Background: After a stroke, up to 20% of patients suffer from aphasia. The preferred treatment for stroke-related aphasia (SRA) is regular speech and language training (SLT). In the present study, we investigated to what extent adjuvant repetitive transcranial magnetic stimulation (rTMS) might enhance recovery. While there is growing evidence of the positive effect of adjuvant rTMS on aphasia, no study has yet been based on an Iranian sample. Method: A total of 12 patients (mean age: 55 years; right-handed; 7 women) underwent treatment for SRA 1 month after stroke. The standard treatment consisted of regular 45-min SLT sessions 5 times a week for 2 consecutive weeks. Additionally, patients were randomly assigned either to adjuvant rTMS (5 times a week for 30 min) or to a sham condition (5 times a week for 30 min). At baseline and after 2 weeks of intervention, the degree of aphasia was assessed with the Farsi version of the Western Aphasia Battery. rTMS was applied to the inferior posterior frontal gyrus of the right hemisphere. Results: Speech and language improved over time, but more so in the rTMS than in the sham condition. Large effect sizes were observed for content, fluency, and the aphasia quotient; medium effect sizes were observed for command comprehension and repetition, while effect sizes were small for auditory comprehension and naming. Conclusions: Among patients with SRA, compared to a sham condition, adjuvant rTMS improved speech and language skills. The present results add to the accumulating evidence that rTMS as a neuromodulation technique has the capacity to enhance the effect of conventional SLT.
Given that antidepressants (ADs) work slowly, there is interest in means to accelerate their therapeutic effect and to reduce side effects. In this regard, thiamine (vitamin B) is attracting growing interest. Thiamine is an essential nutrient, while thiamine deficiency leads to a broad variety of disorders including irritability and symptoms of depression. Here, we tested the hypothesis that adjuvant thiamine would reduce depression, compared to placebo. A total of 51 inpatients (mean age: 35.2 years; 53 % females) with MDD (Hamilton Depression Rating Scale score (HDRS) at baseline: >24) took part in the study. A standardized treatment with SSRI was introduced and kept at therapeutic levels throughout the study. Patients were randomly assigned either to the thiamine or the placebo condition. Experts rated (HDRS) symptoms of depression at baseline, and after 3, 6, and 12 weeks (end of the study). Between baseline and the end of the study, depression had reduced in both groups. Compared to placebo, adjuvant thiamine improved symptoms of depression after 6 week of treatment, and improvements remained fairly stable until the end of the study, though mean differences at week 12 were not statistically significant anymore. No adverse side effects were reported in either group. Results suggest that among younger patients with MDD adjuvant thiamine alleviated symptoms of depression faster compared to placebo. Importantly, improvements were observed within 6 weeks of initiation of treatment. Thus, thiamine might have the potential to counteract the time lag in the antidepressant effects of ADs.
Background: Substance abuse is one of the main health challenges that lead to addiction and physical, psychological, and social issues. It can also eliminate the foundation of family and community. Objectives: The present study aimed at determining the frequency of experience of at least once abuse of addictive drugs in high school students in Hamedan, Iran. Materials and Methods: The present cross-sectional study was carried out in 2015 in high schools of Hamedan City. A self-report questionnaire was used to identify the number of cigarette smokers and other addictive substances abusers. The data were analyzed, using SPSS V. 14. Results: Out of 800 distributed questionnaires, 29 questionnaires were incomplete. In total, 18% of the students had abused addictive substances at least once. The most common substances were hookah, cigarette, and alcohol. Independent risk factors for substance abuse experience included male gender, non-governmental and vocational schools, mathematics major, history of the educational failure, an average of less than 17.00 GPA, unemployment of a student's father, and student's employment other than education. Conclusion: The prevalence of hashish (cannabis) abuse and anabolic-androgenic steroids is high in Iran and codeine is the most commonly used substance in the non-prescribed groups.
Introduction: Occurrence of pleural effusion occurs in both hospitalized and outpatients. Recognizing the most important and common causes of pleural effusion in each region and in different communities can be a useful step in early and timely diagnosis of the causes and, consequently, timely treatment and thus reducing the time and burden of diagnostic and therapeutic costs imposed on patients. Methods: In this descriptive cross-sectional study, 407 patients admitted to Sina and Shahid Beheshti hospitals in Hamadan were studied by census. Data were analyzed with SPSS software (ver. 16). Results: From 407 patients with pleural effusion in this study, 262 persons (64.4%) were men and 145 (35.6%) women. There were 244 persons (60%) with exudative pleural effusion, 110 persons (27%) with transudate effusion and 53 persons (13%) with empyema. Out of 244 exudative effusion cases, in 135 cases (55.3%) were recorded pneumonia, 50 cases (20.5%) lung malignancy, 33 cases (13.5%) other malignancies, 13 cases (5.3%) tuberculosis, 7 cases (2.9%) pulmonary thromboemboli and 6 remained cases (2.5%) were other causes. Pneumonia was the most common cause of empyema. Conclusion: According to results of this study, exudative pleural effusion was the most common type of effusions. In all types of pleural effusions, the most common site of involvement was right hemithorax. Identifying common causes of pleural effusions in each region facilitates the initial treatment of pleural effusions until reaching a definitive diagnosis.
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