Tehran University Medical Journal

Background: Multiple sclerosis (MS) is one of the most common chronic diseases creating major psychological challenges. Hence, the purpose of this study was to investigate the effectiveness of cognitive-behavioral therapy (CBT) on mental toughness and life expectancy of MS patients.
Methods: The design of this quasi-experimental study has been with pre-test, post-test and follow-up with control group that was performed in Zahedan MS community, Iran, from September to November 2016. The sample of the study was selected voluntarily from 30 MS patients which were randomly divided into two experimental and control groups. Among 200 patients, 80 patients had the required qualifications to participate in the study and 38 patients volunteered to enter the study. At last, only 30 patients were selected and put randomly into two experimental and control group. The experimental group received treatment in 8 weekly sessions (90 to 120-minute-long sessions with the classroom task and homework and group discussion) but the control group did not go under such treatment. The research instrument being used in this study was Halajian life expectancy questionnaire and mental toughness questionnaire (MTQ-48).
Results: For the groups to be homogeneous in age and the level of education, T-test and chi-squared test were used respectively, which did not show a meaningful difference between experimental and control group. The analysis of covariance showed that cognitive-behavioral therapy (CBT) group has resulted in meaningful increase in mental toughness and life expectancy of patients. The results showed the average of mental toughness to be 1.05 in for the experimental group in the pre-test, 1.24 in the post-test, 1.21 in the follow-up and the average of life expectancy 4.56 before treatment, 7.20 after treatment and 7.01 in the follow-up (P<0.001).
Conclusion: Practicing group cognitive-behavioral therapy in the process of MS patients’ treatment led to the increase in their mental toughness and life expectancy.
 

Background: Changing the mental structure of students and identifying creativity inhibitors are essential for academic survival and the pursuit of innovation. This study aimed to identify the inhibitory cognitive factors in medical students.
Methods: This study was a directional qualitative content analysis that conducted based on scientific literature review and opinions of experts in a semiformal expert panel by using semi-structured interviews ranging from 20 to 70 minutes from February 2015 to October 2016. Seventeen talented students were interviewed and conversations were recorded with a digital voice recorder at the Exceptional Talent Development Center (ETDC). The extraction and content analysis was continuously done by listening and writing through several times. The students were in various medical disciplines, and most of them were first rank students in scientific performance and they were collaborating with ETDC.
Results: The inhibition variables of creativity were classified in the four main subcategories according to the semantic relationship and after compression, these classes of inhibitory factors included: teacher-related inhibitors, teaching and assessment methods related inhibitors, student barriers and inhibitors of the university's educational system. Finally, 10 codes were extracted from the 4th categories, which were mentioned as inhibitory variables of creativity. The teachers' lack of enthusiasm with the new ideas, the lack of creativity in the academic context and the lack of motivation among the students were the main inhibitors of creativity that were extracted from interviewing with talented students.
Conclusion: In this study, the most important cognitional inhibitory factors in creativity promotion were the inhibitors related to the teacher’s character and his attitude to creativity, methods of teaching and the university environment. Planning for the removal of these barriers in medical students recommended.

Background: For every pregnant woman, it is possible to have a child with chromosomal abnormalities. Although this possibility is not very high, by performing screening tests and considering the mother's background factors, we can largely realize the real extent of this possibility.
Many comorbidities (like high blood pressure, diabetes, and obesity) and high-risk exposures (like alcohol consumption) seem to have an important role in the development of chromosomal abnormalities. This study aimed to determine the predictive factors of a positive first-trimester screening test in the pregnant women.
Methods: This case-control study was done on pregnant women, who were referred to Yas Hospital for their first-trimester screening tests between April 2018 and February 2020. Of those who had positive screening test results, only ones with abnormal biochemical tests, were included in the study regardless of nuchal translucency (NT) examination results and were considered as cases, and the women with normal screening test results were considered as controls.

Results: Out of 98 subjects, 24 (24.5%) had positive rectovaginal culture. Individuals treated with antibiotics based on positive culture results did not show a significant difference in terms of observed pregnancy outcomes compared with the control group. Conclusion: The prevalence of GBS colonization was significantly higher in patients with a history of vaginal discharge than in those without a history. Due to the small number of studies conducted in Iran, it is recommended to conduct studies with a larger sample size in order to explain a more appropriate protocol in terms of effectiveness and economics.

Background: Vitamin D deficiency is common among pregnant women and can lead to maternal and fetal complications during pregnancy. This study was conducted with the aim of investigating the relationship between the mother's vitamin D serum level and the infant's anthropometric indices and neurodevelopment.
Methods: This prospective cohort study was conducted on a group of pregnant women who visited Imam Khomeini Hospital in Tehran from September to March 2020. Demographic information and anthropometric characteristics of the newborn were collected using the medical record. Blood samples were collected at the time of delivery to evaluate the mother's vitamin D status, and serum vitamin D levels were measured using standard laboratory procedures. The neurodevelopment of infants was assessed at the age of 6 months through the Ages and Stages Questionnaires (ASQ). Data analysis included using descriptive statistics to summarize maternal and neonatal characteristics. The relationships between maternal serum vitamin D levels, neonatal anthropometric indicators, and neurodevelopmental outcomes were examined through Spearman's rank correlation and Mann-Whitney U tests.

Results: In total, 123 pregnant women participated in this study, with a mean age of 31.41 years (±5.75). The mean birth weight, height, and head circumference of the neonates were 3208.33 grams (±706.05), 34.32 cm (±3.91), and 50.33 cm (±2.30), respectively. Statistical analysis showed no significant correlations between maternal serum vitamin D levels and the infants' weight (P=0.318), height (P=0.531), or head circumference (P=0.241). Furthermore, there was no significant association between maternal vitamin D levels and any of the assessed neurodevelopmental domains at six months (P > 0.05). Conclusion:  While this study did not find a positive correlation between the mother's vitamin D serum level and the anthropometric indices and neurodevelopmental domains of infants at six months, it is important to interpret these results cautiously due to the study's limitations. Thus, it is advisable to conduct prospective cohort studies with large sample sizes in diverse demographics nationwide.