Original Article

Explaining the Structural Model of Social Anxiety Based on Early Maladaptive Schemas and Family Performance

Himan Naderzadeh, Mahdieh Salehi, Marjan Ja’fari Roshan, Roya Kochak Entezar

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 1-6

Background: The purpose of study was to determine the mediation role of early maladaptive schemas in the relationship between family performance and social anxiety features of students.
Materials and Methods: This study utilized a descriptive correlational design and statistical population of this study was included of all students of Marivan city, with the quantity of 4134 in 2016-2017, through them by an available sampling, 400 students were selected. Research tools were family assessment device by Epstein et al (1983), schema questionnaire- short form by Young (1990), social anxiety by Connor et al (2000).
Results: Results showed that early maladaptive schemas mediate the relationship between family performances and social anxiety features (β=0.52, p=0.001).
Conclusion: Since parental behaviors is one of the most important affecting factors on early maladaptive schemas and formulation of social anxiety features subsequently; Therefore it is necessary for the prevention and treatment of social anxiety disorder pay special attention to the parent’s behaviors and early maladaptive schemas.

Background: Various strategies have been proposed to minimize reperfusion delay in patients who are candidate for primary percutaneous coronary intervention (PCI). Reperfusion time may be affected by both intra- and extra-hospital factors. The study attempted to identify factors affecting reperfusion time to reduce mortality and morbidity.
Materials and Methods: In this cross-sectional study, 95 patients with chest pain who were admitted to a hospital emergency in Tehran (capital city of Iran) were admitted and those who were diagnosed with ST-segment elevation myocardial infarction (STEMI) were candidates for primary PCI. Basic information was asked from the patients or companion of them. In addition, the PCI time recorded in the patient file was entered in the checklist.
Results: The mean interval between the onset of symptoms and primary PCI was 218.6±21.69 min. The interval between the first medical contact (FMC) and primary PCI was determined to be 87.122±183.66 minutes. The mean time of door to balloon in the hospital was 42.49±78.53 min. In addition, the mean time interval from symptom onset to FMC was 19.47±11.84 minutes. In 31 cases (32.6%), the emergency service (EMS) contacted. Three factors were identified to be associated with a delay between the onset of symptoms to primary PCI (or delay reperfusion time) including the previous history of myocardial infarction (MI) (p=0.034), the severity of coronary artery disease, based on angiography (p=0.043) and the type of vehicle used to transfer the patient to the hospital (p=0.007).
Conclusion: The reperfusion delay seems to be higher in our treatment center than in other centers. Three preceding factors of MI, the severity of coronary artery disease and the transmission of patients via EMS are considered factors associated with the reduction of reperfusion delay.

Comparison of Analgesia in Subcutaneous Infiltration of Ropivacaine and Magnesium Sulfate for Postoperative Pain Control of Cholecystectomy

Shayesteh Khorasanizadeh, Maryam Panahi, Gholamreza Mohseni, Faranak - Behnaz, Masih Ebrahymy Dehkordy, Houman Teymourian

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 13-19

Background: The purpose of this study was to compare the effect of analgesia of Ropivacaine and magnesium sulfate as subcutaneous infiltration at the site of surgical cutaneous cholecystectomy in the postoperative period.
Materials and Methods: To achieve the research goals, 80 patients referred to Shohada Tajrish Hospital in Tehran in 2016, which were randomly divided into two groups: Ropivacaine and magnesium sulfate. Patients in both groups had similar anesthetic procedures and all of them were monitored standard were recorded within 24 hours of operation. Overall morphine dose was also recorded for postoperative pain.
Results: The findings showed that there was a significant difference between the two groups in the Ropivacaine group in the next hours despite the no significant difference in age, sex, BMI, duration of operation and pain scoring at first and third hours. In addition, the comparison of the number of requests for at least one dose of morphine in the Ropivacaine group is significantly lower. In addition, the comparison of the number of requests for at least one dose of morphine in the Ropivacaine group is significantly lower. The occurrence of PONV is also higher in the magnesium sulfate group, but this difference is not significant.
Conclusion: Local injection of Ropivacaine reduced acute pain after open cholecystectomy surgery in comparison to local injection of magnesium sulfate. In addition, the use of Ropivacaine is associated with a significant reduction in the need for intravenous morphine for analgesia.

First Molecular Detection of Aichivirus in Pediatric Patients with Acute Gastroenteritis in Iran

Mohammad Taghinejad, Mostafa Ghaderi, Seyed Dawood Mousavi‑Nasab

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 20-25

Background: Aichivirus as a new member of Picornaviridae family was detected and isolated in Japan. Aichivirus species, which belongs to genus Kobuvirus, include of three genotypes A, B and C. Based on previous reports to detect aichiviruses in stool samples as well as environmental samples such as river waters and sewage waters, it has been demonstrated that Aichivirus infect humans by fecal-oral routs. In order to establish an examination for the prevalence of Aichivirus among pediatric patients involved to acute gastroenteritis, we conducted a RT-qPCR assay for detection and quantification of Aichivirus in collected stool samples.
Materials and Methods: In this study, a total of 160 stool samples from September 2018 to May 2019 were collected from presenting pediatric patients with acute gastroenteritis in Karaj hospital, Iran. After viral RNA extraction, the RT-PCR was performed to amplify the 3CD junction region of Aichivirus.
Results: Out of the 160 samples tested, the Aichivirus genomic RNA was detected in 13/160 (8.1%) of stool samples. The maximum viral prevalence rate was related to December (30.7%). The co-infection of Aichivirus with Salivirus and Saffold virus also assessed, among which high double or triple mixed-infections were determined.
Conclusion: This is the first documentation of Aichivirus detection in stool samples that demonstrates Aichivirus has been circulating among Iranian pediatric patients. Our results indicate that Aichivirus in association with Salivirus and Saffold virus may be considered as a causative agent of acute gastroenteritis.


Prevalence of anemia and new onset atrial fibrillation in patient come to imam hossein hospital emergency department

Hadi Saberpour, Seyyed Amir Sheikholeslami, Meghdad Sedaghat, Mohammad Parsa Mahjoob

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 26-30

Background: Recognition of association between anemia and new onset atrial fibrillation would result in better therapeutic approaches and better prognosis. Hence, the purpose was to determine the prevalence of anemia and new onset atrial fibrillation (AF) in patient come to Imam Hossein hospital emergency department.
Materials and Methods: In the observational study that performed as a case-control survey, 150 consecutive addicted patients in imam hossein hospital emergency department in 2018 were enrolled including those with and without AF in electrocardiogram (EKG) and the frequency rate of anemia among groups was determined and compared.
Results: The results in this study demonstrated that 43 patients (27.8%) had anemia that was seen in 36% and 21.3% in case and control groups, respectively with statistically significant difference (p=0.047).
Conclusion: Totally, according to the obtained results there was significant association between anemia and new onset atrial fibrillation.

Efficacy of Levothyroxine Therapy on Diastolic Dysfunction in Patients with Subclinical Hypothyroidism

Roham Gholami, Saeed Kalbasi, Mehdi Sheibani, Zahra Davoudi, Roxana Sadeghi, Fatima Meeckunickee, Mina Nikpoor, Hesamedin Gordan

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 31-35

Background: Hypothyroidism is a cause of left ventricular diastolic dysfunction especially in cases with positive history of coronary artery disease. It is suggested that cardiac dysfunction may be improved with thyroxin replacement therapy. However, it is controversial. Hence, in this study the efficacy of levothyroxine therapy on diastolic dysfunction in patients with subclinical hypothyroidism was assessed.
Materials and Methods: In this, randomized clinical trial 40 consecutive patients with subclinical hypothyroidism attending to Loghman Hospital in 2018 for the treatment were enrolled. The treatment was 25-50 microgram per day of levothyroxine for one year. During this period, the patients were followed up with visit or phone call with a monthly manner. The echocardiography indices were rechecked after one year beside the thyroid tests by initial lab and operators.
Results: The mean BMI was significantly decreased (P=0.001). The T3 and TSH were significantly differed but The T4 had no significant alteration (P>0.05). Among the echocardiographic indices the MV.E, MV.A to MV. E ratio, EF, Eʹ septal, Eʹ lateral had significant increase and the MV.A and PV. Adur had significant reduction. After intervention among 40 patients, there were 17 cases with normal diastolic function. The BMI, MV. A, PV Adur, Eʹ Septal, Eʹ Lateral, and E to Eʹ ratio showed significant correlation.
Conclusion: Totally, according to the obtained results, it is concluded that diastolic dysfunction as a common problem in patients with subclinical hypothyroidism may be treated with administration of levothyroxine. In addition, screening for diastolic dysfunction in patients with subclinical hypothyroidism is recommended to decrease the burden of problem.

Background: Pneumococcal vaccines are recommended in patients with immune deficiencies such as kidney transplant recipients and dialysis subjects. Streptococcus pneumoniae is an agent of pneumonia, meningitis, important morbidities and mortality in such patients. The purpose of this study was to evaluate and compare the antibody responses in hemodialysis patients, peritoneal dialysis, kidney transplant recipients and normal subjects after administration of 23-valent pneumococcal polysaccharide vaccine (PPV23).
Materials and Methods: The present randomized clinical trial was conducted on 162 subjects including 57 hemodialysis patients, 29 peritoneal dialysis patients, 48 kidney transplant recipients, and 28 healthy controls. The participants received a single-dose pneumococcal vaccine (Pneumovax 23) of 0.5 ml in the upper limb muscle. The efficacy of vaccination was evaluated by measuring the antibody response to the entire vaccine. Serum samples were collected before, one and six months after vaccination.
Results: The levels of IgG pneumococcal antibodies at pre-vaccination periods, one and six months after vaccination were 11.6±1.52 IU/ml, 14.98±1.98 IU/ml and 14.87±0.66 IU/ml in kidney transplant recipients, 12.03±1.93 IU/ml, 15.26±0.49 IU/ml and 14.3±0.72 IU/ml in hemodialysis patients, and 11.5±1.55 IU/ml, 15.2±1.81 IU/ml, and 14.2±1.7 IU/ml, respectively. The serum antibody level was significantly higher in kidney transplant recipients than in both dialysis groups after six months of vaccination (p=0.029).
Conclusion: We found that patients with renal failure respond to pneumococcal vaccination in hemodialysis and kidney transplantation. However, they lost their serum antibodies within six months of vaccination. Determining the protective level for serum IGG and IGG2 in these patients helps us to follow up on these patients more precisely in order to re-vaccinate when the protective level of serum antibody is broken.

A Comparative Assessment of Autologous Conditioned Serum and Ozone for Knee Osteoarthritis Treatment: Mid-Term Follow up

Masoud Hashemi, Hossein Adlkhoo, Payman Dadkhah, Ramin Rohanifar, Mehrdad Taheri

Novelty in Biomedicine, Vol. 8 No. 1 (2020), , Page 45-52

Background: Knee osteoarthritis is a common disease associated with knee pain, physical disability, and joint stiffness. The use of non-surgical treatment methods in patients with knee osteoarthritis is important. Autologous conditioned serum (ACS) is a new regenerative therapeutic method that was investigated by a limited number of clinical trials. So far, using ACS in patients with Knee osteoarthritis remains to be controversial among physicians. Thus, the current study was carried out to compare the therapeutic effects of intra-articular ACS and ozone injections in patients with knee osteoarthritis.
Materials and Methods: This prospective, double-blind randomized clinical trial was conducted among 60 patients (30= interleukin-1 receptor antagonist (IL-1Ra) group, 30= ozone group) with knee osteoarthritis, who referred to the Pain Management Clinic of Akhtar Educational Hospital during 2018 to 2019. In the IL-1Ra group, 2 ml of IL-1Ra was injected into the knee joint. The regimen protocol consisted of 4 injections, performed on the first, seventh, fourteenth, and twenty-first days of the treatment and ozone group, 10 ml of ozone (30 μg/ml) + 5 ml of lidocaine 1% were injected into the knee joint. The regimen protocol consisted of 3 injections, performed on the first day of the treatment, one month after the first injection, and two months after the first injection. The severity of pain was assessed by the patients’ self-report of pain and using the visual analog scale (VAS), before the treatment and 1, 3 and 6 months after the treatment. The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were also measured at before and 6 months following treatment.
Results: The changes in the VAS pain at different time periods showed statistically significant differences in the two groups, (P=0.0001). There was no significant difference between the two groups before the treatment and one month and three months after the initiation of the treatment; however, there was a significant difference between the two groups six months after the initiation of the treatment (P=0.0001). KOOS scores of symptoms, daily activities, and athletic and recreational functions were significantly higher in the IL-1Ra group, and the WOMAC scores of physical function and joint stiffness and the overall scores were significantly higher in the IL-1Ra group, (p<0.05).
Conclusion: The intra-articular injection of IL-1Ra is a low-invasive, safe, effective, and long-acting method. In patients with knee osteoarthritis, clinical improvements and responses to the intra-articular IL-1Ra injection are better and longer compared to ozone injection. Therefore, it can be considered as a suitable choice in treating patients with chronic knee pain.


Background: Increasing the number of complaints against medical staff emphasizes the need for physicians to be more familiar with legal issues before and during providing medical services to the patient. Signing the informed consent form before medical practices and informing the patient of all possible outcomes can cause mental health and better collaboration of patients as well as increase the physician's self-confidence to provide better services. The current study aimed at determining the status of standard informed consent in medical cases related to different surgical fields referring to Tehran's Commission of Forensic Medicine during the first quarter of 2017.
Materials and Methods: In the current descriptive, cross-sectional study, the cases of medical malpractice related to different surgical fields referring to Tehran's Commission of Forensic Medicine in the first quarter of 2017 were investigated. Data were analyzed with SPSS version 16.
Results: In the current study, 124 cases of complaints against the medical staff of the surgical fields were examined. Based on the obtained data, the age and specialty of physicians, faculty status, and type of treatment center were effective in obtaining standard informed consent, and the highest percentage of allegations against the charge was related to cases attempted to obtain informed consent.
Conclusion: Obtaining the standard consent can significantly improve the patient-physician relationships and reduce the rate of medical malpractice complaints.