988368

---

Negative symptoms in schizophrenia are among the important barriers against psychosocial rehabilitation of such patients. Adjunctive drugs can be used for reducing the severity of these symptoms. In this research we studied the efficacy of Clomipramine, Alprazolam, Citalopram, Bromocriptine, Fluoxetine, Nortriptyline, Maprotiline and Fluvoxamine, in this regard. After a primary prevalence survey regarding Negative symptoms, 170 schizophrenic patients were divided into three different groups, and then the aforesaid adjuvant drugs were examined in three double-blind clinical controlled trials. Estimation of negative symptoms by "SANS" were done at the beginning of each trial for the first time and then three weeks later, after prescription of drugs in lower dosage and finally at the end of sixth week, means three weeks after doubling the dosages. The data were analyzed by z and chi-square (X2test) formula. Clomipramine, Alprazolam, Citalopram, Nortriptyline and Maprotiline could reduce the severity of negative symptoms. Their effectiveness in comparing with placebo was statistically remarkable. No important side effect or worsening of positive symptoms was seen in our samples during aforesaid trials. Conservative usage of adjuvant drugs can be an advantageous means for making rehabilitative programs more efficacious than before.

---

Razi Psychiatry Hospital is one of the most important clinical and educational fields with respect to mental health in Iran. It has a long record of service in this regard since the last century. This piece of writing aims to make a concise acquaintance with its different goals, committees, departments, activities and investigational efforts.

---

Objectives: Myotonic Dystrophy type I (DM1) is a dominantly inherited disorder with a multisystemic pattern affecting skeletal muscle, heart, eye, endocrine and central nervous system. DM1 is associated with the expansion and instability of CTG repeat in the 3' untranslated region of the myotonic dystrophy protein kinase (DMPK) gene located on chromosome 19q13.3. The aim of this study was to determine clinical and genetic characteristic of DM1 in Iranian patients. Genotype-phenotype correlation was also assessed in a small group of studied patients.

Methods: Twenty six DM1 patients belonging to seventeen families were analyzed. Clinical assessment was based on the muscular disability rating scale (MDRS) and a sum of symptoms score (SSS). Molecular analysis (PCR and Southern blot) was used to clarify uncertain clinical diagnosis and in order to confirm clinical findings.

Results: There was an inverse and significant correlation between age of onset  and expanded allele  length (P=0.026, tau-b=-0.360) based on Kendall's tau-b correlation coefficient, while there was no significant correlation between age of onset and severity of the clinical symptoms (P<0.05). Also no significant correlation was observed between the two severity scales of the disease (MDRS and SSS) and expanded allele length (P<0.05). Expanded allele length was correlated with hypogonadism (P=0.007) and cognitive impairment (P=0.034).

Discussion: There was no correlation between cataract and endocrine dysfunction with the expansion size in DM1 patients. Generally it seems there is discordant correlation between clinical symptoms and expanded allele length.

---

Objectives: Stroke is a neurological syndrome with sudden onset or gradual destruction of brain vessels, which may take 24 hours or more. Complications of stroke effect in the variation aspects of the individual. According to De Spulveda and Chang’s Studies, disability reduced the effective adjustment. This study aimed to overview the adjustment of stroke patients based on the main concepts of rehabilitation nursing Mauk model.

Methods: In a quasi-experimental one group pre-posttest design study, data was collected in the neurology clinic of Imam Khomeini hospital and stroke patient rehabilitation centers in Tehran (Tabassom). Data collection included demographic and adjustment questionnaires of stroke patients. The intervention included seven sessions as Mauk model, each session with one hour training, for seven patients. Data analysis performed with SPSS software with paired t-test and was compared with previous results.

Results: There were significant differences between the mean scores of patients with stroke adjustment questionnaire in the pre-test-post-test. But in the adjustment sub-scales, except for relationship with wife and Personal adjustment, in other areas, there is no statistically significant difference between the pre and posttest.

Discussion: The results indicated that training has been affected on some aspects of adjustment of stroke patients in order to, as improving functions, complications and its limitations. Nurses can help then with implementing of plans such as patients education in this regard.

---

Objectives:  Stroke is a major event in one's life, and patients will inevitably require the use of coping strategies in order to try to reestablish acceptable life equilibrium. Due to the extensive role that nurses can be active members in the patient's rehabilitation plan, the Mauk model is a model that focuses on stroke patients. For each stage of this model,  Mauk has developed appropriate rehabilitation nursing interventions. This study aimed to analyze the effect of implementation of the Mauk nursing rehabilitation model (Agonizing phase, Fantasy phase, Realizing phase) on the coping strategies of stroke patients.

Methods: This study is a quasi-experimental one-group pre-test-post-test study. The interventions are identified and coping strategies for patients based  on the Mauk model have been trained. Convenience sampling has been done in Imam Khomeini hospital and Tabassom rehabilitation center in 1392. Data collection instruments included a demographic questionnaire and a coping strategies questionnaire for stroke patients. The educational program was implemented in sessions of 45 minutes. The patients’ coping strategies, before and after training, were  assessed. Data was statistically analyzed using
descriptive and inferential tests in SPSS software 16.

Results: The mean score for coping strategies before intervention was 111.42±11.71, and after intervention was 102.14±12.45 (P<0.05). The physical, mental and social dimensions in the coping strategies showed significant differences before and after intervention.

Discussion: Using the rehabilitation program interventions for effectively dealing with stress, changing and unpredictable behavior patterns in chronic patients is an important component of the treatment protocol, and helps deliver an increase in coping strategies for stroke patients.

---

Objectives: Today quality of life is considered as a comprehensive health issue. The paper aims to study the quality of life of the elderly residing in Zahedan, Iran, in 2016. The study is regarding the increasing number of elderly people and the effect of socio-environmental factors on their health. 
Methods: It was a descriptive and correlational study. The sample included 117 elderly people residing in Zahedan city who were recruited by population-based cluster random sampling. Data was collected by Quality of Life questionnaire (SF-36) and analyzed by Pearson correlation coefficient, ANOVA, and t-test using SPSS software, version 19.
Results: The mean score of quality of life was 58.2±6.25. Quality of life of women was significantly lower than that of men (P=0.04). Quality of life scores were associated with marital status; so widowed individuals gained less score than married or single individuals (P=0.048), but the quality of life showed no significant relationship with other demographic variables such as age and educational level (P>0.05).
Discussion: In the study conducted it was found that the quality of life among the elderly was moderate and that the status of social performance was better than their physical health. It was also found that there was no significant relationship between educational level and quality of life. It was found that the quality of life was low, especially in elderly women; hence more attention needs to be paid to them.

---

Objectives: Premature neonates are at greater risk of developmental problems such as cerebral palsy, developmental delays, and hearing and vision problems. The challenge of healthcare professionals who support preterm neonates and their parents is not only ensuring neonates’ survival but also optimizing infant development. Interventions to reduce adverse health outcomes are very important. The present study was focused on exploring the effect of the Creating Opportunities for Parent Empowerment (COPE) schedule on the developmental outcomes of premature infants 
Methods: The randomization process was done using a randomized block design, and neonates were assigned randomly to the treatment (n=20) and control (n=20) groups. Neonates in two groups were matched in gestational age, birth height, head circumference at birth, birth weight, Apgar scores (1 min, 5 min), prematurity, and new Ballard score. So, there was not a significant difference between them at the baseline. In the intervention group, the parents received a COPE schedule in a set of CD’s in conjunction with written instruction and supplemental activities (guidebook). COPE schedule was performed in 5 steps. In the control group, neonates received only routine services and interventions, and the research therapist performed no additional interventions. New Ballard examination was done in all neonates at the time of enrollment, followed by administration of Ages and Stages Questionnaire (ASQ) by an occupational therapist, who was double-blinded for the study, to any available parent (mostly mothers) at 6 months of corrected age. 
Results: The results showed more maturity in “communication”, “gross motor”, “problem-solving”, and “personal-social” in the intervention group, and the observed differences between the two groups in these outcomes were statistically significant (P<0.05).
Discussion: This educational-behavioral intervention program could promote mothers’ knowledge about their neonates and improve the developmental aspects of premature infants during their first months of life.

---

Objectives: Automated Auditory Brainstem Responses (ABR) peak detection is a novel technique to facilitate the measurement of neural synchrony along the auditory pathway through the brainstem. Analyzing the location of the peaks in these signals and the time interval between them may be utilized either for analyzing the hearing process or detecting peripheral and central lesions in the human hearing system.
Methods: In this paper, model-based signal processing is proposed to estimate the effective parameters of ABR signals. In this process, the biological parameters of the signal are assessed by utilizing a Finite Impulse Response (FIR) adaptive filter in which its adaptation procedure is performed based on the correntropy concept. The proposed method is applied on a set of ABR signals recorded in response to three stimuli of /da/, /ba/, and /ga/, and then its performances are compared with an existing state-of-the-art technique. 
Results: The results show that the proposed method can significantly increase the accuracy of estimating the parameters in stable stimulations (/da/, /ba/) for major positive and negative peaks. This improvement is more significant (up to 2-3 times) for /ba/ stimulus and especially in major positive peaks. However, in other peaks, the improvements also occurred in smaller amounts. However, for unstable stimuli (/ga/), no significant improvement was achieved.
Discussion: Increasing the accuracy performance of the proposed method for detecting the stable stimuli (while its performance remains unchanged) for detecting unstable stimuli indicates its effectiveness in automated clinical analysis of ABR signals.