Background and Objective: Alopecia is one of the most common skin disorders that can affect the quality of life (QOL) in patients. Since few studies have simultaneously evaluated the QOL and quality of sleep in patients with alopecia, this study aimed to evaluate these two important factors in patients with different types of hair loss and among demographic variables. Materials and Methods: Using a convenience sampling method, this cross-sectional study was performed on all patients with various types of alopecia referring to the Dermatology Clinic of Rasoul-e-Akram Hospital, Tehran, Iran, in 2016. For data collection, Dermatology Life Quality Index (DLQI), Short Form Health Survey (SF-36), and Pittsburgh Sleep Quality Index (PSQI) questionnaires were used. Results: A total of 70 patients with four types of hair loss, including androgenic alopecia, alopecia areata, telogen effluvium, and discoid lupus erythematosus (DLE) were evaluated. The overall sleep quality score was 5.51 ± 2.93, which was not significantly different in all four patient groups (P > 0.05). The overall DLQI score was 4.40 ± 4.30, which had little effect on the QOL in most patients with alopecia (40.6%). The overall QOL and quality of sleep scores were not significantly correlated with such demographic variables as age, gender, marital status, education, and employment (P > 0.05). The SF-36 questionnaire and DLQI had a significant inverse relationship (r = -0.285, P = 0.026). Conclusion: Our study showed that the quality of sleep and QOL were affected in all four types of patients with alopecia. As a result, attention to quality of sleep and QOL in these patients with any demographic characteristics is important. However, more studies are needed to confirm the results.

Background: A negative attitude toward treatment is a major obstacle to treat bipolar disorder. Objectives: The current study aimed at assessing the reliability and validity of Persian version of drug attitude inventory (DAI-10) in patients with bipolar I disorder and finding its relationship with patients' compliance in order to predict the disorder. Methods: To assess test-retest reliability, 30 outpatients with bipolar I disorder were selected. They were asked to answer the questions at the onset of the study and four to ten days later. Then, the relationship between DAI-10 scores of 82 patients in bipolar disorder patients' follow-up (BDPF) study, and medication possession ratio (MPR) were investigated. The patients were divided into poor and good compliance, and cut off point of the tool was assigned. Positive and negative predictive value of DAI score was also calculated.

: Electroconvulsive therapy (ECT) was first experienced in 1938 and had been conducting without anesthesia for 30 years. In this study, the most common indication for ECT was mood disorder (major depressive disorder and bipolar I disorder). We introduce a patient with a history of COVID-19 and suicide who required emergency ECT. Electroconvulsive therapy can be life-saving in patients with suicide history or catatonic schizophrenia. Health workers are at the front line of the COVID-19 outbreak control and must follow health instructions. Aerosol-producing procedures such as suction in anesthesia for ECT may facilitate the transmission of infectious diseases such as COVID-19. When performing aerosol-producing procedures during the pandemic of novel coronavirus, every patient should be considered suspicious.

Background: Diagnosis of obstructive sleep apnea syndrome (OSAS) is valuable, but it is time-consuming and expensive. Appropriate screening instruments help clinicians select high-risk individuals for further investigations. In the present study, we compared 4 popular instruments used in screening OSAS including Berlin, STOP, STOP-BANG questionnaires, and Epworth Sleepiness Scale (ESS). Methods: A total of 250 individuals, who referred to Sleep Laboratory of Shoorideh Hospital (Tehran, Iran) for polysomnography during May 2015 to November 2015, were recruited for this cross-sectional study. In addition to taking history and physical examination, 4 screening instruments including Berlin, STOP, STOP-BANG questionnaires, and ESS were completed. Diagnosis of OSAS was established using apnea-hypopnea index (AHI) in 3 categories of mild, moderate, and severe. Results: Severe OSAS was diagnosed in 159 (63.6%), moderate OSAS in 43 (17.2%), and mild OSAS in 41 (16.4%) of the participants, moreover, AHI was within normal range in the other 7 (2.8%). To diagnose OSAS with any severity, Berlin questionnaire was a preferable instrument, with a sensitivity of 79.8% and specificity of 71.4%, considering the cut-point value of 3.5. In addition, in cases of severe OSAS, Berlin questionnaire showed superiority over other instruments, with a sensitivity of 80.5% and specificity of 61.5% using the cut-point value of 3.5. Conclusion: None of the 4 instruments are ideal to predict OSAS. However, considering the simplicity and availability of the instruments, Berlin and STOP-BANG questionnaires had maximum diagnostic values that helped us distinguish OSAS and severe OSAS, respectively.

Background and Objectives: Sleep is a complex biological process. Early insomnia is one of the most common problems among young people. This study aims to investigate the sleep-wake pattern of adolescents in Makran region of Sistan and Baluchestan province, Iran Methods: In this descriptive study, 530 high school students in Makran region of Sistan Baluchestan province (three main cities of Saravan, Iranshahr, Chabahar) in the academic year 2019-2021 were selected by a multi-stage sampling method. They completed a demographic form and the morningness-eveningness questionnaire (MEQ). Data were analyzed in SPSS softwareو version 21 software using independent t-test and ANOVA. Results: The students had moderate circadian rhythm, but sleep preferences were reported in these students mostly among boys. The preferred pattern of students in Iranshahr, Saravan and Chabahar cities was the sleep preference. The wake preference, sleep preference, and peak performance preference of students in Iranshahr were lower than in Saravan and Chabahar cities. Conclusion: The sleep-wake pattern of adolescent students in Makran region of Sistan Baluchestan province is at a moderate level, and all students prefer the sleep pattern over other patterns. It is recommended that the circadian rhythms of these students should be investigated and the necessary measures should be taken to inform their parents and adjust the school and home schedule so that the students have better sleep.

No abstract

Background:  Multiple-choice questions are among the most common written tests. This study aimed to evaluate the faculty members’ability to determine and predict the level of difficulty and discrimination coefficient of multiple-choice tests at Psychiatry Department. Methods: All faculty members at Psychiatry Department of Iran University of Medical Sciences participated in this study. The difficulty and discrimination coefficient of all questions (150 questions) of the mid-term exam of psychiatric residents were measured with both software program and formulas by hand. Then, from each group of questions with high, medium, and low difficulty coefficient, 10 questions (30 questions in total) were selected and provided to faculty members for ranking each question in terms of difficulty and discrimination coefficient. Finally, the correlation between faculty members’ evaluation and standard results was measured by the Spearman’s correlation. To calculate the discrimination coefficient, the number of people who answered a question correctly in the low-score group was subtracted from the high-score group and then the result was divided by the number of people in a group. Results: Twenty-five faculty members participated in this study. There was a significant negative correlation between difficulty level and discrimination coefficient in the whole group (r=-0.196, p=0.045), but this was not the case in the upper and lower groups (r=-0.063, p=0.733). In addition, the correlation between the discrimination coefficient obtained from the formula and the average discrimination coefficient of faculty members was not significant (r=-0.047, p=0.803). Conclusion: It seems that the ability of faculty members to predict the discrimination coefficient and difficulty level of questions is not sufficient.

BACKGROUND Despite the fact that there is theoretical evidence about the association between unconscious defense mechanisms and irritable bowel syndrome (IBS), experimental evidence in this regard is limited. The aim of the present study was to compare the defense mechanisms used by the patients with IBS and a control group, and to investigate the relationship between these mechanisms with the severity of the disease and patients’ quality of life. METHODS Fourty-five patients with IBS (mean age of 37.1 years; 14 males) and 45 controls (mean age of 38.0 years; 13 males) were evaluated. IBS diagnosis was determined based on Rome III criteria and the predominant pattern of the disease was determined based on the patient’s history (13 diarrheapredominant, 16 constipation-predominant, and 16 alternating IBS). Defense Style Questionnaire-40, IBS Severity Scale, and IBS-Quality of Life questionnaire were used.RESULTSThe mean scores of projection, acting-out, somatization, autistic fantasy, passive-aggression, and reaction formation in the IBS group were significantly higher than the control group and the mean scores of humor and anticipation mechanisms were higher in the control group. There was no significant correlation between the score of defense mechanisms and the severity of IBS and the patients’ quality of life.CONCLUSIONThe severity of immature defenses in the IBS group was significantly higher, whereas the severity of mature defenses was higher in the control group. These defenses were not correlated with the severity of IBS. Considering the limited sample size, these relationships need to be more investigated.