Journal of Iranian Medical Council
Volume:5 Issue: 3, Summer 2022

The analysis of complaints against health professionals assists in improving health care services. The objective of this study was to evaluate complaints against dentists working in Mashhad, Iran during 2012-2017.

In this study, all the available completed dental complaint cases from the archive of the Mashhad Medical Council addressed within a six-year time period (from 2012 through 2017) were reviewed. The required information was extracted based on a checklist including variables such as the gender of dentists and complainants, the age of dentists and complainants, dentists’ degree, the place of service provision, the type of services provided, the causes of complaints, and the sentences issued to dentists (conviction or non-conviction).

A total of 208 cases were evaluated, and in 67 (32.2%) cases, dentists had been found guilty. Most cases involving convicted dentists were associated with male dentists, female complainants, general dentists, and in-office services. In the cases of convicted dentists, the most common service provided was endodontic treatment and the most common cause of complaint was failed or incomplete treatment.

To reduce the growing number of complaints against dentists, their skills should be improved, especially in endodontic treatment services. It is advisable for general dentists to consider referring patients to specialists either for more skilled treatments or to allow their patients’ expectations to be better met.

For many people who work in the nursing profession, a large part of their work involves emotional (psychological) and physical stress. The work environment of psychiatric hospitals imposes a high level of stress to staff due to dealing with patients with psychiatric disorders. Moreover, there is a negative attitude in the society towards patients with mental disorders and mental hospitals. Therefore, it is possible that psychiatric hospital nurses suffer more problems. In this study, workload and burnout have been investigated as two important factors affecting health among nurses working in a psychiatric hospital. 

In this cross-sectional study, a total sample of 82 nurses working in Iran psychiatric hospital was included and participated in the survey. Demographic information questionnaire, Maslach burnout questionnaire and NASA-TLX index were used for data collection.

The depersonalization subscale had the highest score in the burnout variable and the mental stress subscale had the highest score in the workload variable. The results of this study showed that there is a significant and positive relationship between workload and emotional fatigue as well as workload and depersonalization and also no correlation was found between workload and individual performance. 

This study shows that workload, emotional fatigue and depersonalization have positive correlation. In addition, the mental stress subscale had the highest score in the workload variable. Further attention to workload and burnout of the nurses in psychiatric hospitals is suggested and future large and multi-center studies on the topic are necessary.

To find different variables involved in the hospitalization of patients referred to the respiratory Emergency Room (ER) at the time of COVID-19 pandemic.

A questionnaire was designed to determine different hypothetical factors involved in the hospitalization of 3481 patients during the COVID-19 pandemic.

This study suggests that the following factors/variables are involved in the hospitalization of patients: age, respiratory distress, duration of symptoms, cough, 5-day-prolonged fever, diabetes mellitus, respiratory diseases, renal conditions, history of chemotherapy, saturation of blood oxygen, sore throat, and fever.

We found that through having an insight towards what may and may not be involved in the severity of the novel coronavirus infection, one might be able to decide if a patient could potentially benefit from hospitalization.

Head injury is a silent epidemic in developed countries and is one of the leading causes of death and disability. Determining the precise and early prognosis of head injury, especially in severe cases, is essential and will help define treatment actions and rehabilitation plans and counsel other family members. The purpose of this study was to determine the relationship between electroencephalographic findings and prognosis in patients with decreased levels of consciousness due to head injury.

This is a retrospective descriptive-analytical study on patients with reduced levels of consciousness due to head injury, referred to Tir Hospital (Tehran) in the first half of 2018. Overall, 52 patients were studied and divided according to their GCS into two groups: favorable prognosis (30 patients, 57.7%) and poor prognosis (22 patients, 42.3%). We tried to find the relation between EEG findings such as voltage, electrographic seizures, periodic and rhythmic patterns, and the prognosis.

Normal voltage was associated with a favorable prognosis, with a high specificity (95%) and a less robust sensitivity (63%). The isoelectric voltage (electrocerebral shutdown) was associated with a poor prognosis. Normal and isoelectric voltages were good predictors with 95% and 100% Positive Predictive Values (PPV), respectively. There was a statistically significant relationship between EEG frequency range and prognosis.  

This study showed that EEG parameters might provide valuable data regarding the prognosis of decreased consciousness of patients with a head injury, also for the guidance of physicians and informing the patients’ family.

This study aimed to evaluate the ABO blood group characteristics in women with Gestational Diabetes Mellitus (GDM).

This cross-sectional research was conducted on pregnant women with GDM in Yas Hospital, Tehran, Iran, from April 2018 to March 2019. 

Totally, 449 pregnant women enrolled in the study. The average age of the participants was 32.26±5.08 years with a range between 18 and 45 years. 46% of the participants were treated with insulin. In this study, 35% were typed as group O, 34.3% as group A, 24.3% as group B, and 6.5% as group AB. The Rh+ blood antigen was present in 92% of the pregnant women. Blood group A (35.7%) was the highest in pregnant women with insulin therapy and the frequency of blood group O was the highest in pregnant women with diet (39.5%) and metformin therapy (35.7%). 

In pregnant women with insulin therapy, the most prevalent blood group was A. This was different from those that are frequent in the Iranian normal population and pregnant women with GDM who underwent diet therapy. It seems that blood group A, as a probable associated factor for GDM, can be beneficial in high-risk pregnancy detection for GDM in the Iranian population.

Severe mental disorders impose a significant burden of illness directly on the patient and their caregivers. In this study, the prevalence of suicidal ideation and the severity of depression in patients who received home care were evaluated in comparison with other patients who experienced usual outpatient care. 

The study design was cross-sectional and the sample was assigned in two groups. Structured scale and inventory were used to evaluate the prevalence of suicidal thoughts and severity of depression among the patients. Beck Depression Inventory and Ideation for Suicide Beck Scale were utilized for this evaluation. The study was conducted from June 2019 to June 2020.

The total number of participants in the study was 71 patients. The results of multivariate analysis showed that the observed difference between the two groups in all components and in the total score of Beck Suicide Scale and Beck Depression Scale was statistically significant. Regarding Ideation for Suicide Beck Scale, the mean in the home visit group was 0.94 (standard deviation (SD)= 4.24) and in the Treatment as Usual (TAU) group was 3.83(SD =5.44) (p-value=0.016). Regarding Beck Depression Scale, the mean in the home visit group was 6.14(SD= 7.75) and in the TAU group was 11.17(SD= 9.18) (p-value=0.015).

It seems that home care for patients with severe mental disorders may be more effective than outpatient care in reducing suicidal ideation and severe depression. The use of longitudinal and multicenter studies with larger sample sizes can be effective in assessing the impact of home care on improving indicators of suicidal ideation and severity of depression.

The aim of this study was to compare the severity of depression, impulsive behaviors and suicidal ideation in patients with obesity with Low Density Lipoprotein (LDL) below 100 or above 100 mg/dl.

This was a cross-sectional study. The study population included patients with obesity referred to the obesity clinic of Rasool-e-Akram Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. Patients were divided into two groups with LDL below and above 100 mg/dl. The Beck scale for suicidal ideation and Depression and the Barratt   Impulsiveness Scale questionnaires were filled. Finally, the score of questionnaires and demographic variables were compared between the two groups. P-values below 0.05 were considered as statistically significant. 

300 patients entered the study. There was a statistically significant difference regarding the severity of depression betweeen the two groups, as in patients with LDL over 100 mg/dl, depression was more severe (p-value = 0.02). Moreover, there was a statistically significant difference regarding the impulsivity score and its subgroups or the suicidal ideation between the two groups (higher in patients with LDL) above 100 mg/dl, p-values <0.05). 

Elevated serum LDL levels could be associated with psychological factors such as depression or suicidal ideation and motor, cognition and unplanned impulsivity in patients with morbid obesity. This might be justified by an increase in BMI. Further clinical trials are required to assess these findings.

The safety climate, which is a subset of the organizational climate in the field of safety, mirrors the attitudes of those involved in care centers towards safety. In addition to being in connection with diverse parts of the organization’s function, the safety climate can also affect the nurses’ performance. The present study aimed at investigating the predictive role of the safety climate on professional behavior among nurses working in the hospitals affiliated to Bushehr University of Medical Sciences.

In this descriptive-analytical study, which uses the cross-sectional design, 595 expert nurses participated who had at least 6 months of experience and were employed in the wards of the hospitals affiliated to Bushehr University of Medical Sciences. The data was collected from the nurses revolving around their viewpoints, which were determined using a demographic information form, professional behavior scale and safety climate questionnaire. 

Among the diverse domains of the safety climate, the field of nursing education (p= 0.027, ß=0.104), communication with other nurses (p= 0.027, ß=0.101) and error reporting (p= <0.001, ß= 0.191) were the direct predictors of professional nursing behavior. Also, apart from the safety climate, satisfaction with nursing as a job had a direct, statistic and significant relationship with professional behavior (p= <0.001, ß= 0.142). 

This study found that most of the domains of the safety climate predicted the nurses’ professional behavior. Therefore, it is recommended that hospital administration and nursing leaders improve the safety climate by paying more attention to education and creating friendly working environments that remove nurses’ fear of penalties. All these factors can be effective in enhancing the professional behavior of nurses and increase patient safety in health care settings.

This study was designed to compare postoperative complications, mortality and quality of life associated with the type of surgery (subtotal colectomy vs. segmental colectomy) in patients with left colon tumors. Subtotal colectomy and segmental colectomy are the two most common strategies used for treating the left colon’s malignant tumors. However, each patient’s optimal elective surgical treatment for the left colon’s malignant tumors is unclear. Choosing the optimal treatment for each patient, taking into account the individual conditions and preferences of the patients, with the least chance for occurrence of complications and the highest quality of life can help patients to ultimately return to everyday life. 

In this retrospective multi-centric study, patients with left colon tumors who had not received neoadjuvant and have undergone subtotal colectomy or segmental colectomy from 2016 to 2018 were enrolled. Mortality rate, quality of life and postoperative complications such as problems with defecation were assessed as the main outcome measures.

In patients with malignant tumors of left colon, both subtotal colectomy and segmental colectomy surgical methods reached the satisfactory results. In fact, there was no significant difference between the two surgical methods except that patients who had undergone subtotal colectomy showed better stool control capability.

There was no significant difference between the two surgical procedures regarding postoperative complications and quality of life. 

Prevalence of Halitosis includes a variety of 22 up to 50% in different societies. There have been reports of remarkable improvements in Halitosis after Gastroesophageal Reflux Disease (GERD) treatment. The aim of this study was to investigate the relationship between oral factors and halitosis in patients suffering from GERD. 

This cross-sectional analytical study was conducted on 98 patients (45 females and 53 females) with mean age of 19.4 years whose gastroesophageal reflux was diagnosed by gastroenterologist. Halitosis was detected by organoleptic method. Decayed, Missing, and Filled Teeth (DMFT) was utilized to record the dental status. Oral hygiene was evaluated using the Oral Hygiene Index (OHI-S), Debries Index (DI), Calculus Index (CI), and coated tongue. Data were analyzed by Spearman and Pearson correlation tests.

There was not a significant relationship between halitosis and DMFT, OHI-S, and debris index and calculus index, and coated tongue (p>0.01). Also, there was a direct and significant relationship between DI and CI (p<0.01).

Based on the results of the present study, there is no relationship between oral factors (debris index, calculus index, oral hygiene index, and DMFT) and halitosis in patients with GERD. Therefore, the presence of halitosis might be attributed to the presence of GERD in these patients.

Some clinical scoring systems as the quantitative tools have been developed to assess the presence and severity of Diabetic Peripheral Neuropathy (DPN) based on both the patient’s complaints and the physicians’ findings. This study was aimed at assessing the presence and severity of sural and peroneal nerve neuropathies using Michigan Neuropathy Screening Instrument (MNSI) and United Kingdom Screening Test (UKST) questionnaire compared with electrodiagnosis assessments.

148 patients with Diabetes Mellitus (DM) including 80 females and 68 males with a mean age of 57.6, 19 type 1DM and 129 type 2 DM were recruited in this study. The findings of the electrophysiological study such as peroneal and sural nerves’ conduction delay, velocity and amplitude were gathered. The patients were also assessed regarding the clinical neuropathy status using the two instruments of MNSI and UK.

The mean neuropathy score of MNSI and UKST were 2.2 (1.7) and 4.1 (3.0), respectively. Each instrument detected the DPN in 47.3% and 64.9% of the patients, respectively. Also, based on the nerve conduction studies (NCS), the neuropathy of sural and peroneal nerves was found in 54.1% and 79.7%, respectively. Unlike the peroneal nerve, there was a significant agreement between the electrodiagnosis assessment and the screening tools in the diagnosis of sural nerve neuropathy.

 Given that NCS is a practical, simple, and non-invasive approach and also can determine the level of damage and regeneration in peripheral nerves, sural nerve conduction study is suggested as a convenient option for screening and diagnosing the diabetic neuropathy.

The curriculum is the most important component of the educational system and evaluation is one of the most significant and sensitive components of the curriculum too. Through evaluation, the efficiency and effectiveness of programs can be increased.

This is a descriptive cross-sectional study that was conducted to evaluate the residency curriculum of the Pediatrics Department of Hormozgan Medical School using the CIPP model. The statistical population in the study included 20 Pediatrics residents and 20 faculty members who were selected by the census method. Researcher-made questionnaires were used to collect data. Data analysis was performed via descriptive-analytical statistical methods using SPSS version 22.

The dimensions of context, input, process, and product were evaluated as relatively desirable. The context, input, process, and product status had a statistically significant difference from the participant’s perspective. According to (p≤0.01) and the average score of faculty members and residents respectively (M=3.15) and (M=2.57), it can be said that faculty members have a more positive attitude towards residents in evaluating the Pediatrics residency curriculum except for the product dimension.

Generally the curriculum of the Pediatrics Department of Hormozgan Medical School was evaluated as relatively desirable from the perspective of faculty members and residents. This issue shows, there is a long way to improve the quality of the curriculum, which will be achieved by eliminating the shortcomings in various areas of education. Consequently, it will be effective to evaluate the periodical of the Pediatrics department curriculum to improve it and achieve long-term educational goals.

COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has turn into a pandemic and has extended all over the world. Since the virus has the potential ability to severely impair heart and liver, analyzing the biochemical parameters is a suitable approach for clinicians to assess the outcome.

This study was conducted along with 614 recognized COVID-19 patients. All samples were from Emergency department of Sina Hospital in Tehran, Iran, from February to May, 2020.

A total of 614 COVID-19 patients with mean age of 57.8 years (16-94 years) consisting of 385 (62.7%) male and 229 (37.2%) female were studied. Patients with COVID-19 had no significant difference between cardiac and liver parameters on the presentation and discharge time (p-value≥0.05). Patients with COVID-19 had significant correlation in Lactate dehydrogenase (LDH), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), and Total Bilirubin with recovery and mortality outcome (p-value≤0.05). Also, high sensitivity cardiac Troponin-I, LDH, AST, and ALT in patients with COVID-19 were significantly associated with high in-hospital mortality (p-value<0.05).

Several laboratory parameters may ease the evaluation of COVID-19 in-hospital mortality. Cardiac and liver parameters are critical in assisting COVID-19 cases.

The negative experience of hospitalization in psychiatric wards is a common issue that can have destructive effects on treatment outcomes. Considering the significance of improving inpatient psychiatric care, this qualitative study was implemented to elucidate the patients’ experience of hospitalization in a psychiatric hospital from September 2017 to February 2018.

The information was gathered using two approaches: focus groups, and in-depth individual interviews with hospitalized patients. Twenty-two patients, including 16 women and 6 men, participated in this research. Content analysis method was used for analyzing the data. 

Participants’ negative experiences were categorized into three main categories: imprisonment, loneliness, and untrustworthy atmosphere. According to our study, the numerous restrictions and inflexible regulations of the ward, insufficient interaction with the psychiatrist and nurses, coercion, and insufficient physical facilities caused negative experiences. 

It seems to be critical that the extent of care for each patient be individualized and free of humiliation. 

Autism Spectrum Disorder (ASD) is a developmental neurological disorder characterized by impaired social interactions. The aim of study was to examine the telepractice Prelinguistic Milieu Teaching (PMT) for ASD children. 

This study followed a pretest–posttest design. 11 mothers of children with ASD aged 26-71 months (mean=47.09 months, SD=14) were included. Mothers were given the necessary training on the PMT for 12 one-hour weekly sessions, through the WhatsApp software. The self-reported McArthur-Bates communication development inventories (CDIs) was the main outcome measure. The data were analyzed using Wilcoxon test.

Mean scores of expressive and perceptive words significantly improved after treatment with large effects sizes (Cohen’s d >0.8). The activity and gestures section scores showed significant improvements after treatment in the areas of communication gestures, play and routines, working with objects and imitation of adult activities (Cohen’s d >0.8). 

This study provides preliminary evidence that the telepractice of PMT is effective for children with autism spectrum disorder. Further study with a rigours design is warranted.

Retinopathy of Prematurity (ROP) is a pathologic condition in the retina characterized by abnormal vasoproliferation. We aim to investigate the correlation of different birth- and hospitalization-related factors in the progression of ROP.

This historical cohort study performed in the ophthalmology center of Ayatollah Rouhani Hospital in Babol (Babol University of Medical Sciences, Babol, Iran), included 828 infants (gestational age <35 weeks and birth weight <2500 g). Also, data were collected from the history of hospitalized premature infants.  

The lower gestational weight of infants has been observed in ROP infants (1418.05±547.09 g) compared to non-ROP infants (1917.31±486.01 g) (p<0.001). In addition, the average gestational age of ROP infants (30.28±2.34 weeks) was younger than non-ROP infants (33.26±1.00 weeks) (p=0.042). Increase in the duration of hospitalization increased 6% the chance of ROP in infants (OR=1.06; 95%CI: [1.05,1.08]) (p<0.001). Furthermore, increase in the count of blood replacement decreased 29% the chance of complete remission of ROP (OR=0.71; 95%CI: [0.51,0.95]) (p=0.029). The blood group does not have an impact on ROP development or remission.  

More birth weight of premature infants is associated with less chance of ROP incidence. Moreover, the lower gestational age is related to more chances of ROP.

Cleaning is one of the most important steps in preparing surgical instruments for reuse. Thorough cleaning can ensure more effective sterilization, protect treatment teams and patients from transmissible infections, and extend the life of surgical instruments. This study was conducted to compare the manual, automated, and ultrasonic methods of cleaning surgical instruments. 

In this quasi-experimental study, three types of surgical instruments, namely curved hemostats, suction tips, and Metzenbaum scissors, (n=90) from among 20 surgical sets were randomly selected and assigned to three cleaning groups viz manual, automated, and ultrasonic. After the instruments were cleaned, surface protein and blood residue swab tests were conducted and the results were recorded on a data-registration form. Data were analyzed using SPSS version 16 and descriptive and inferential statistical methods.

According to the research results, in manually cleaned instruments group, 8 (26.7%) tested positive for blood and 10 (33.3%) tested positive for protein. Of the 30 automatically cleaned instruments, 6 (20%) tested positive for blood and 7 (23.3%) tested positive for protein and of the 30 ultrasonically cleaned instruments, 1 (3.3%) tested positive for blood and protein. The chi-square test showed a statistically significant difference between the three methods of cleaning residual blood and protein from the surgical instruments (p<0.05).

The results revealed that according to the research results, of the three cleaning methods, ultrasonic cleaning was by far the most effective in removing blood and protein residues from the surgical instruments. Hence, we suggest that ultrasonic cleaning can be routinely utilized as an efficient cleaning method in medical centers.

Mastoid Pressure Dressing (MPD) has been commonly used by otolaryngologists from 1960 as a post-operative care after mastoid or middle ear surgeries. MPD may be removed after the first day or 5 days after the surgery but it is not clear whether early or late removal is associated with less side effects. To clarify the optimal time of MPD removal, we conducted this prospective study. 

A total of 56 patients, including 19 males and 37 females with the mean age of 38.23±15.9 years, were included in this study. Among these, 31 patients underwent early MPD removal (after one day) and for the other 25 patients, MPD was removed five days following the surgery, Tympanoplasty or Tympanomastoidectomy. 

There was no significant difference between the two groups in gender distribution or mean age. In addition, no significant between-group difference was detected in developing hematoma and sleep disturbance, but patients with late MPD removal showed higher rates of headache and erythema. 

Current study suggests that MPD may be removed as soon as possible after the surgery due to its side effects inducing headache and irritation.

Surgery in premature neonates following Necrotizing Enterocolitis (NEC) is an awful event. There are many concerns regarding the future of these neonates. Releasing inflammatory substances following perforation can have a significant impact on the premature brain. Based on the ASQ questionnaire, we aimed at finding out whether there is any neurodevelopmental delay following NEC surgery. 

We compared developmental aspects of neonates who underwent NEC surgery with control using the Ages and Stages Questionnaire (ASQ II). 

We compared 29 children that had surgical NEC in their neonatal period with their premature peers. They were homogeneous in age, sex, head circumference, weight, and Apgar count at birth in the neonatal period; they had no significant difference in the incidence of sepsis and ventilation-requiring days and cerebral incidence hemorrhage. At the study time, there was a significant difference in growth parameters, weight (p<0.001), and height (p=0.014). Also, there was no significant difference in head circumference and developmental parameters such as communication, motor, and problem-solving domains.

This study indicates that if these patients do not develop severe neurological complications in the neonatal period, their abilities are close to their premature peers in arrival to community and school. However, we still recommend close monitoring of these cases due to the possibility of impaired central nervous-gastrointestinal coordination.

Cyclic Vomiting Syndrome (CVS) is an idiopathic, complex, multifactorial disorder that is often characterized by recurrent episodes of vomiting and is usually separated by asymptomatic episodes. Prophylaxis should be considered in children with frequent or severe periods. Prevention and treatment of CVS in children is very difficult and no specific and effective treatment has been proven in clinical trials. Propranolol is approved for the prophylaxis of CVS in children of all ages, but its effectiveness has been variable. In this study, we investigated the efficacy and safety of adding L-Carnitine to propranolol therapy in the prevention of pediatric CVS. 

76 children who were diagnosed with CVS were included in this study. They were divided into two equal groups. The first group received high dose of Propranolol and the case group received L-Carnitine with low dose of propranolol for 6 months. 

CVS attacks’ frequency in both groups of treatment with propranolol alone and in combination with L-Carnitine and propranolol, before and after the treatment was significantly reduced. But there is no significant difference between the two groups 70.6%) vs. 90.9%) (p-value=0.062). There was no significant reduction in the duration days between vomiting attack index in both groups (31.6 % vs.43.2%) (p-value= 0.345).

Our research revealed that combination of low dose propranolol with L-Carnitine has comparable efficacy with high dose Propranolol in prophylaxis of CVS.

COVID-19 is a newly emerging disease that causes a pandemic situation in the world. Coronavirus can enter into the body in several ways and it damages other organs of the body in addition to the respiratory system. This study aimed at verifying extra-pulmonary manifestation of COVID-19.

The present study was conducted as cross-sectional in a single center from March 1 to May 1 2020 at Firoozgar educational Hospital in Tehran, Iran. 107 patients with confirmed COVID-19 pneumonia according to WHO interim guidance were recruited in this study. Extra-pulmonary manifestations of COVID-19 were recorded. SPSS version 26 was used for all the analyses.

The mean (SD) and the median age were 59.3 (17.4) and 62.0 years, respectively and 58 (54.2%) were men. Body temperature of the patients who were equal or less than 60 years was significantly higher than other patients (39.02 vs. 38.08°C, p=0001). The most common extra-pulmonary manifestation was GI symptoms including nausea, vomiting, abdominal pain, diarrhea, hepatocellular Liver Function Test (LFT) abnormality, cholestatic LFT abnormality, and amylase lipase incensement [37 patients (34.6%]. Ophthalmological, cardiac, neurological and dermatological manifestations were shown in 6.5, 6.5, 14.9 and 14.0% of the patients, respectively. 

Investigating the clinical and radiological symptoms of COVID-19 showed that SARS-CoV-2 infection may also be associated with extrapulmonary symptoms. Therefore, clinicians and radiologists should be familiar with such symptoms of the disease.

Premenstrual Syndrome (PMS) is a common problem in women with migraines. Due to the importance of recognizing aspects of this issue, this study was conducted to investigate the role of alexithymia and self-efficacy factors in predicting PMS.

This analytical cross-sectional study was performed on the statistical population of women with migraine referred to medical centers in Rasht in 2021. 160 women with migraines participated in convenience sampling methods from medical centers and responded to the Demographic Information Questionnaire, Premenstrual Symptoms Screening Tool (PSST), Toronto Alexithymia Scale (TAS-20) and General Self-Efficacy Scale (GSE). Data analysis was performed using IBM SPSS 21 (IBM Inc, New York, USA) statistical software.

The results showed that 59.6% of the women had PMS. Pearson correlation coefficient showed that PMS was negatively associated with self-efficacy (r=-0.28; p=0.001) and positively associated with alexithymia (r=0.22; P=0.001). Multiple linear regression analysis indicated that the self-efficacy variable (β=-0.27) negatively predicts 11% of the changes in the PMS variable.

Self-efficacy and alexithymia are PMS-related factors; thus it is suggested that health care providers pay attention to the importance of these psychological factors in developing treatment plans.

Topiramate is being widely used to prevent migraine headaches and treat epilepsy and mental disorders; however, Oral Lichenoid Lesion (OLL) is one of its rare side effects. The present report has been provided based on a patient case study who had developed OLLs following treatment with topiramate. The patient was a 50-year-old woman referred to a psychiatric clinic with complaints of severe headaches, anxiety, insomnia, and symptoms of Obsessive-Compulsive Disorder (OCD). For this purpose, fluoxetine, topiramate, and nortriptyline were prescribed. Two months after increasing the topiramate dosage to 400 mg per day, she developed OLLs. The Topiramate dose was reduced within two weeks and finally discontinued. The lesions were removed four weeks after the cessation. The patient had no lesions for 6 months. With restarting the drug, the lesion reappeared and finally, ceasing topiramate usage. To conclude, the mentioned lesions are one of the rare complications of this anticonvulsant drug.

Sporadic cases of sinus aplasia have been reported in the literature, but only a few cases of total aplasia of paranasal sinuses have been recorded. In this report, we aim to present a case of aplasia of all paranasal sinuses except for the right ethmoid sinus which was hypoplastic. 

Case Report: 

The patient was a 50-year-old female referred for obtaining Cone Beam Computed Tomography (CBCT) prior to dental implant placement. The patient was asymptomatic and did not have any complaints or discomforts associated with the craniofacial structures. CBCT views showed bilateral absence of paranasal sinuses. Only two ethmoid air cells were detected on the right side. 

This is the first case report for aplasia considering paranasal sinuses except for right ethmoid cells which were hypoplastic in Iranian population.