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1.  Paradoxical attitudes toward premarital dating and sexual encounters in Tehran, Iran: a cross-sectional study 
Reproductive Health  2016;13(1):102.
Background
The purpose of this study is to assess attitudes toward premarital dating and sexual encounters in individuals aged 15–49 years in Tehran.
Methods
Utilizing the attitudes section of an original cross-sectional study (n = 755) aimed at assessing sexual health needs of adults, this paper examined personal attitudes towards premarital dating, non-sexual relationships and sexual encounters in both male and female adults aged between 15–49 years. Multi-stage cluster random sampling and a validated/reliable questionnaire were used. Descriptive, bivariate and multivariate analyses were conducted using statistical software.
Results
The results indicated that the majority of the participants were supportive of dating. Almost three-fourths of the males were more positively inclined towards non-sexual, yet tactile, affectionate interactions between unmarried males and females as opposed to only half of the females (70 % vs. 50.5 %). Also, males held significantly more liberal attitudes than females in their acceptance of premarital sex. On preserving virginity prior to marriage, 43 % of the males felt that it was important for a female to be a virgin, whereas only 26 % felt it was important for males to remain a virgin. Interestingly, more females (61 %) supported the importance of a female’s virginity compared with the importance of males’ virginity (48 %). This study showed that, being a male, of a younger age, single, and being less religious or being secular were important determinants of a liberal sexual attitude.
Conclusion
These results might reflect a socio-cultural transition in the sexual attitudes of different age groups of participants - a phenomenon that will need empirical studies to unpack in the Iranian socio-cultural context.
doi:10.1186/s12978-016-0210-4
PMCID: PMC5006512  PMID: 27576489
Sexual attitude; Premarital sex; Virginity; Sexual health; Sexual encounters
2.  Effect of add-on valproate on craving in methamphetamine depended patients: A randomized trial 
Background:
Methamphetamine dependence lead to the compulsive use, loss of control, and social and occupational dysfunctions. This study aimed to compare the effect of valproate in reducing the craving in methamphetamine dependents.
Materials and Methods:
This is a randomized, double-blind, controlled clinical trial on 40 men of 18–40 years old referred to Noor Hospital during December 2012–September 2013 in Isfahan, Iran. The subjects participated in matrix program and randomly were divided into two groups of valproate and placebo. A 4-months program of intervention with valproate or placebo was arranged for each group. The rate of craving to methamphetamine and positive methamphetamine urine tests were evaluated in both groups every 2 weeks using cocaine craving questionnaire-brief (CCQ-Brief) and urine test. After the 4 months (active treatment with valproate and placebo), the drug was tapered and discontinued within 10 days, and patients were introduced to self-help groups and monitored regularly on a weekly basis over another 3 months. Collected data were analyzed with SPSS 20 using analysis of covariance repeated measure, Chi-square, and t-test.
Results:
CCQ score of the intervention group was significantly less than the placebo group (P < 0.001), except on weeks 1, 3, and 28. The ratio of a positive urine test for methamphetamine in the intervention group was significantly lower than the control group in all screenings except weeks 3 and 28.
Conclusion:
Adding valproate to matrix program in the treatment of methamphetamine dependence showed significant effect on the reduction of the craving to methamphetamine.
doi:10.4103/2277-9175.187404
PMCID: PMC5025910  PMID: 27656618
Matrix program; methamphetamine; valproate
4.  Acceleration rate of mitral inflow E wave: a novel transmitral doppler index for assessing diastolic function 
Background
We performed comprehensive transmitral and pulmonary venous Doppler echocardiographic studies to devise a novel index of diastolic function. This is the first study to assess the utility of the acceleration rate (AR) of the E wave of mitral inflow as a primary diagnostic modality for assessing diastolic function.
Methods
Study group consisted of 84 patients (53 + 11 years) with left ventricle (LV) diastolic dysfunction and 34 healthy people (35 ± 9 years) as control group, who were referred for clinically indicated two-dimensional transthoracic echocardiogram (TTE) during 2012 and 2013 to Imam Hospital. Normal controls were defined as patients without clinical evidence of cardiac disease and had normal TTE. LV diastolic function was determined according to standardized protocol of American Society of Echocardiography (ASE). As our new parameter, AR of E wave of mitral inflow was also measured in all patients. It was represented by the slope of the line between onset of E wave and peak of it. Correlation between AR of E wave and LV diastolic function grade was measured using the Spearman correlation coefficient. Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity of AR of E wave in diagnosing LV diastolic dysfunction in randomly selected two-thirds of population then its derived cutoff was evaluated in rest of the population. The institutional review board of the hospital approved the study protocol. All participants gave written informed consent. This investigation was in accordance with the Declaration of Helsinki.
Results
The mean value of AR was 1010 ± 420 cm/s2 in patients whereas the mean value for the normal controls was 701 ± 210 cm/s2. There was a strong and graded relation between AR of E wave of mitral inflow and LV diastolic function grade (Spearman P ≤0.0001, rs =0.69). ROC curve analysis revealed that AR of E wave of mitral inflow =750 cm/s2 predicted moderate or severe LV diastolic dysfunction with 89 % sensitivity and 89 % specificity (area under curve [AUC] = 0.903, P <0.0001). Application of this cutoff on test group showed 96 % sensitivity and 77 % specificity with AUC = 0.932 and P <0.0001.
Conclusion
AR of E wave of mitral inflow could be used for assessment of diastolic function, especially moderate or severe diastolic dysfunction. However, before its clinical application, external validation should be considered.
doi:10.1186/s12947-016-0067-2
PMCID: PMC4902964  PMID: 27287228
5.  Anesthetic implication of tricuspid valve replacement in a patient with acute intermittent porphyria 
Annals of Cardiac Anaesthesia  2016;19(2):367-371.
Facing a patient with acute intermittent porphyria (AIP), there is narrow safety margin which circumscribe all the therapeutic actions including choice of drugs. This would become even more complicated when it comes to a stressful and drug-dependent process like a cardiopulmonary bypass. According to author's researches, no specific AIP case of tricuspid valve (TV) replacement is reported recently. Furthermore, fast-track anesthesia was safely used in this 37-year-old male known the case of AIP, who was a candidate for TV replacement and removing the port catheter. The patient was extubated subsequently, only 3 h after entering the Intensive Care Unit.
doi:10.4103/0971-9784.179623
PMCID: PMC4900341  PMID: 27052088
Acute intermittent porphyria; Cardiac surgery; Tricuspid valve replacement surgery
6.  Coronary Artery Bypass Grafting in Patients with Advanced Left Ventricular Dysfunction: Excellent Early Outcome with Improved Ejection Fraction 
Background: The prevalence of patients with severe left ventricular dysfunction (LVD) referred for coronary artery bypass grafting (CABG) is increasing. Preoperative LVD is an established risk factor for early and late mortality after revascularization. The aim of the present study was to assess the early outcome of patients with severe LVD undergoing CABG.
Methods: Between December 2012 and November 2014, 145 consecutive patients with severely impaired LV function (ejection fraction ≤ 30%) undergoing either on-pump or off-pump CABG were enrolled. The primary end point was all-cause mortality. Different variables (preoperative, intraoperative, and postoperative) were evaluated and compared.
Results: The mean age of the patients was 58.7 years (range, 34 to 87 years), and 82.8% of the patients were male. The mean preoperative LV ejection fraction was 25.33 ± 5.07% (10 to 30%), which improved to 26.67 ± 5.38% (10 to 40%) (p value < 0.001). An average of 3.85 coronary bypass grafts per patient was performed. Significant improvement in mitral regurgitation was also observed after CABG (p value < 0.001). Moreover, 120 patients underwent conventional CABG (82.8%) and 25 patients had off-pump CABG (17.2%). In-hospital mortality was 2.1% (3 patients). Patients who underwent off-pump CABG had higher operative mortality than did those undergoing conventional CABG despite a lower severity of coronary involvement and a significantly lower number of grafts (p value < 0.050). Conversely, morbidity was significantly higher in conventional CABG (p value < 0.050).
Conclusion: CABG in patients with severe LVD can be performed with low mortality. CABG can be considered a safe and effective therapy for patients with a low ejection fraction who have ischemic heart disease and predominance of tissue viability.
PMCID: PMC4939258  PMID: 27403183
Coronary artery bypass; Ventricular dysfunction, left; Myocardial revascularization
7.  Native Larvivorous Fish in an Endemic Malarious Area of Southern Iran, a Biological Alternative Factor for Chemical Larvicides in Malaria Control Program 
Iranian Journal of Public Health  2015;44(11):1544-1549.
Background:
The widespread use of chemical insecticides, resistance in vectors and environmental problems, all have led to an increased interest in the use of biological agents in malaria control programs. The most important functional elements are the native fish. The aim of this study was to identify the native species of lavivorous fish in Rudan County, southern Iran, to introduce an effective species and to propose its’ implementation in the national malaria control program.
Methods:
This ecologically descriptive study was conducted during 2011–2012 using random sampling from different fish habitats of Rudan County. The shoals of fish were caught using fishing net. Fish samples were then identified in the Ichthyology lab, Department of Fisheries and the Environment, Hormozgan University.
Results:
Three species of larvivorous fish were identified as follows: Gambusia holbrooki, Aphaniusdispar dispar and Aphanius sp. The latter species has the most distribution in the study area and needs more morphological and molecular studies for identification at the species level.
Conclusion:
Two species of native fish, i.e., A. dispar and A. sp. with larvivorous potential live in the area. Further studies on their predatory property are recommended in order to apply this local potential against malaria vectors in the area.
PMCID: PMC4703235  PMID: 26744713
Malaria; Biological control; Larvivorous fish; Aphanius; Iran
8.  Self-esteem, general and sexual self-concepts in blind people 
Background:
People with visual disability have lower self-esteem and social skills than sighted people. This study was designed to describe self-esteem and general and sexual self-concepts in blind people.
Materials and Methods:
This was a cross-sectional study, conducted in the Isfahan University of Medical Sciences in 2013-2014. In this study, 138 visually impaired people participated from Isfahan Province Welfare Organization and were interviewed for measuring of self-esteem and self-concept using Eysenck self-esteem and Rogers’ self-concept questionnaires. The correlation between above two variables was measured using Statistical Package for the Social Sciences (SPSS) software by Pearson correlation test.
Results:
Mean [± standard deviation (SD)] age of patients was 30.9 ± 8 years. The mean (±SD) of general self-concept score was 11 ± 5.83. The mean (±SD) of self-esteem score was 16.62 ± 2.85. Pearson correlation results showed a significant positive correlation between self-esteem and general self-concept (r = 0.19, P = 0.025). The mean of sexual self-concept scores in five subscales (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear, and sexual depression) were correspondingly 11 ± 4.41, 19.53 ± 4.53, 12.96 ± 4.19, 13.48 ± 1.76, and 5.38 ± 2.36. Self-esteem and self-concept had significant positive correlation with sexual anxiety (r = 0.49; P < 0.001) (r = –.23; P < 0.001) and sexual fear (r = 0.25; P = 0.003) (r = 0.18; P = 0.02) and negative correlation with sexual self-efficacy (r = –0.26; P = 0.002) (r = –0.28; P = 0.001) and sexual-esteem (r = –0.34; P < 0.001) (r = –0.34; P < 0.001).
Conclusion:
Self-esteem and self-concept had significant correlation with sexual anxiety and sexual fear; and negative correlation with sexual self-efficacy and sexual-esteem.
doi:10.4103/1735-1995.172764
PMCID: PMC4746865  PMID: 26929756
Self-concept; self-esteem; sexual self-concept; visual impairment
9.  The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review 
Background:
In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context.
Objective:
In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models.
Materials and Methods:
For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD.
Results:
The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings.
Conclusion:
Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women’ sexual problems such as FOD in the Iranian settings.
PMCID: PMC4609319  PMID: 26494987
Iranian women; Orgasm; Reproductive health; Sexual dysfunction
10.  The Relationship Between Self-Esteem and Sexual Self-Concept in People With Physical-Motor Disabilities 
Background:
Self-esteem is the value that the individuals give themselves, and sexual self-concept is also a part of individuality or sexual-self. Impairment or disability exists not only in the physical body of disabled people but also in their attitudes. Negative attitudes affect the mental health of disabled people, causing them to have lower self-esteem.
Objectives:
This study aimed to examine the relationship between self-esteem and sexual self-concept in people with physical-motor disabilities.
Patients and Methods:
This cross-sectional study was conducted on 200 random samples with physical-motor disabilities covered by Isfahan Welfare Organization in 2013. Data collection instruments were the Persian Eysenck self-esteem questionnaire, and five domains (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression) of the Persian multidimensional sexual self-concept questionnaire. Because of incomplete filling of the questionnaires, the data of 183 people were analyzed by the SPSS 16.0 software. Data were analyzed using the t-test, Man-Whitney and Kruskal-Wallis tests and Spearman correlation coefficient.
Results:
The mean age was 36.88 ± 8.94 years for women and 37.80 ± 10.13 for men. The mean scores of self-esteem among women and men were 15.80 ± 3.08 and 16.2 ± 2.90, respectively and there was no statistically significance difference. Comparison of the mean scores of sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression among men and women showed that women scored higher than men in all domains. This difference was statistically significant in other domains except the sexual self-esteem (14.92 ± 3.61 vs. 13.56 ± 4.52) (P < 0.05). The Kruskal-Wallis test showed that except for sexual anxiety and sexual self-esteem, there was a statistical difference between other domains of people’s sexual self-concept and degree of disability (P < 0.05). Moreover, Spearman coefficient showed that there was only a correlation between men’s sexual anxiety, sexual self-esteem and sexual self-efficacy with their self-esteem. This correlation was positive in sexual anxiety and negative in two other domains.
Conclusions:
Lack of difference in self-esteem of disabled people in different degrees of disability and in both men and women suggests that disabled people should not be presumed to have low self-esteem, and their different aspects of life should be attended to, just like others. Furthermore, studies should be designed and implemented based on psychological, social and environmental factors that can help disabled people to promote their positive sexual self-concept through marriage, and reduce their negative self-concept.
doi:10.5812/ircmj.25359
PMCID: PMC4341498  PMID: 25763279
Self-Esteem; Physically Disabled; Sexual Self-Concept
11.  Community knowledge and practices regarding malaria and long-lasting insecticidal nets during malaria elimination programme in an endemic area in Iran 
Malaria Journal  2014;13:511.
Background
Since malaria is one of the foremost public health problems in Iran, a malaria elimination phase has been initiated and application of long-lasting insecticidal nets (LLINs) is an important strategy for control. Success and effectiveness of this community based strategy largely dependent on proper use of LLINs. In this context, to determine the community’s knowledge and practices about malaria and LLINs, a study was conducted in Rudan County, one of the important malaria endemic areas in southeast of Iran.
Methods
In this cross-sectional study, 400 households in four villages were selected by cluster randomly sampling method. Community knowledge and practices about malaria and LLINs including symptoms and transmission of malaria and washing, drying and using of bed nets were investigated using pre-tested structured questionnaires. The data were analysed using SPSS.16 software.
Results
In this study nearly 89% of the respondents knew at least one symptom of malaria and 86.8% considered malaria as an important disease. The majority of respondents (77.8%) believed that malaria transmits through mosquito bite and 72.5% mentioned stagnated water as a potential mosquito breeding place. About 46% of respondents mentioned the community health worker as the main source of their information about malaria. Approximately 44.8% of studied population washed the LLINs once in six months and 92% of them mentioned that they dry the bed nets in direct sunlight. While 94% of households reported they received one or more LLINs by government and 60.8% of respondents mentioned that LLINs were the main protective measure against malaria, only 18.5% of households slept under bed nets the night before the survey, this use rate is lower than the targeted coverage (80%) which is recommended by World Health Organization.
Conclusion
Although, majority of studied population were aware of the symptoms and cause of malaria, a majority had misconceptions about LLINs. Therefore, appropriate educational intervention by trained health workers should be developed for a behaviour change and motivating people to use LLINs which would improve malaria elimination programme.
Electronic supplementary material
The online version of this article (doi:10.1186/1475-2875-13-511) contains supplementary material, which is available to authorized users.
doi:10.1186/1475-2875-13-511
PMCID: PMC4364076  PMID: 25539639
Malaria; Knowledge; Practice; Long-lasting insecticidal nets; Rudan; Iran
12.  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
13.  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
14.  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
15.  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
16.  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
17.  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
18.  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
19.  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
20.  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
22.  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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