients undergoing septorhinoplasty.

This is a cohort study. In this study, 384 patients aged 18 to 45 years who referred to the Ear, Nose and Throat department at Rasoul Akram hospital and private clinics in 2019 underwent septorhinoplasty. All patients were tested by the Persian Smell Identification Test (PSIT) or Rapid Smell Test (RST) before surgery. They were also reassessed one and three months after surgery. Those patients with dissatisfaction with olfactory function after surgery were also followed up for three months and assessed by PSIT or RST to determine their olfactory dysfunction.

One month after surgery, 73.5% of patients who were not satisfied with their nasal appearance also complained about the olfactory sense. In addition, 1.5% of patients who were satisfied with their nasal appearance also complained about the olfactory sense. There was a significant difference regarding complaints of the olfactory sense between patients satisfied with their nasal appearance and those not satisfied with their appearance (P<0.05). Three months after surgery, 78.9% patients who were not pleased with their nasal appearance also had an olfactory complaint. Besides, 0.9% of patients who were pleased with their nasal shape also had an olfactory complaint. There was a significant difference regarding olfactory complaints between patients who were pleased with their nasal shape and those who were not (P<0.05).

One and three months after septorhinoplasty, most patients who are satisfied with their nasal appearance have no complaints about their olfactory sense, and most patients who are not satisfied with their nasal appearance complain about the olfactory sense. An appropriate outcome of septorhinoplasty with regard to improving olfactory functional status is accompanied by patients’ satisfaction level of achieving good nasal appearance.

Autologous conditioned serum (ACS) has been effectively used in treatment of osteoarthritis. However, less is known about its efficacy in tendon disorders. In this pilot study, we aimed to evaluate the short- and long-term effects of intratendinous injection of ACS in lateral epicondylitis (LE) of the elbow.

This prospective cohort included 42 patients with LE of the elbow who received 4 intratendinous injections of Orthokine® (Orthogen Lab Services GmbH, Düsseldorf, Germany) under local anesthesia over 2 weeks in an outpatient setting. The clinical and functional outcomes of injections were evaluated at 3 months and 1 year after the procedure. Pain was assessed using a visual analog scale (VAS) and functional assessment was made using the Mayo Elbow Performance Score (MEPS) and Oxford Elbow Score (OES).

The pre-injection VAS score (7.07±1.19) improved significantly after the procedure at both 3 months (3.55±0.56, P<0.001) and 1 year (1.73±0.82, P<0.001). Similarly, the mean MEPSs were significantly different between baseline and 3 months (56.42±7.51 vs. 79.76±3.81, P<0.001) and between baseline and 1 year (56.42±7.51 vs. 94.28±4.06, P<0.001). The baseline OESs (84.17±6.07) also improved with intratendinous injection of ACS at 3 months (41.96±9.23, P<0.001) and 1 year (7.43±4.31, P<0.001). Only six patients (14.2%) had mild ecchymosis and swelling around the injection site which resolved spontaneously.

ACS is a promising option for treatment of LE of the elbow, given its early onset of pain-relieving action and longlasting functional effects. These findings await confirmation by large-scale and prospective trials.

High tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA) are two procedures of choice in moderate medial-sided knee osteoarthritis. In this study, we aimed to compare the outcomes of patients undergoing either unilateral knee arthroplasty or open-wedge HTO both clinically and radiologically.

Clinical records of 105 patients treated surgically with either medial unilateral knee arthroplasty or high tibial osteotomies were reviewed. Fifty-one cases of HTO (group 1) and 54 cases of unicompartmental knee arthroplasty (group 2) were reviewed. Radiographic follow-up data included Kellgren Lawrence index and mechanical alignment measurements using the PACS system. Clinical and functional follow-up data included range of motion degrees and functional assessment scores (Tegner, Lysholm, Knee Society Score and VAS).

Mean time of follow-up was 66.10±8.14 months and 65.27±6.95 months for groups 1 and 2, respectively. The HTO group had better radiographic improvement and greater range of motion than the unicompartmental knee arthroplasty group. Despite a significant difference in Lysholm Knee Score and a slight difference in VAS score in favor of HTO, both groups were similar with regard to functional outcomes.

Both techniques are satisfactory in terms of functional outcomes about five years after the operation and may be considered in cases of middle-aged medial-sided gonarthrosis (<65 years of age) who do not have additional ligament or compartmental pathology.

One in eight adults in Iran is estimated to have major depressive disorder (MDD) – a leading cause of disability in the country. Many remain undiagnosed, and some receive only partial treatment. An estimated 60% of those with MDD were reported to have received no treatment during the past year. In this paper, we have critically reviewed the current health-care structure in the country along with prevailing patterns of health-care service utilization. We have addressed the role of psychiatrists, general practitioners (GPs), psychologists, and other health-care personnel in the treatment and care of patients with MDD, with an emphasis on the quality of service provision. In addition, the strengths and weaknesses of primary healthcare (PHC), the health insurance system, and inpatient care have been discussed. We have paid attention to the contextual issues such as mental health literacy, stigma, and healthcare inequity where relevant. Finally, practical recommendations have been provided to improve the quality of care for patients with MDD in Iran.

In this study, we describe a new missense variant on the β-globin gene in a heterozygous form in a female individual. Standard methods were used to determine red blood cell indices and perform hemoglobin analyses. Molecular studies were performed on the genomic DNA isolated from peripheral blood cells. Beta-globin genes were amplified and sequenced. We report a novel mutation on the β-globin gene (HBB), c.134 C>T; p.S44F variant, in the heterozygote state which was detected in a female of Persian ethnic origin in the Khuzestan province, southern Iran, that we named Hb Narges Lab (HbNL) variant. This mutation was predicted to be disease-causing in all except one in silico prediction tools. This variant was reported for the first time worldwide, had no shown hematological abnormalities but should be considered when inherited in the compound heterozygous form with β- thalassemia (β0-thal) carrier, which might result in the phenotype of thalassemia intermedia.