Avicenna Journal of Neuro Psych Physiology Avicenna Journal of Neuro Psych Physiology Avicenna J Neuro Psych Physio http://www.avicennajnpp.com 2383-2436 2383-2444 10.5812/ajnpp. en jalali 2017 6 26 gregorian 2017 6 26 3 1
en 10.17795/ajnpp-37911 Factors Affecting the Risk of Mental Disorders in Patients With Bipolar Disorder in the West of Iran Factors Affecting the Risk of Mental Disorders in Patients With Bipolar Disorder in the West of Iran research-article research-article Background

Drug addiction, obsessive compulsive disorders (OCD), and other anxiety disorders are the disorders most commonly found in patients with bipolar disorder.

Objectives

The purpose of this study was to identify the factors affecting the risk of drug addiction, obsessive compulsive disorders, and other anxiety disorders in patients with bipolar disorder.

Patients and Methods

In this retrospective cohort study, the medical records of 400 patients with bipolar disorder hospitalized in Hamadan, Iran, between 2008 and 2014 were examined. Patient information, including demographic characteristics and comorbidity, was collected. A data analysis was performed using a separate logistic regression for each disorder. The statistical package used was STATA software version 11. A P-value of less than 0.05 was considered statistically significant.

Results

The mean (SD) age of the patients with bipolar disorder was 34.62 (1.68) years. Of the 400 patients with bipolar disorder, 135 (33.75%) patients had anxiety disorders, 67 (16.8%) patients suffered from drug addiction, and 45 (11%) patients had OCD. An association was established between drug addiction and OCD, and gender (P ≤ 0.05). The ORs of anxiety disorders, drug addiction, and OCD were 1.05 (95% CI = 0.65 - 1.68), 0.26 (95% CI = 0.10 - 0.63), and 2.33 (95% CI = 1.21 - 4.48) for women, and 0.92 (95% CI = 0.52 - 2.13), 3.01 (95% CI = 1.64 - 5.55), and 0.64 (95% CI = 0.25 - 1.62) for the patients who smoked, respectively. In addition, there was no significant association between the different disorders and age, marital status, history of relapse, and history of suicide.

Conclusions

The results showed that there was a greater risk of anxiety disorders with bipolar disorder than other disorders. While women with bipolar disorder were at higher risk of anxiety disorders and OCD, men were at greater risk of drug addiction.

Background

Drug addiction, obsessive compulsive disorders (OCD), and other anxiety disorders are the disorders most commonly found in patients with bipolar disorder.

Objectives

The purpose of this study was to identify the factors affecting the risk of drug addiction, obsessive compulsive disorders, and other anxiety disorders in patients with bipolar disorder.

Patients and Methods

In this retrospective cohort study, the medical records of 400 patients with bipolar disorder hospitalized in Hamadan, Iran, between 2008 and 2014 were examined. Patient information, including demographic characteristics and comorbidity, was collected. A data analysis was performed using a separate logistic regression for each disorder. The statistical package used was STATA software version 11. A P-value of less than 0.05 was considered statistically significant.

Results

The mean (SD) age of the patients with bipolar disorder was 34.62 (1.68) years. Of the 400 patients with bipolar disorder, 135 (33.75%) patients had anxiety disorders, 67 (16.8%) patients suffered from drug addiction, and 45 (11%) patients had OCD. An association was established between drug addiction and OCD, and gender (P ≤ 0.05). The ORs of anxiety disorders, drug addiction, and OCD were 1.05 (95% CI = 0.65 - 1.68), 0.26 (95% CI = 0.10 - 0.63), and 2.33 (95% CI = 1.21 - 4.48) for women, and 0.92 (95% CI = 0.52 - 2.13), 3.01 (95% CI = 1.64 - 5.55), and 0.64 (95% CI = 0.25 - 1.62) for the patients who smoked, respectively. In addition, there was no significant association between the different disorders and age, marital status, history of relapse, and history of suicide.

Conclusions

The results showed that there was a greater risk of anxiety disorders with bipolar disorder than other disorders. While women with bipolar disorder were at higher risk of anxiety disorders and OCD, men were at greater risk of drug addiction.

Anxiety Disorders;Bipolar Disorder;Comorbidity;Drug Addiction;Obsessive Compulsive Disorder;Logistic Regression Anxiety Disorders;Bipolar Disorder;Comorbidity;Drug Addiction;Obsessive Compulsive Disorder;Logistic Regression http://www.avicennajnpp.com/index.php?page=article&article_id=37911 Roya Najafi Vosough Roya Najafi Vosough Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Ali Ghaleiha Ali Ghaleiha Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Javad Faradmal Javad Faradmal Modeling of Noncommunicable Disease Research Canter, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Modeling of Noncommunicable Disease Research Canter, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran Hossein Mahjub Hossein Mahjub Research Center for Health Sciences and Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran; Research Center for Health Sciences and Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8138380025, Fax: +98-8138380509 Research Center for Health Sciences and Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran; Research Center for Health Sciences and Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8138380025, Fax: +98-8138380509
en 10.17795/ajnpp-37470 Adjustment to Diabetes Among Diabetic Patients: The Roles of Social Support and Self-Efficacy Adjustment to Diabetes Among Diabetic Patients: The Roles of Social Support and Self-Efficacy research-article research-article Results

The data revealed that self-efficacy (P < 0.001) and social support (P < 0.001) are indicators than can significantly anticipate levels of adjustment in diabetic patients. Moreover, it has been revealed that self-efficiency plays a significant and, indeed, fundamental role in adjustment anticipation.

Conclusions

It can be concluded that self-efficacy and social support are important in predicting the adjustment levels of diabetic patients. Furthermore, self-efficacy has a more potent function here than social support as it affects every individual’s self-confidence and quality of life.

Objectives

The aim of this study is to examine the roles of social support and self-efficacy in predicting the level of adjustment to living with diabetes in diabetic patients.

Patients and Methods

In this cross-sectional study, we investigated the ability to predict diabetic patients’ adjustment to diabetes through analyzing levels of social support and self-efficacy. The population used for this survey was a random sample of 167 diabetic patients, who were dependent on insulin injections. The participants were 18 to 60 years old and had been members of the Iranian Diabetes Society since 2014. They were asked to complete Sullivan’s “adjustment to diabetes” test, and were examined using 1) Zimet’s Multidimensional Scale of social support and 2) the Coping Self-efficacy scale for confrontation of problems. Data analysis was performed using the SPSS (version 16) statistical software package, for which Pearson’s correlation test and the multiple regression method (linear method) were used.

Background

Controlling diabetes requires management of the relationship between the patient and the initial attention team. Social and environmental factors lead to lifestyle variations in relation to the health care, community support, and social support received. Theess areas have an effect upon patients’ self-organization and self-efficacy. Self-efficacy can be recognized objectively as one of the strongest predictors of a patient’s physical condition, causing behavior variations. It can be defined as an individual’s level of trust in his/her ability to adopt a particular kind of behavior.

Results

The data revealed that self-efficacy (P < 0.001) and social support (P < 0.001) are indicators than can significantly anticipate levels of adjustment in diabetic patients. Moreover, it has been revealed that self-efficiency plays a significant and, indeed, fundamental role in adjustment anticipation.

Conclusions

It can be concluded that self-efficacy and social support are important in predicting the adjustment levels of diabetic patients. Furthermore, self-efficacy has a more potent function here than social support as it affects every individual’s self-confidence and quality of life.

Objectives

The aim of this study is to examine the roles of social support and self-efficacy in predicting the level of adjustment to living with diabetes in diabetic patients.

Patients and Methods

In this cross-sectional study, we investigated the ability to predict diabetic patients’ adjustment to diabetes through analyzing levels of social support and self-efficacy. The population used for this survey was a random sample of 167 diabetic patients, who were dependent on insulin injections. The participants were 18 to 60 years old and had been members of the Iranian Diabetes Society since 2014. They were asked to complete Sullivan’s “adjustment to diabetes” test, and were examined using 1) Zimet’s Multidimensional Scale of social support and 2) the Coping Self-efficacy scale for confrontation of problems. Data analysis was performed using the SPSS (version 16) statistical software package, for which Pearson’s correlation test and the multiple regression method (linear method) were used.

Background

Controlling diabetes requires management of the relationship between the patient and the initial attention team. Social and environmental factors lead to lifestyle variations in relation to the health care, community support, and social support received. Theess areas have an effect upon patients’ self-organization and self-efficacy. Self-efficacy can be recognized objectively as one of the strongest predictors of a patient’s physical condition, causing behavior variations. It can be defined as an individual’s level of trust in his/her ability to adopt a particular kind of behavior.

Diabetes;Adjustment;Social Support;Self-Efficacy Diabetes;Adjustment;Social Support;Self-Efficacy http://www.avicennajnpp.com/index.php?page=article&article_id=37470 Saeid Yazdi-Ravandi Saeid Yazdi-Ravandi Young Researchers and Elite Club, Rudehen Branch, Islamic Azad University, Rudehen, IR Iran; Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Young Researchers and Elite Club, Rudehen Branch, Islamic Azad University, Rudehen, IR Iran; Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Zahra Taslimi Zahra Taslimi Young Researchers and Elite Club, Rudehen Branch, Islamic Azad University, Rudehen, IR Iran; Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Young Researchers and Elite Club, Rudehen Branch, Islamic Azad University, Rudehen, IR Iran; Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Mohammad Ahmadpanah Mohammad Ahmadpanah Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Ali Ghaleiha Ali Ghaleiha Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran; Behavioral Disorders and Substance Abuse Research Center, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9358331910, Tel/Fax: +98-8118271066 Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran; Behavioral Disorders and Substance Abuse Research Center, Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-9358331910, Tel/Fax: +98-8118271066
en 10.17795/ajnpp-38613 Frequency of Multiple Sclerosis (MS) Among Relatives of MS Patients in Hamadan Society, Iran Frequency of Multiple Sclerosis (MS) Among Relatives of MS Patients in Hamadan Society, Iran research-article research-article Patients and Methods

This cross-sectional study was performed on 1202 MS patients in Farshchian hospital, Hamadan, in 2013. All patients were diagnosed with definite MS. A questionnaire was used to gather information; demographic characteristics, medical history, signs and symptoms at onset, course of disease, relatives with MS, and degree and type of relationship were recorded.

Conclusions

There has been an increase in the rate of the disease in Hamadan province in recent years. It was found that there are lower rates of familial prevalence relative to this sample being studied in Hamadan society. The familial MS is more common among sisters. Further studies on the MS patients in Hamadan will be needed for a better assessment of familial and environmental factors.

Background

Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system with unknown causes. In the last decade, the prevalence of MS in Iran has increased.

Objectives

This study evaluated the frequency of familial MS among patients in the Hamadan society for MS.

Results

The mean age of the patients with familial MS was 28 ± 10.4 years, with higher rates among women (the female to male ratio was 3.2: 1). Familial MS was found in 8.65% of the patients, and 58.58% of those patients had a first-degree relative with MS. The highest rate for familial MS was observed in sister-sister relations and brother-sister relation. The MS risk changed from 57.69% in first-degree relatives to 35.57% in second-degree relatives and 6.73% in third-degree relatives.

Patients and Methods

This cross-sectional study was performed on 1202 MS patients in Farshchian hospital, Hamadan, in 2013. All patients were diagnosed with definite MS. A questionnaire was used to gather information; demographic characteristics, medical history, signs and symptoms at onset, course of disease, relatives with MS, and degree and type of relationship were recorded.

Conclusions

There has been an increase in the rate of the disease in Hamadan province in recent years. It was found that there are lower rates of familial prevalence relative to this sample being studied in Hamadan society. The familial MS is more common among sisters. Further studies on the MS patients in Hamadan will be needed for a better assessment of familial and environmental factors.

Background

Multiple sclerosis (MS) is a chronic inflammatory demyelinating and neurodegenerative disease of the central nervous system with unknown causes. In the last decade, the prevalence of MS in Iran has increased.

Objectives

This study evaluated the frequency of familial MS among patients in the Hamadan society for MS.

Results

The mean age of the patients with familial MS was 28 ± 10.4 years, with higher rates among women (the female to male ratio was 3.2: 1). Familial MS was found in 8.65% of the patients, and 58.58% of those patients had a first-degree relative with MS. The highest rate for familial MS was observed in sister-sister relations and brother-sister relation. The MS risk changed from 57.69% in first-degree relatives to 35.57% in second-degree relatives and 6.73% in third-degree relatives.

Multiple Sclerosis;Heredity;Prevalence;Hamadan Multiple Sclerosis;Heredity;Prevalence;Hamadan http://www.avicennajnpp.com/index.php?page=article&article_id=38613 Mehrdokht Mazdeh Mehrdokht Mazdeh Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran Mojtaba Khazaei Mojtaba Khazaei Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran; Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118380315, Fax: +98-08138276010 Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran; Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118380315, Fax: +98-08138276010 Nasrin Hashemi-Firouzi Nasrin Hashemi-Firouzi Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Masoud Ghiasian Masoud Ghiasian Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Neurology, Hamadan University of Medical Sciences, Hamadan, IR Iran
en 10.17795/ajnpp-39755 Comparison of the Effect of Schema Therapy and Cognitive Group Therapy on Depression in Women Engaging in High-Risk Sexual Behaviors Who Were Referred to Hamadan Health Center Comparison of the Effect of Schema Therapy and Cognitive Group Therapy on Depression in Women Engaging in High-Risk Sexual Behaviors Who Were Referred to Hamadan Health Center research-article research-article Background

Treatment for psychological disorders is generally based on signs and symptoms, and research in this area has shown that major depression has become one of the most significant psychiatric disorders of the last decade.

Objectives

This study was conducted to compare the effects of schema therapy and cognitive group therapy on women with depression who were engaging in high-risk sexual behaviors and were referred to the Hamadan Health Center for AIDS testing.

Conclusions

The results show that schema therapy is more effective than cognitive group therapy for treating depression in women engaging in high-risk sexual behaviors.

Results

The findings support the idea that a significant difference exists in terms of the mean of depression between schema therapy and cognitive therapy, as follows: F (1, 41) = 60.650 P < 0.01.

Patients and Methods

This research was done at the Hamadan shohada infirmary from 2015 to 2016 and was confirmed by the ethics committee of Hamadan University of Medical Sciences. It was a semi-experimental study using single stage cluster sampling. The statistical sample consisted of 500 women ranging in age from 20 to 60 years old with at least a diploma. The women were engaging in high-risk sexual behaviors and were referred to the health center for AIDS testing. Psychologists and a physician conducted a diagnostic interview, and 217 subjects were randomly chosen using a sample volume formula, in addition to Depression Anxiety Stress Scales (DASS). Eighty five of the subjects were diagnosed with depression, of whom 45 were chosen randomly and divided into three groups of 15 consisting of two experimental groups and one control group. Twelve sessions of cognitive group therapy and 12 sessions of schema therapy were implemented for 90 minutes per session. At the end of the training period, the three groups were post-tested and depression components were then investigated in the pretest and post-test results.

Background

Treatment for psychological disorders is generally based on signs and symptoms, and research in this area has shown that major depression has become one of the most significant psychiatric disorders of the last decade.

Objectives

This study was conducted to compare the effects of schema therapy and cognitive group therapy on women with depression who were engaging in high-risk sexual behaviors and were referred to the Hamadan Health Center for AIDS testing.

Conclusions

The results show that schema therapy is more effective than cognitive group therapy for treating depression in women engaging in high-risk sexual behaviors.

Results

The findings support the idea that a significant difference exists in terms of the mean of depression between schema therapy and cognitive therapy, as follows: F (1, 41) = 60.650 P < 0.01.

Patients and Methods

This research was done at the Hamadan shohada infirmary from 2015 to 2016 and was confirmed by the ethics committee of Hamadan University of Medical Sciences. It was a semi-experimental study using single stage cluster sampling. The statistical sample consisted of 500 women ranging in age from 20 to 60 years old with at least a diploma. The women were engaging in high-risk sexual behaviors and were referred to the health center for AIDS testing. Psychologists and a physician conducted a diagnostic interview, and 217 subjects were randomly chosen using a sample volume formula, in addition to Depression Anxiety Stress Scales (DASS). Eighty five of the subjects were diagnosed with depression, of whom 45 were chosen randomly and divided into three groups of 15 consisting of two experimental groups and one control group. Twelve sessions of cognitive group therapy and 12 sessions of schema therapy were implemented for 90 minutes per session. At the end of the training period, the three groups were post-tested and depression components were then investigated in the pretest and post-test results.

Schema Therapy;cognitive therapy;Depression Schema Therapy;cognitive therapy;Depression http://www.avicennajnpp.com/index.php?page=article&article_id=39755 Akbar Hemmati Sabet Akbar Hemmati Sabet Department of Counseling, Science and Research Branch, Islamic Azad University, Tehran, IR Iran Department of Counseling, Science and Research Branch, Islamic Azad University, Tehran, IR Iran Shokouh Navabi Nejad Shokouh Navabi Nejad Professor, Department of Counseling, Kharazmi University, Tehran, IR Iran; Professor, Department of Counseling, Kharazmi University, Tehran, IR Iran Professor, Department of Counseling, Kharazmi University, Tehran, IR Iran; Professor, Department of Counseling, Kharazmi University, Tehran, IR Iran Javad Khalatbari Javad Khalatbari Assistant Professor, Department of Psychology, Tonekabon Branch, Islamic Azad University, Mazandaran, IR Iran Assistant Professor, Department of Psychology, Tonekabon Branch, Islamic Azad University, Mazandaran, IR Iran
en 10.17795/ajnpp-34444 Morphological Effects of Hydroalcoholic Zingiber Officinalis Extract in the Murine Hippocampus of Male Rat Offspring Morphological Effects of Hydroalcoholic Zingiber Officinalis Extract in the Murine Hippocampus of Male Rat Offspring research-article research-article Background

The hippocampus is responsible for memory. A diet full of antioxidants improves brain damage and cognitive function. Regard the antioxidant effects of zingiber officinalis (ginger) and its flavonoids components.

Objectives

The aim of this study was to evaluate the effect of the extract of ginger on memory by using hippocampus tissue of the male offspring of rats.

Materials and Methods

In this study, 60 rats, 15 males and 45 females, were used. We separated pregnant female rats from males on the first day of pregnancy (determined by vaginal plug), and during days 16 - 18 of pregnancy, via intraperitoneal injection, three groups received hydroalcoholic extract of ginger, with low (200 mg/kg bw), medium (400 mg/kg bw), and high (800 mg/kg bw) concentration doses. The control group did not receive anything, and the sham group received normal saline during these days. Then at day 50, the males offspring in each group were sacrificed, their brains were removed, and the hippocampus sections were prepared for microscopic studies. Data was analyzed by SPSS 20 and by using one-way ANOVA and then a Tukey post-test (P < 0.05 considered as the significance level).

Results

This research showed that the number and thickness of pyramidal and granular layers of the CA1 and dentate gyrus areas of the hippocampus had increased in male offspring according to the increase in the ginger extract dose.

Conclusions

It seems as though ginger extract, which contains compounds such as gingerols, shogaols, and zingerone, can affect memory ability in rats through these compounds’ antioxidant properties by affecting embryonic acetylcholine content and place cells.

Background

The hippocampus is responsible for memory. A diet full of antioxidants improves brain damage and cognitive function. Regard the antioxidant effects of zingiber officinalis (ginger) and its flavonoids components.

Objectives

The aim of this study was to evaluate the effect of the extract of ginger on memory by using hippocampus tissue of the male offspring of rats.

Materials and Methods

In this study, 60 rats, 15 males and 45 females, were used. We separated pregnant female rats from males on the first day of pregnancy (determined by vaginal plug), and during days 16 - 18 of pregnancy, via intraperitoneal injection, three groups received hydroalcoholic extract of ginger, with low (200 mg/kg bw), medium (400 mg/kg bw), and high (800 mg/kg bw) concentration doses. The control group did not receive anything, and the sham group received normal saline during these days. Then at day 50, the males offspring in each group were sacrificed, their brains were removed, and the hippocampus sections were prepared for microscopic studies. Data was analyzed by SPSS 20 and by using one-way ANOVA and then a Tukey post-test (P < 0.05 considered as the significance level).

Results

This research showed that the number and thickness of pyramidal and granular layers of the CA1 and dentate gyrus areas of the hippocampus had increased in male offspring according to the increase in the ginger extract dose.

Conclusions

It seems as though ginger extract, which contains compounds such as gingerols, shogaols, and zingerone, can affect memory ability in rats through these compounds’ antioxidant properties by affecting embryonic acetylcholine content and place cells.

Ginger;Memory;Offspring;Male Rats;Hippocampus Ginger;Memory;Offspring;Male Rats;Hippocampus http://www.avicennajnpp.com/index.php?page=article&article_id=34444 Fariba Ghodrati Fariba Ghodrati Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran Minoo Mahmoodi Minoo Mahmoodi Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran; Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran. Tel: +98-9183138358 Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran; Department of Biology, Hamadan Branch, Islamic Azad University, Hamadan, IR Iran. Tel: +98-9183138358 Siamak Shahidi Siamak Shahidi Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran Hamid Reza Ghadimipoure Hamid Reza Ghadimipoure Pathology Ward, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran Pathology Ward, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran