Yafteh

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Background: The number of invasive procedures performed in newborns admitted in neonatal units is very high. Nonpharmacologic interventions are valuable alternatives for pain relief during minor procedures in neonates. The aim of this study was to assess the analgesic effect of orally administered glucose with different concentration in neonate using a validated behavioral acute pain rating scale. Materials and methods: A clinical trial study was conducted in 65 neonates. Each infant received 3 treatments with sterile water, 30% Dextrose Solution and 50% solution during consecutive Venus blood sampling and their responses was measured by behavioral acute pain rating scale for neonate (DAN score). This study was done in form of double blind and observer was unaware. Data analysis was perform using SPSS software. Results: Results of this study showed that pain score significantly is lower in neonates that received sweet solution. Mean of pain scores for sterile water, Dextrose 30% and Dextrose 50% solutions, respectively were 8.74, 6.9 and 5.48. There was no statistical relationship between sex, gestational age and weight with pain score. Conclusions: A small dose (0.5ml) of 30% or 50% of oral glucose have an analgesic effect in neonates during Venus blood sampling. This effect is higher in 50% glucose solution and it can be detected by a behavioral pain rating scale.

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Background: The branches of right and left subclavian arteries are important in conducting of blood to spinal cord, posterior cranial fossa, base of the neck, thyroid gland, wall of the thorax and abdomen. The routine use of internal thoracic artery as a conduit in coronary artery bypass grafting surgery requires appreciation of the anatomical variations of these vessels. So far, there is not any report about the variation of subclavian artery and it’s branches in Iran, for this reason this study have been done to see the variations of the subclavian arteries and its branches. Materials and methods: The base of the neck of 40 male cadavers approximately 40-80 years old were dissected bilaterally with appropriate equipments. The specimens were fixed with routine fixative in dissection hall. Findings: In all specimens the left subclavian artery had normal origin but the right subclavian artery in one case originated from the beginning of the arch of aorta and in another one a retroesophageal right subclavian artery was present. We have seen that, the left vertebral artery in 2 cadavers and right vertebral artery in 1 specimen, rose from arch of aorta. This study showed that the variation of thyrocervical and internal thoracic arteries are uncommon. Conclusion: For preserving the integrity of important structures in the base of the neck, especially thyroid gland in surgery, this vascular variations are presented to physicians to keep in mind that such variations exists during diagnostic investigation and surgical procedures of the neck. An awareness of these variations is important, because this area in used for diagnostic and surgical procedures.

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Background: Mucocele of the appendix is a clinical term for a pseudocyst that is associated with mucus extravasation into the surrounding medium. This may be the result of neoplastic causes. Case Presentation: Two cases of the mucocele of the appendix at Golestan hospital of Ahwaz were found. The first case was a 70 years lady who complained of the pain in lower part of her abdomen since 1 year ago. The patient suffered from constipation. In physical examination, there was fullness in RLQ and right flank. In complementary investigation, sonography showed a cystic mass with solid component in lower pole of right kidney with the diagnosis of mesenteric and hydatic cyst. In Abdominal CT scanning, there was duplication cyst and mesenteric cyst. The Second case was a 38 years man with chief compliant of abdominal pain since 5 days ago that was localized in RLQ with anorexia. In complementary investigation there was leukocytosis (11000 cells/µl). In sonographic examination, there was a cystic mass in RLQ with the diagnosis of appendiceal abscess. The patients were underwent operation. In both cases we observed mucocele of appendix. The pathologic report was also indicative of benign mucocele of appendix. Conclusion: appendiceal malignancies are extremely rare. The two above-mentioned new cases presented with abdominal cystic mass and abdominal pain. A mucocele of benign etiology is adequately treated by a simple appendectomy.

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Background: Post partum psychosis is a mood disorder which starts 2 or 3 weeks after delivery. In acute form, the symptoms of this disorder are so obvious that the sick mother doesn’t want to take care of her child in some cases, she wants to hurt either the child or herself or both (the child & the mother). It seems that there are some psychosocial factors that cause this problem to occur. Material and methods: The present study aims to survey the effect of social, cultural, economical and related factors on the post partum psychosis in 2003-2005. The study was cross sectional. The study included all the women who immediately return to the one of the clinical and educational centers for psychosis symptoms. All the women came to the clinics with one of the symptoms of mood disorder 3 to 12 weeks after their delivery. They were examined by psychiatrists. They were also interviewed by clinical psychologists. Those who recognized as having acute depression and psychotic symptoms were included in the study. The data were analyzed using “SPSS” software. Results: Most of the subjects were in the range of 20-30 years old. They were housewives. In most case, they gave birth to a female newborn and the delivery was done in a normal way. Most of the patients declared that they had unplanned pregnancy. 29.6% of the patients had mental disease background. 9.1% had major depression, 5.6% had dysthymic disorder. 18.5% of the subjects had physical disease like UTI, hyper thyroid and seizure. Conclusion: There was a significant relationship between post partum psychosis and variables such as age, education, job, and disease background, number of delivery and lack of child acceptance. It is suggested that for prevention of post partum psychosis, there should be a very suitable situation for pregnant mothers. Moreover by planning and designing educational programs, we could provide the proper background for child birth in the family.

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Background: Plastic deformity is a fixed deformity of bones after application of force which is in contrast to elastic deformity, so it remains unchanged. It is a rare condition and is seen more commonly in upper extremity (forearm). Inability to recognize it causes limitation of motion and remaining of angular deformity. It occurs more commonly in children because of flexibility of their bones. For treatment of this deformity, at first we must aware to recognize this condition then it should be corrected before correction of fractured bone and after that it must be controlled to 2-3 weeks by weekly radiographs to ensure that deformity is corrected fully. Case report: An eight years old boy with leg fracture due to motorcycle accident referred to emergency department. At first we tried to reduce it by closed method but we were unsuccessful, so we treat it with open reduction and internal fixation. Conclusion: Always keep in mind one of the reasons of closed reduction failure, especially in extremities with two parallel bones (like leg and forearm) is plastic deformity of one bone which means constant change in the shape of the bone which interferes with reduction of the second .We should be aware of operation necessity.

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Saki M¹, Safa M², Jazayeri H³, Asti P⁴, Jariani M², Saki M⁵

1. Instructor, Department of psychology, Faculty of nursing and midwifery, Lorestan University of medical sciences

2. Assistant professor, Department of psychology, Faculty of medicine, Lorestan University of medical sciences

3. Master of science, psychology

4. Instructor, Department of midwifery, Faculty of nursing and midwifery, Lorestan University of medical sciences

5. Instructor, Department of pediatrics, Faculty of health, Lorestan University of medical sciences

Abstract

Background: Family environment is the first place in which child may recognize his potentialities and talents and tries to raise those potentialities. If family fails to provide the child with an appropriate situation to grow and evolve his character, he may develop the basis of social delinquencies.All kinds of crimes may form in the family. Studies show family as a social factor and character as an inner factor can create the grounds for the criminal behavior. The present study tries to investigate the psychological and personality factors learning people to run away from their homes.

Materials and methods: The present survey is a descriptive- analytical study. The cases were selected by census method. All the women and girls who were kept in the intervening centers were studied during one year. A two-section questionnaire containing demographic, family characteristics as well as the standard questionnaire named SCL 90 were used for data collection. The questionnaire was completed using clinical interview. The data was analyzed using SPSS software.

Results: Among 73 cases participated in the study, 37.5% was under 20 years, 91.7% was housewife and 58.3% had elementary education, 58 % was of those who migrated from villages to towns. Most of them were among the mid born of the families. 36% had imprisonment, 30.6% had substance abuse, and 63.9% was among those who had previous crime records. 46.3% of the married ones mentioned compulsory marriage as the cause of leaving their homes. 41.7% had a bad economic situation. 25% of the children were criminal. 54.2% had challenges and disputes with parents which they mentioned this as the cause of leaving their homes. 46.3% of the participants had Phobia, 64.3% had psychotism, 83.5% had hypochondriasis, 90.4% had obsessive compulsive, and 82.8% had depression, 84.9 % anxiety, 68.6% was aggressive, 41% paranoid and 56.2% had supportive problems.

Conclusion: There is a significant relationship between leaving homes and variables such as challenges with parents, compulsory marriages, parents’ education and unemployment. Also there is a significant relationship between personal and emotional characteristics and running away from home.

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Safa M¹, Mohmoudi GhA², Soultani far M³, Saki M⁴, Farhadi A⁵

1. Assistant professor, Department of psychology, Faculty of medicine, Lorestan University of medical sciences

2. Assistant professor, Department of forensic medicine, Faculty of medicine, Lorestan University of medical sciences

3. General practitioner

4. Instructor, Department of nursing, Faculty of nursing and midwifery, LorestanUniversity of medical sciences

5. Instructor, Department of psychology and health, Faculty of medicine, LorestanUniversity of medical sciences

Abstract

Background: Suicide is one of the social problem which brings about death of active characters in the society and it is considered as a remarkable problem for health. Suicide is the number 9 factor of death in America. Nearly 85 cases of suicide happen per day within 20 minutes each. Drug abuse is of psychiatric urgency and it is regarded as an important variable related to suicide.

Materials and methods: All clients who committed suicide and were hospitalized in Shohadaye Ashayer hospital were included in this study ( from July 83 to January 83 ).

Results: The results showed that there is a significant relationship between drug abuse and chronic organic disease among patients with suicide intention . Among 67 suicide cases, 55.2% were male and 44.8% were female. The highest frequency (55.2%) covered the age group (19–26) .Most of the cases were unmarried. 47.8% were unemployed . 79.1 % were city residents and 21.9 % were living in the country. 53.7% of the participants had elementary school and junior high school education .

Conclusion: The study was to determine the frequency of personal, familial psychological characteristics and drug abuse among clients with suicide. The results emphasize on the preventive effect of the level of education in this Province. The results also showed that the more the number of people in the family, the more suicide cases in the family. Further more among married ones, cases with one or two children were prominent.

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Nazari H¹, Saki M², Sohrabi P³, Tarrahi MJ⁴, Movahedi M⁵, Badrizadeh A⁶, Baqeri Kh⁷

1. Assistant Professor, Department of Psychiatry, Faculty of Medicine, Lorestan University of Medical Sciences

2. Instructor, Department of Psychiatry, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences

3. General Practitioner, Neurology and Psychoiatry Hospital, Khorramabad

4. Instructor, Department of Epidemiology and Statistics, Faculty of Medicine, Lorestan University of Medical Sciences

5. Assistant Professor, Department of Epidemiology, Faculty of Medicine, Lorestan University of Medical Sciences

6. B.Sc of Nursing, Staff Member of Research and Technology Office, Lorestan University of Medical Sciences

7. B.Sc of Nursing, Psychology hospital

Abstract

Background: Major depressive disorder (MDD) is one of the most common mental disorders all over the world. An effective treatment preserves an acceptable level of function in the affected patients. Different drugs are used in the treatment of MDD, and each of them has specific therapeutic and adverse effects. Recently, SSRI drugs are used in the treatment of this disorder, and yet there is not enough study about them. Thus, we decided to compare the effectiveness and adverse effects of Nortriptyline with that of Citalopram in MDD.

Materials and methods: In this double-blinded clinical trial, 80 MMD (DSM-IV-TR) patients, who that not any other mental, substance and organic disorders were selected. Samples were randomly assigned into two groups which were treated with Nortriptyline or Citalopram. Efficacy and adverse effects were evaluated at 2, 4, 6, 8 and 12 weeks after the treatment. Data were analyzed by SPSS software.

Results: Efficacy was similar in two groups, and no significant differences between the two groups were observed in the mean scores. The comparison of adverse effects between the two groups showed a significant difference in the hypersomnia, dry mouth, anorexia and nausea. There was not a significant difference between the two groups in the sexual dysfunction, insomnia headache, tremor, vertigo, obesity, diarrhea, vomiting and abdominal pain.

Conclusion: Tricycles and SSRI drugs have an equal efficacy in the treatment of MDD. But they have different adverse effect profiles, thus they must be administrated with an attention to their adverse effects.

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Qasemi F1, Valizadeh F1, Toulabi T2, Saki M3 1. Instructor, Department of Children, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 2. Instructor, Department of Internal Surgery, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 3. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences Abstract Background: Family has an important role on childrens personality and preparing them for future. Corporal punishment involves the application of some forms of physical pain in response to undesirable behavior for the purpose of correction or control of the childs behavior. Corporal punishment constitutes a human-rights violation and has physical and mental health consequences for children. Materials and methods: This survey was conducted to detect and compare some behavioral disorders due to parental corporal punishment in school age children. This case-control trial deals with 240, primary school children aged 7-12 years old. These subjects were selected through cluster randomized sampling in Korramabad and divided into two (case and control) groups. Instruments for measuring data consisted of three components: 1) a questionnaire on demographic information, 2) a questionnaire on corporal punishment and, 3) a rating scale about behavioral disorder such as verbal and behavioral aggression, withdrawal, and cooperation in school. Data were analyzed by SPSS ver11. Results: Results indicated that in 92.6% of cases the corporal punishment method was slapping. Significant differences were found between the two groups in terms of mothers educational level (p=0.001), mothers job (p=0.004), mothers child-birth number (p=0.024), verbal aggression (p=0.001), behavioral aggression (p=0.001), withdrawal (p=0.05), and cooperation (p=0.001). Conclusion: Results indicated that housekeeper mothers and mothers with low educational level use more corporal punishment and behavioral disorders were more in school age children who had suffered parental corporal punishment. Based on the results of this study, educating parents and families about results of corporal punishment in young children is suggested. Public health actions including training programs on alternative methods of discipline are also suggested.

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Safa M1, Saki M2, Matin-rohani Sh3 1. Assistant Professor, Department of psychiatry, Faculty of Medicine, Lorestan University of Medical Sciences 2. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 3. GP Abstract Background: Coronary heart disease as a reason for mortality is occurring with psychiatric disorders. This descriptive- analytic study aims at assess mental health of patients who need to perform coronary angiography and its relationship with drug abuse. Materials and methods: Sampling was done by census and data was collected using General Health Questionnaire and clinical interview. At first, all the patients who needed coronary angiography completed questionnaire and after calculating the patients’ score, psychiatrist visited the patients with score more than 28. Results: Data showed that from 200 patients surveyed in this search, 49.5 percent had mental disorders specially physical signs, distress and sleep disorders, but they were healthy from view point of social functioning and depression. Also, drug abuse is known as an effective factor of mental disorder and rises the chance of mental disorders, so the drug abusers are susceptible to mental disorders 7 times more than the patients with no drug abuse. Conclusion: This study proved that being married plays a positive role on mental health, so the risk of mental disorders in divorcees and widows are 20 times greater than in married patients. Consequently we prefer that patient with coronary heart disease who needs angiography get psychiatric cares and consultation.

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Saki M¹, Mohsenzade A², Tarrahi MJ³, Saki M4 1. Instructor, Department of Health, Faculty of Health, Lorestan University of Medical Sciences 2. Assistant Professor, Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences 3. Instructor, Department of Health, Faculty of Health, Lorestan University of Medical Sciences 4. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences Abstract Background: Neonates expose to painful procedures even when come to birth healthy. Pain reduction is a definite right for each living creature during medical intervention. It has bee proved by many studies that painful experiences during babyhood, besides the early complications such as tachycardia, tachypnea and increase of body metabolic needs, can intensify individual’s physiologic and behavioral responses to pain in next stages of life. The purpose of this study is to examine the efficacy of supine, prone and kangaroo care (KC) positions on diminishing the pain response of term neonates during acute pain of venopuncture. Materials and methods: In this clinical trial study, 50 healthy neonates between 39 to 40 weeks of gestational age with physiologic icter requiring bilirubin estimation were assigned to receive a venous puncture and assessed for their responses to the pain of venopuncture performed in a standard manner. Blood sampling was performed by an expert nurse in charge of each neonate in three positions including supine, kangaroo care (KC) at a 24-hour interval during 3 days. The place and condition of sampling were equal for all neonates. Pain responses were assessed using DAN scale, then the gathered data were analyzed using SPSS software and statistical tests. Results: According to the obtained results there was no significant differences between pain score in supine and prone positions. Limb movements score in supine position was significantly higher than two other positions (P<0.001) and vocal expression score in KC position was significantly higher than two other positions. In supine position, pain profile score was significantly lower in subjects with higher weight and there was same result in KC position. Conclusion: Based on the results, KC position seems to effectively decrease pain during venopuncture and other painful procedures, but it is suggested to do similar studies to complete the outcome of the present study.

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Safa M1, Mohammadi MR2, Saki M3, Delfan B4, Tarrahi MJ5, Rouhandeh M6 1. Assistant Professor, Department of psychiatry, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran 2. GP, Khorramabad, Iran 3. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran 4. Associate Professor, Department of Pharmacology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran 5. Instructor, Department of Epidemiology, Faculty of Health, Lorestan University of Medical Sciences, Khorramabad, Iran 6. BSc in Nursing, Khorramabad, Iran Abstract Background: Chronic mental disorders are among the problems in psychiatrics. Atypical anti psychotic drugs are new effective medications to treat these disorders. Unfortunately these drugs lead to side effects such as increase in blood glocuse, weight gain and edema. This study aims to investigate adverse effects of Olanzapine and Rispridone on lipid level and blood glocuse and other complications in patients with psychotic disorders. Materials and methods: This clinical trial-double blinded study, patients with psychotic disorders were randomly categorized into two groups. Group one treated with Olanzapine and other with Rispridone. All the subjects were initially assessed for blood sugar and lipids, and in the case of normal, they were randomly assigned to two groups in a double- blinded method to be treated with Olanzapine or Risperidone. Blood sugar and lipids tests were performed for all subjects at the 1st week and 3 months after initiation of therapy. Other complications were assessed too, then the data were analyzed using SPSS software. Results: The results of the study indicated that the levels of cholesterol, triglycerides and blood suger rose significantly at the 1st week and third month after beginning the treatment. Increase of cholesterol and triglyceride in the Olanzapine and Risperidone groups was significant, while blood sugar level showed no significant difference in these two groups. Other side effects including restlessness, impotence, weight again, edema and drowsiness were significantly different between the two groups. Conclusion: Based on the findings of this study and the emphasis of other related studies on the metabolic changes of the body resulting from atypicad antipsychotic drugs, it is suggested that these drugs should be prescribed for high risk patients with great care and cautions.

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Background: The investigation done in recent years have shown considerable prevalence of ecstasy abuse as a drug desirable for the youth. The present study tries to view the high school students knowledge and attitude towards Ecstasy in risky and non- risky areas in Khorramabad city.

Materials and Methods: In this study, a 200 male and female students were selected using random multiphase sampling. A questionnaire with 50 items was used as data gathering tool. The data were analyzed using statistical variance.

Results: The results showed that in risky areas of the city 6.2 % of the subjects had positive attitude towards ecstasy and 45.45 % had highly negative attitude. In non risky areas 2% of the subjects had positive attitude and 8.2 % had highly negative attitude towards ecstasy.

In surveying the degree of knowledge and awareness towards ecstasy,44.29% of the subjects in risky areas had poor knowledge and 7.1% had high level of knowledge.In non risky areas 48.5% had poor knowledge and 42.5% had average and 5% had high level of knowledge towards ecstasy. The analyzed data showed that there was no significant relationship between the students’ attitude and level of knowledge with their parents job, education, sex, age and the number of siblings.There was a significant relationship between students level of knowledge and their school performance while these two variables had no relationship with students attitude.

Conclusion: Based on the obtained findings, it is suggested that responsible bodies improve and enhance the public knowledge of people by the mass media. This matter should be emphasized more in risky areas.

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Background: Depression is one of the most common psychological disorders. Most depressed patients experience multiple recurrences despite the pharmacologic therapy. Many studies have reported that countries with high rates of fish consumption have low rates of depressive disorder. The aim of present study is to evaluate the effect of omega-3 as a complementary treatment on the patients with recurrent unipolar depressive disorder who were receiving maintenant antidepressant therapy.

Materials and Methods: In a clinical trial, eighty patients with a diagnosis of recurrent major depressive disorder were divided into two groups of forty. One group received standard anti-depressive therapy (with SSRIs) and the other received omega-3 in addition to standard therapy. Results: Findings of the study showed that adding omega-3, significantly reduced depression score and increased patients’ function.

Conclusion: Results showed that omega-3 can be added to the standard treatment in patients with recurrent and refractory depressive disorder as complementary treatment.

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Background: A large number of students tend to carry school backpacks. Carring heavy backpacks is increasingly putting the students at risk, and may cause long term damage to their growing body. This survey was conducted on Khorramabad primary school students to determine if their backpacks are too heavy and the methods of packing and wearing them, and history of back pain among them.

Materials and Methods: This Cross – sectional Study included taking 1009 students, Weighting them and their backpacks, While asking about Packing and wearing methods and the history of back pain.

Results: The results showed that backpacks were heavy in 57/8% of the cases. 24/6% had history of back pain and there were significant relationships between the carrying heavy backpacks and wearing them improperly, and the history of back pain.

Conclusion: The main conclusion in this study was that many students are carrying heavy backpacks and packing and wearing them improperly which put them at risk of back pain and other complications.

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Background: Social damage is one of the problems which destroys the active manpower and young population in the country and also prevents social development.

Family is the first environment in which social ground for the child is provided.Any dispute, controversy or inferiority complex in the family may lead to wrong doings

The present study aims at the effective family and personality factors on felony in felon adolescents kept in Khorramabad bouse of correction.

Materials and Methods: This descriptive- analytic study was carried out on all of the adolescents in Khorramabad house of correction as case group selected using census random sampling and high school students as control group selected by cluster random sampling. Data gathering tool was a 2-part questionnaire including demographic information and standard SCL 90 questionnaire.

Results: Results showed that there is a significant relationship between the place of residence, failure in school program, economic status of the family, parents presence, fathers job and education, mothers job and education, parents inter personal relationship and family conflicting.

The results also showed that aggression, anxiety, depression, somatic complain, obsessive compulsive, inter personality sensitivity, Psychotic, paranoid and phobia had a significant difference in the case and control groups.

Conclusion: Regarding the fact that family environment is considered as the most important educative factor and no social damage has not occurred out of family influence, so no society can claim to be healthy unless to have healthy families.

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Appendix carcinoid tumors are of rare cases. Their commonest place is in digestive system in appendix intensine and rectom respectively. They have no symptoms and they are detected along with laparotomy or inflation in appendix. The aim of the present study was to determine the frequency of carcinoid tumor in appendix and its prognosis in a period of 3 to 8 years in Shohada hospital in khorramabad. Materials and Methods: The present study is a cross – sectional which was carried out on 2845 patients with appendectomy in Shohada hospital in khorramabad in 2003-2006. The needed data were collected through a questionnaire from the pationts files who had the tumor operation in the hospital. The data were analyzed using descriptive statistics. Then the patients prognosis was determind. Results: The results showed that among all the cases with tumors, three out of five were carcdinoids, one was mucucell, one was mucucell associated lymphoid tissue. In adition to these cases, one case was colon carcinoid related to metastatic΄s deodenom, but no adenocarcinoma tumor was observed. After pathological analysis, the results showed that none of the patients with carcinoid appendix needed any treatment in 3-8 years follow up program and there was no recurrent growth for the disease. Conclusion: As carcinoid in appendix can be malignant and spread over other tissues and causes short life, it needs special care and follow and the patients should be referred to the specialist to complete treatment. Carcinoid appendix should be considerd as a neoplasm since it has the special power of spreading and metastasis over distant tissues.

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Suicide is liable for one percent of mortality and is one of the eight major causes of mortality. One of the planning factors of suicide is the psychiatric disorders, and two Internalizing and Externalizing problems have been found as the most significant psychiatric problems in suicide attempters. In this study, the prevalence of Internalizing and Externalizing in suicide attempters and their relationship with times number of suicide attempts and chance of suicide attempt in future were studied. Materials and Methods: In this study, 200 patients hospitalized for suicide were studied and a questionnaire was used to determine the prevalence of Internalizing and Externalizing among them. Also, times number of suicide attempt and chance of suicide reattempt in each patient were accounted. And their mean was compared between Internalizing and Externalizing groups and normal group. Results: Briefly, of 200 studied patients, 120 cases (60%) were inclined to Externalizing, 70 cases (35%) were inclined to Internalizing and 10 cases (5%) were normal. The times number of suicide attempt had no significant difference in Internalizing and Externalizing, and also in normal group. Though its mean was further in Externalizing group than in Internalizing group and further in the both groups than in normal group. The chance of suicide reattempt was significantly higher in Externalizing group than in Internalizing and higher in both groups than the normal group. Conclusion: Internalizing and Externalizing are commonly associated with the risk of suicide attempt. The risk of suicide attempt in Externalizing individuals is higher than in Internalizing people.

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High blood pressure is a disorder associated with stress. In numerous people, behavioral strategies or stress management interventions such as relaxation and massage are useful in control of their response to stress and consequently , the reduction of blood pressure. Regarding to more effects of combinational intervention therapy based on behavioral methods rather than application of pharmacotherapy , it is expected that the use of these methods including massage is more effective in decreasing blood pressure. Materials and Methods: In this quasi-experimental,based on pilot study, 90 hypertensive patients were chosen and their blood pressure and radial pulse were measured in 20 sessions during 5 weeks before and after back massage on Saturdays and Tuesdays and without massage on Sundays and Wednesdays . Data were collected by a demographic questionnaire and check list to record blood pressure and pulse, then these data were analyzed by STATA software. Results: The results showed that there was a decrease in the systolic and diastolic blood pressure and radial pulse by 6.3 and 3.9 mmHg and 2.9 beats per minute (p=0.0001). Conclusion: The results revealed that massage had decreasing effect on blood pressure and pulse of the primary hypertensive patients . Use of stress management interventions such as massage is an acceptable, simple and teachable method to families for better control of the disease.

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Bipolar disorder type I is one of the most disturbing psychiatric syndromes .It is basically treated by stablizing mood medicienes , psycho- social intervention and, in accute cases ,Electro convulsive therapy . As resources with Omega 3 have been considered effective in treatment of many diseases as well as mental disorders, we decided to study effect of Omega 3, compared to Feluvoxamine, on the treatment of depression in bipolar patients referring to. psychiatric clinic Materials and Methods:The present study which is a clinical trial , carried out on 80 patients selected using double blind randomization in two groups :case and cotrol .The case group Took Feluvoxamine and Omega3 tablets and the control group received only Feluvoxamine . All the subjects were given Hamilton Rating Scale as well as psychiatric clinical interview from the start of the study and after the second ,fourth eighth and twelfth weeks . The data were analyzed after they were collected . Results:The results of the study showed that the mean of the marks in Hamilton Depression Scale in both groups under study in the start of the study and in 2nd, 4th, 8th and 12th weeks was decreased significantly and the patients ‘performances were improved . The statestical Repeated Measures showed a significant difference in mean of depression marks in both groups before the treatment program and in weeks 2 , 4 , 8 and 12 . Conclusion :Considering research findings related to the effect of Omega3 and its harmlessness , it is suggested that Omega3 can be prescribed with other anti depressive medicines