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1.  Validation of the partner version of the multidimensional vaginal penetration disorder questionnaire: A tool for clinical assessment of lifelong vaginismus in a sample of Iranian population 
Background:
The role of spousal response in woman's experience of pain during the vaginal penetration attempts believed to be an important factor; however, studies are rather limited in this area. The aim of this study was to develop and investigate the psychometric indexes of the partner version of a multidimensional vaginal penetration disorder questionnaire (PV-MVPDQ); hence, the clinical assessment of spousal psychosexual reactions to vaginismus by specialists will be easier.
Materials and Methods:
A mixed-methods sequential exploratory design was used, through that, the findings from a thematic qualitative research with 20 unconsummated couples, which followed by an extensive literature review used for development of PV-MVPDQ. A consecutive sample of 214 men who their wives’ suffered from lifelong vaginismus (LLV) based on Diagnostic and Statistical Manual of Mental Disorders 4th version (DSM)-IVTR criteria during a cross-sectional design, completed the questionnaire and additional questions regarding their demographic and sexual history. Validation measures and reliability were conducted by exploratory factor analysis (EFA) and Cronbach's alpha coefficient through SPSS version 16 manufactured by SPSS Inc. (IBM corporation, Armonk, USA).
Results:
After conducting EFA PV-MVPDQ emerged as having 40 items and 7 dimensions: Helplessness, sexual information, vicious cycle of penetration, hypervigilance and solicitous, catastrophic cognitions, sexual and marital adjustment and optimism. Subscales of PV-MVPDQ showed a significant reliability (0.71-0.85) and results of test-retest were satisfactory.
Conclusion:
The present study shows PV-MVPDQ is a multi-dimensional valid and reliable self-report questionnaire for assessment of cognitions, sexual and marital relations related to vaginal penetrations in spouses of women with LLV. It may assist specialists to base on which clinical judgment and appropriate planning for clinical management.
doi:10.4103/2277-9531.145913
PMCID: PMC4275613  PMID: 25540787
Clinical assessment; cognitions; pain; reliability; self-report measure; sexual partner; vaginismus; validation
2.  Undiagnosed interrupted aortic arch in a 59-year-old male patient with severe aortic valve stenosis: A case report and literature review 
ARYA Atherosclerosis  2014;10(4):230-232.
BACKGROUND
Interrupted aortic arch (IAA) is defined by a lack of the luminal continuity between the ascending and descending thoracic aorta. It is a rare, severe congenital heart defect which without surgery is associated with high mortality in the neonatal period. The aims of this study were to present a case with IAA who was alive until the age of 59 years without any surgical intervention and to review the literatures that have presented IAA cases.
CASE REPORT
The patient was admitted with respiratory distress and pulmonary edema. Echocardiography showed the sever stenosis in aortic valve and sever left ventricular dysfunction. Cardiac catheterization and angiography confirmed interrupted aorta (type A). The descending thoracic aorta was supplied by extensive collateral vessels from the vertebrobasilar system down to the posterior chest wall and the spine. Surgical correction including coronary artery bypass graft and aortic valve replacement and repair of interruption of the aorta was performed. Three weeks later the patient was died due to uncontrollable gastrointestinal bleeding and hospital acquired pneumonia. We described diagnosis and management of our case.
CONCLUSION
This case was very interesting for us, because the patient had not been diagnosed until the recent presentation. Similar cases with this diagnosis do not reach adulthood, but our patient was alive up to 59 years of age.
PMCID: PMC4173315  PMID: 25258640
Interrupted; Aorta; Aortic Valve Stenosis; Thoracic Aorta; Aortic Arch
3.  Development and validation of the multidimensional vaginal penetration disorder questionnaire (MVPDQ) for assessment of lifelong vaginismus in a sample of Iranian women 
Background:
Vaginismus is considered as one of the most common female psychosexual dysfunctions. Although the importance of using a multidisciplinary approach for assessment of vaginal penetration disorder is emphasized, the paucity of instruments for this purpose is clear. We designed a study to develop and investigate the psychometric properties of a multidimensional vaginal penetration disorder questionnaire (MVPDQ), thereby assisting specialists for clinical assessment of women with lifelong vaginismus (LLV).
Materials and Methods:
MVPDQ was developed using the findings from a thematic qualitative research conducted with 20 unconsummated couples from a former study, which was followed by an extensive literature review. Then, during a cross-sectional design, a consecutive sample of 214 women, who were diagnosed as LLV based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR criteria completed MVPDQ and additional questions regarding their demographic and sexual history. Validation measures and reliability were tested by exploratory factor analysis and Cronbach's alpha coefficient via Statistical Package for the Social Sciences (SPSS) version 16.
Results:
After conducting exploratory factor analysis, MVPDQ emerged with 72 items and 9 dimensions: Catastrophic cognitions and tightening, helplessness, marital adjustment, hypervigilance, avoidance, penetration motivation, sexual information, genital incompatibility, and optimism. Subscales of MVPDQ showed a significant reliability that varied between 0.70 and 0.87 and results of test–retest were satisfactory.
Conclusion:
The present study shows that MVPDQ is a valid and reliable self-report questionnaire for clinical assessment of women complaining of LLV. This instrument may assist specialists to make a clinical judgment and plan appropriately for clinical management.
PMCID: PMC4115350  PMID: 25097607
Clinical assessment; Clinical psychology; Cognitions; Reliability; Self-report measure; Vaginismus; Validation; Women
4.  A comparison of substance dependence treatment information system in America, England, and Iran 
Context:
Addiction, as a social problem, is a phenomenon that causes structural changes in cultural, social, political, and economic system in society. Prevention of this problem means decrease of risk factors and increase of protective factors; and recognition of these factors is possible with the help of update, accurate, and complete information in information systems.
Aims:
The aim of this study was to compare substance dependence treatment information system (SDTIS) in America, England, and Iran.
Materials and Methods:
This research was an applied and comparison-descriptive study, in which SDTIS was compared in America, England, and Iran. These countries were chosen based on available information on the Internet and also on the development of these countries in the health information management field. Information resources included library resources, electronic resources, and expert people (Health Information Management, Medical Records Education, Psychologist, Psychiatrist, and Medical Informatics). The data collection tool was the data raw form, whose reliability was proved by expert people.
Statistical Analysis Used:
Findings were analyzed by theory and descriptive method.
Results:
America and England had the SDTIS. Their systems had special characteristics such as goals, scope, special method for collecting, processing, reporting, quality and validity control, and confidentiality principles. However, there was no such system in Iran and the present situation in Iran has many differences with similar situations in the studied countries.
Conclusion:
Presence of an information system in the substance dependence treatment field helps to prevent, control, and treat addicted people. Hence, we try to submit a suitable model for implementing this system.
doi:10.4103/2277-9531.127597
PMCID: PMC3977395  PMID: 24741657
Information system; psychoactive substances; substance dependence treatment; substance dependence
5.  Comprehensive View of the Human Mating Process Among Young Couples in Isfahan-Iran: An Explanatory Mixed-Method Study 
Background:
Heterosexual relationship is the main component of mate selection. Regardless of the importance of mate favorites, little is known about exact valued criteria in potential mates.
Objectives:
This study was designed to comprehensively explain the theoretical view of the human mating process.
Materials and Methods:
This was as an explanatory mixed–method study. The first phase was a cross-sectional quantitative study with two Farsi-modified versions of instruments: preferences concerning potential mates and factors of choosing a mate; content analysis was the second phase. The quantitative phase of this study consisted of 202 dating couples, decided to get married. The qualitative phase consisted of 28 participants who acquired the extreme scores (highest and lowest) in the first phase.
Results:
Average age of marriage for women and men was 23.04 and 26.41 respectively; the actual age difference was 3.37 years (women younger than men). The results of this study in support of evolution-based theory explained that, age is a preference and choosing an older husband and a younger wife is due to having reproductive capacity. Also, they mentioned that appearance is necessary for men because of sexual attraction, not as a prediction for the next generation appearance. In both phases of this study, both genders had a strong emphasis on “chastity” in a potential mate. Results showed that, men preferred a mate who was a good housewife, capable of cooking, and women preferred a mate with “Good earning capacity”, “Good financial prospect” “university education”, “Favorable social status” and “Industriousness”.
Conclusions:
The results confirmed that for a comprehensive view in human mating process, we need a combined theoretical approach as well as qualitative and quantitative study to explore the real meaning of each preference in a mate.
doi:10.5812/ircmj.10445
PMCID: PMC3955495  PMID: 24693380
Humans; Mating; Young Adult; Couples; Iran
6.  Psychometric properties of the Farsi version of modified Multidimensional Sexual Self-concept Questionnaire 
Background:
The awareness regarding the contribution of sexual self-concept to healthy sexual well-being is on a rise. The Multidimensional Sexual Self-concept Questionnaire (MSSCQ) was developed to assess the 20 aspects related to sexual self-concept and has been widely applied in Western societies. The adequacy of its application in Iran has not been determined in order to guaranty its reliability and validity. An attempt was made here to interpret this questionnaire in Farsi and adopt it in Iran with respect to psychometric properties of the native youth.
Materials and Methods:
A cross-sectional design was employed and 352 couples were recruited from a premarital consulting center in Isfahan, Iran on a random basis. The MSSCQ was translated into Farsi and back-translated by four bilingual scholars. Face and content validity of the questionnaire was determined. Internal consistency was evaluated by applying Cronbach's alpha. Pearson correlation coefficient was employed. The adopted model was tested through confirmatory factor analysis using SPSS-AMOS software (version 16).
Results:
The mean age of couples was 25.68 years (women 23.92 ± 2.92 years and men 27.44 ± 3.14 years). The obtained Cronbach's alpha was 0.88. Twenty-two items with an impact score below 1.5 and content validity index <0.70 were omitted. Pearson correlation showed positive and negative correlations among the dimensions. Sexual anxiety, fear of sex, and sexual depression had negative correlation with the other dimensions (r = −0.36, r = −0.43, r = −0.32, respectively). The model exhibited adequate fitness: χ2/df = 4.95, goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.91, normed fit index = 0.94, comparative fit index = 0.95, and root mean square error of approximation = 0.07.
Conclusion:
The Farsi version of MSSCQ with 78 items is valuable and reliable to be applied on the youth in Isfahan. This questionnaire was verified under two main categories through confirmatory factor analysis: negative sexual self-concept and positive sexual self-concept.
PMCID: PMC3917125  PMID: 24554940
Couples; Farsi; Iran; MSSCQ; psychometric; sexual self-concept
7.  Diagnostic dilemma: Saccular aneurysm or pseudoaneurysm of the ascending aorta with dissection above level of leaflets 
ARYA Atherosclerosis  2012;8(3):167-169.
BACKGROUND
In true aneurysm, the wall of aneurysm is composed of the normal histological components of aorta. A false aneurysm (pseudoaneurysm) represents a rupture which does not contain the normal histological components of aorta. It is a fibrous peel that has formed from a small perforation of aorta. We describe an unusual presentation that has signs which some of them are only manifested in true aneurysm and some others only in pseudoaneurysm.
CASE REPORT
An 85-year-old man underwent elective coronary angiography for chest pain work-up. Our evaluation by invasive angiography and CT angiography showed aortic dissection. In surgery we found that dissection flap was composed of some parts of intima and media layers. These signs leaded to confusing symptoms. Localized bulging of ascending aorta had continued to brachiocephalic artery (transverse arch involvement). Dissection flap was composed of some part of intima and media layers. It was a strange case, it was not solely a perivascular hematoma and it did not have all three layers of aorta wall. Partial aorta replacement was performed. The operation and recovery was uneventful.
CONCLUSION
This unusual presentation of disease has not been mentioned in literatures. Our experience can help to manage similar cases. This case was the first unusual presentation of its type.
PMCID: PMC3557002  PMID: 23358558
Saccular Aneurysm; Aortic Dissection; Pseudoaneurysm; Aneurysm
8.  Effects of Dextromethorphan on reducing methadone dosage in opium addicts undergoing methadone maintenance therapy: A double blind randomized clinical trial 
BACKGROUND:
Dextromethorphan (DM) is an N-methyl-D-aspartate (NMDA) receptor antagonist that may be useful during opiate addiction process, especially in reducing methadone consumption in methadone maintenance therapy (MMT). The goal of the current study was to evaluate the effects of oral administration of DM on reducing methadone dose in MMT used to treat illicit opioid drug abuse.
METHODS:
A double-blinded randomized clinical trial was designed. Seventy two opiate abusers undergoing MMT were randomly divided into two groups. Participants in the intervention group were medicated by DM while those in the control group received placebo. After a 6-week follow-up, methadone consumption dosage, quality of life (QOL) and withdrawal symptoms were assessed and compared between the two groups by repeated measure ANOVA statistical test.
RESULTS:
The mean of methadone consumption in the DM and control groups were 62.7 mg/day (52.7-72.7) and 70.4 mg/day (60.4-80.4), respectively. No statistically significant difference was found between the two groups among the four evaluations made (F = 1.192, P = 0.279). There were not any significant differences in withdrawal symptoms between the two groups (P > 0.05). Total mean scores of QOL in the intervention and control groups were 84.8 (78.7-90.8) and 77.8 (71.8-83.7) (P > 0.05), respectively.
CONCLUSIONS:
Although DM might be useful for opioid dependence treatment, results of the current study did not reveal any statistically significant differences. Therefore, further studies exploring this possibility are needed.
PMCID: PMC3430027  PMID: 22973331
Methadone; Dextromethorphan; Opiate Dependence; Addiction; Maintenance Therapy
9.  Positive and negative perfectionism and their relationship with anxiety and depression in Iranian school students 
BACKGROUND:
Although many studies have investigated the relationship between perfectionism, anxiety, and depression among the adults, little is known about the manifestations of perfectionism among schoolage youths. This study has investigated this relationship in an Iranian sample.
METHODS:
Using multistage cluster random sampling, 793 Iranian school students in 2007 were studied. Data of demographic characteristics, children's depression inventory, revised children's manifest anxiety scale, and the positive and negative perfectionism scales were obtained using questionnaires.
RESULTS:
The results indicated that both aspects of perfectionism are associated with depression and anxiety. Negative and positive perfectionism have positive and negative associations, respectively, with depression and anxiety. The interaction of anxiety and depression with perfectionism reveals that depression is in association with lower scores of positive perfectionism, whereas in students with higher scores of negative perfectionism, the anxiety scores are also higher. Moreover, the accompaniment of anxiety with depression is in association with relatively lower levels of negative perfectionism.
CONCLUSIONS:
It was concluded that negative perfectionism is a risk factor for both depression and anxiety, while positive perfectionism is a protective factor. However, the interventions which encourage the positive aspects of perfectionism and decrease its negative aspects may be able to diminish psychopathological subsequence.
PMCID: PMC3063422  PMID: 21448388
Depressions; Anxiety
11.  Oral Ascorbic Acid in Combination with Beta-Blockers Is More Effective than Beta-Blockers Alone in the Prevention of Atrial Fibrillation after Coronary Artery Bypass Grafting 
Texas Heart Institute Journal  2007;34(3):268-274.
Because adrenergic beta antagonists are not sufficient to prevent atrial fibrillation after coronary artery bypass grafting, this prospective, randomized trial was designed to evaluate the effects of ascorbic acid as an adjunct to β-blockers.
Fifty patients formed our ascorbic acid group, and another 50 patients formed our control group. All patients were older than 50 years, were scheduled to undergo coronary artery bypass grafting, and had been treated with β-blockers for at least 1 week before surgery. The mean age of the population was 60.19±7.14 years; 67% of the patients were men. Patients in the ascorbic acid group received 2 g of ascorbic acid on the night before the surgery and 1 g twice daily for 5 days after surgery. Patients in the control group received no ascorbic acid. Patients in both groups continued to receive β-blockers after surgery. Telemetry monitoring was performed in the intensive care unit, and Holter monitoring was performed for 4 days thereafter.
The incidence of postoperative atrial fibrillation was 4% in the ascorbic acid group and 26% in the control group (odds ratio, 0.119; 95% confidence interval, 0.025–0.558, P = 0.002). We conclude that ascorbic acid is effective, in addition to being well-tolerated and relatively safe. Therefore, it can be prescribed as an adjunct to β-blockers for the prophylaxis of post-bypass atrial fibrillation.
PMCID: PMC1995047  PMID: 17948074
Adrenergic beta-antagonists; anti-arrhythmia agents/administration & dosage; ascorbic acid/administration & dosage/therapeutic use; atrial fibrillation/drug therapy/prevention & control; clinical trials coronary artery bypass/adverse effects

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