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Background. Post-traumatic stress disorder (PTSD) is a disorder that can occur after exposure to a traumatic event. Objectives. This study is designed to evaluate PTSD in front-line and non-front-line medical staff who provide care for COVID-19 patients. Material and methods. This cross-sectional study was conducted on 200 medical staff in two hospitals of Ahvaz. The inclusion criterion was having more than six months of service. Health providers with psychological disorders, a history of crises in the past six months or divorced subjects were excluded from the study. A demographic questionnaire and the PTSD questionnaire were completed by participants. The Independent t-Test, chi-square test and linear regression were used to analyze the data. Results. The total score of PTSD was 50.08 +/- 12.24 and 44.06 +/- 11.32 in front-line and non-front-line medical staff, respectively (p < 0.001). 10% and 1% of front-line and non-front-line medical staff had severe PTSD, respectively. Females were 7.47 times more likely to have PTSD compared to males. Medical staff who had a child were 6 times more likely to have PTSD compared with those without a child. Medical staff involved in the care of COVID-19 patients were 5.67 times more likely to have PTSD (p < 0.001). Health providers whose relatives died from COVID-19 were 10.59 times more likely to have PTSD. Conclusions. The results of this study showed that front-line medical staff are more susceptible to PTSD in comparison to non-front-line medical staff. Health policymakers should pay attention to the psychological health of medical staff in times of crises such as the COVID-19 pandemic.

Background The COVID-19 pandemic has affected many countries around the world and Iran was no exception. The aim of this study was to evaluate health anxiety of Iranian pregnant women during the COVID-19 pandemic. Methods In this cross-sectional study, 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety Questionnaire were used to collect data. Scores of Results Mean (SD) total anxiety scores were 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimesters of pregnancy, respectively. 9, 13 and 21% of women had severe anxiety in the first, second and third trimesters of pregnancy, respectively. Women in the third trimester had significantly higher health anxiety scores than those in the first trimester (p = 0.045). Conclusion At the time of the COVID-19 pandemic, women in the second and third trimesters of pregnancy were more worried about consequences of disease, but total health anxiety scores were significantly higher among women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as the COVID-19 pandemic.

The outbreak of COVID-19 closed educational institutions and universities. The aim of this study was to explain the strengths and weaknesses of the e-learning system in Iranian universities of medical sciences in the COVID-19 pandemic. This is a qualitative study that was conducted with students enrolled in Iranian medical universities. Data was collected through an open-ended electronic questionnaire based on the interview guide and was analyzed through content analysis. 122 students from 46 medical universities participated in this study. 122 questionnaires from 46 universities of medical sciences were completed. From a total of 54 codes extracted from the results, seven (strengths/positive experiences) and six (weaknesses/challenges) themes were extracted, each of which had several subsets. E-learning has both visible and hidden layers in terms of advantages and disadvantages. The e-learning system is an essential tool to continue education during the COVID-19 pandemic. Most students believe that e-learning was a great complement to prevent academic failure, but it cannot replicate the same efficiency of face-to-face training.

The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with acute respiratory infection (ARI). During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients. Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003). In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-CoV-2 with a real-time PCR method is the first line of choice.

Background The pandemic of COVID-19 affected many countries as well as Iran. The aim of this study was to evaluate the health anxiety of the Iranian pregnant women in time of the pandemic of the corona virus. Methods In this cross-sectional study 300 pregnant women in different trimesters (n = 100 in each trimester) were recruited. A demographic questionnaire and the Health Anxiety questionnaire were used to collect data. Because of quarantine data were collected through social media groups. The chi-square, ANOVA and multiple linear regression were used to analyze data. Results The total score of anxiety was 22.3 ± 9.5, 24.6 ± 9.3 and 25.4 ± 10.6 in the first, second and third trimester of pregnancy. Totally 9%, 13% and 21% of the women had severe anxiety or scores ≥ 35 in the first, second and third trimester of pregnancy respectively. Pregnant women in the third trimester significantly had more health anxiety score than the first trimester ones. Pregnant women in the third trimester had significantly higher scores of “total health anxiety”, in comparison with that of first trimester (p = 0.045). Conclusion At the time of the pandemic of COVID-19, women in the second and third trimester of pregnancy were more worry about consequences of disease, but the total score of health anxiety was significantly more in the women in the third trimester of pregnancy. Health care providers should pay more attention to the mental health of pregnant women in times of crises such as Corona pandemic.

Background Obsessive-compulsive disorder (OCD) is a chronic disorder with unknown etiology. Failure in OCD treatmentcompulsive is common and finding effective augmentations in treatment of OCD will benefit patients. Antipsychotic augmentation is a common strategy for treatment resistant OCD. This trial evaluated the efficacy of adding aripiprazole in patients whose OCD was insufficiently responsive to an adequate SSRI treatment. Methods Thirty-nine adult outpatients, who met the DSM-IV-TR criteria for OCD and had treatment resistant OCD were evaluated in a double-blind randomized clinical trial. The patients received either aripiprazole 10 mg/day or placebo, for 12 weeks. Data were analyzed using intention-to-treat analysis with last observation carried forward. All statistical tests were two-sided, and were considered statistically significant at P < 0.05. Results A significant reduction in total scores of Y-BOCS (P < 0.0001) was found in the aripiprazole group. Aripiprazole was generally well tolerated. There was no significant difference between the two groups in terms of observed side effects. Conclusion Results of the present study indicate that aripiprazole could be an effective augmentation medicine in treatment resistant OCD.

Traditionally, the dried flower of Echium amoenum (Boraginaceae) has been used in Iran as an anxiolytic and mood enhancer. This study investigated the efficacy and safety of an aqueous extract of E. amoenum in treatment of obsessive-compulsive disorder. Forty-four patients were randomly assigned to receive either E. amoenum aqueous extract (500 mg/day) or placebo in a 6-week, double blind, parallel-group trial. Patients were assessed before the study and during weeks 1, 2, 4, and 6 by the Yale-Brown Obsessive Compulsive (Y-BOCS), the Hamilton Rating Scale for Anxiety (HAM-A), and a score sheet on adverse effects. In weeks 4 and 6, the extract showed a significant superiority over placebo in reducing obsessive and compulsive and anxiety symptoms. There was no significant difference between the two groups in terms of adverse effects. The results suggest that E. amoenum aqueous extract has some anti obsessive and compulsive effects. However, further studies are needed to confirm these findings.

The aim of this study was to evaluate the effects of Atorvastatin on negative symptoms in patients with chronic schizophrenia. The study was a prospective, double-blind, 6-week trial. Forty patients participated in the study; 19 patients were assigned to the Atorvastatin group as well as 21 patients to the placebo group. For assessing negative signs, we used Scale for the Assessment of Negative Symptoms (SANS) in weeks 1st, 3nd, 4th, and 6th. Moreover, patients were randomly assigned to treatment groups with Risperidone (6 mg/day) plus 20 mg Atorvastatin or with Risperidone (6 mg/day) plus placebo. Mean scores of Scale for the Assessment of Negative Symptoms (SANS) decreased during the treatment but there was no significant difference between the mean scores of two groups. The result of this trial suggested that Atorvastatin can be effective in reducing negative sign in schizophrenia although further studies seem to be needed.

The aim of this study was to evaluate the benefits, impact, and overall efficacy of tonsillectomy or adenotonsillectomy on quality of life in patients with recurrent, chronic tonsillitis or adenotonsillar hypertrophy before and after surgery in adults and children. A multi-center, observational, retrospective study of all adults and children who had undergone tonsillectomy in adults (14 years or older) and adenotonsillectomy in children for chronic, recurrent tonsillitis or adenotonsillar hypertrophy between September 2003–September 2008 in Ahwaz Imam and Apadana Hospitals. Patients were asked by questionnaire to compare their symptoms 6-months period before and after tonsillectomy or adenotonsillectomy. Outcome measures included the frequency of tonsillitis per year, days off work (or school), doctor visits and feelings of well-being. 812 adults and children were sent a questionnaire regarding their symptoms in the 6 months before and 6 months after surgery. A total of 812 patients (81 adults and 731 children) were enrolled in the study. The age of the patients ranged from 3 to 42 years. In adults group there were 34 men and 47 women. In child group there were 325 boys and 406 girls. The mean age of the children patients was 8.6 years and adults 26.5 years. The mean duration of symptoms was 3.6 years. The mean frequency of tonsillitis per year, days off work (or school), doctor visits decreased postoperatively. We concluded that tonsillectomy in adult and adenotonsillectomy in children is benefit for patients with adenotonsillar hypertrophy and/or recurrent, chronic tonsillitis and results in significant improvement in overall quality of life, physical health and general well-being.

Introduction: Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with various mental and physical problems, which may affect their general health. Previous studies have shown that, general health level in these patients is lower than general population. However, definitive studies comparing the general health between the two groups of patients undergoing hemodialysis and kidney transplant recipients have not been done, yet. Objectives: In this study, we aimed to compare the general health between the two groups of chronic hemodialysis patients and kidney transplant recipients. Methods and Patients: This investigation was a cross-sectional descriptive-analytic study that has been conducted on 31 hemodialysis and 33 kidney transplant patients in two university hospitals of Ahvaz, Iran. Data were collected through a general health questionnaire (GHQ-28) and they were analyzed with SPSS software. Results: The mean score of general health was 28.8 and 27.57 in hemodialysis and kidney transplant patients, respectively. There was no statistically significant difference between the two groups, (p =0.7). Also, anxiety, serious depression, physical symptoms and social function were not significantly different between the two groups (p>0.5). Conclusion: In this study, no difference of general health level between hemodialysis and kidney transplantation was observed.

Obsessive-compulsive disorder (OCD) is a chronic disorder with unknown etiology. Failure in OCD treatmentcompulsive is common and finding effective augmentations in treatment of OCD will benefit patients. Antipsychotic augmentation is a common strategy for treatment resistant OCD. This trial evaluated the efficacy of adding aripiprazole in patients whose OCD was insufficiently responsive to an adequate SSRI treatment.Thirty-nine adult outpatients, who met the DSM-IV-TR criteria for OCD and had treatment resistant OCD were evaluated in a double-blind randomized clinical trial. The patients received either aripiprazole 10 mg/day or placebo, for 12 weeks. Data were analyzed using intention-to-treat analysis with last observation carried forward. All statistical tests were two-sided, and were considered statistically significant at P0.05.A significant reduction in total scores of Y-BOCS (P0.0001) was found in the aripiprazole group. Aripiprazole was generally well tolerated. There was no significant difference between the two groups in terms of observed side effects.Results of the present study indicate that aripiprazole could be an effective augmentation medicine in treatment resistant OCD.

Objective Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric condition. Many herbs with psychotropic effects exist which can have fewer side effects compared to more conventional medications. Valeriana Officinalis L. is a well-known medicinal plant with a long history of usage in the world with an effect on GABA. This plant is reported to be safe on humans. Our objective in this study was to compare the efficacy of the extract of Valeriana Officinalis L. with placebo in the treatment of OCD. Methods The study was an 8-week pilot double-blind randomized trial. Thirty-one adult outpatients who met the DSM-IV-TR criteria for OCD based on the structured clinical interview participated in the trial. In this double-blind and randomized trial, patients were randomly assigned to receive either capsule of the extract (765 mg/day) or placebo (30 mg/day) for 8 weeks. Results The results showed significant difference between the extract and placebo in the end of treatment (P=0.000). Somnolence was the only significant difference between the two groups in terms of observed side effects (P=0.02). Conclusion The results suggest that Valeriana Officinalis L. has some antiobsessive and compulsive effects. However, further studies are needed to confirm these findings. Psychiatrists often find that many patients cannot tolerate the side effects of psychiatry medicine Valeriana Officinalis L. is a well-known medicinal plant with a long history of usage in world with effect on GABA.The results showed significant difference between the extract and placebo in the treatment of OCD. There was also no significant difference between the two groups in terms of observed side effects.

Obsessive–compulsive disorder is a common neuropsychiatric condition. Although a variety of pharmaceutical agents is available for its treatment, psychiatrists have found that many patients cannot tolerate the side effects, do not respond to treatment adequately, and may finally discontinue their treatment. However, augmentation strategies have been shown to have some benefits in the treatment of OCD. These include reducing both the overall cost of treatment and the side effects. The purpose of this study was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of OCD in an 8-week, double-blind, placebo controlled trial. To this end, 25 patients were assigned to a study group and were given fluoxetine 20 mg/day plus celecoxib 400 mg/day (200 mg BID). The control group included 25 patients who were given fluoxetine 20 mg/day plus placebo. Both protocols significantly lowered scores on the Yale-Brown Obsessive-Compulsive Scale over the trial period. The combination of fluoxetine and celecoxib decreased the symptoms of obsessions and compulsions significantly more than fluoxetine plus placebo. The results of this study suggest that celecoxib can be an effective adjuvant agent in the management of patients with OCD; therefore, anti-inflammatory therapies should be further investigated.

Obsessive-Compulsive Disorder (OCD) is a common neuropsychiatric condition. Although a variety of pharmaceutical agents is available for the treatment of OCD, psychiatrists often find that many patients cannot tolerate the side effects of these medications; do not respond properly to the treatment; or the medications lose their effectiveness after a period of treatment. Herbal medicine can be a solution to some of these problems. In fact many herbs with psychotropic effects exist which can have fewer side effects. They can provide an alternative treatment or be used to enhance the effectiveness of conventional anti-obsessive and compulsive symptoms. Silybum marianum (L.) Gaertn. is a well-known medicinal plant with a long history of usage in Iran. This plant is reported to be safe on humans. Our objective in this study was to compare the efficacy of the extract of S.marianum (L.) with fluoxetine in the treatment of OCD. The study was an 8-week pilot double-blind randomized trial. Thirty five adult outpatients who met the DSM-IV-TR criteria for OCD based on the structured clinical interview participated in the trial. The minimum score of Yale-Brown Scale for OCD was 21 for all patients. In this double-blind and randomized trial, patients were randomly assigned to receive either capsule of the extract (600 mg/day) or fluoxetine (30 mg/day) for 8 weeks. The results showed no significant difference between the extract and fluoxetine in the treatment of OCD. There was also no significant difference between the two groups in terms of observed side effects.