Patient is a 24 year .old male with valvular heart disease, severe mitral & aortic & tricuspid valve stenosis and regurgitation. After MVR & AVR & tricuspid surgical repair, he has undergone cardiac rehabilitation for 8 weeks (24 sittings). After completion of a cardiac rehabilitation, review of cardiovascular tests showed obvious improvement in the functional capacity, blood pressure and heart rate. Physically and mentally patient feels very comfortable and hopeful of a good healthy life.

The familial violence is any violent action based on sexual dispute that result in somatic, sexual or psychiatric hurts or pain. One of the familial violence is child and spouse abuse that result in depression, anxiety and PTSD. The aim of this article is study of familial violence phenomena from different psychiatric and social views and the rate of appearance and epidemiology and clinical character of PTSD as the result of sexual rape. This study is based on review of literature and antecedent & internal and external investigations from 1989 to 2004 from internet sites like NC PTSD psychilt – psych Info.

Conclusions of different accidental and nonaccidental studies sign the rate of 25 – 30% psychiatric side effects as the result of somatic and sexual abuse and appearance of PTSD-Depression and Anxiety. Because the phenomena of familial and sexual violence has social and psychiatric nature, It is necessary to take health care and educative and preventive methods for prevention of appearance of such injuries in society and support from familial and social network.

Objective: Disorder of consciousness is the common problem of severe traumatic brain injury. There is controversy about the effects of sensory stimulation on the level of consciousness in comatose patients. The aim of this study was to compare the effect of early (7th days post injury) and late (15th DPI) onset sensory stimulation on the level of consciousness of the comatose patients.

Materials & Methods: In this experimental and interventional study twenty – one patients with Glasgow Coma Scale (GCS) £ 8 at least be stable for 3 days post injury (DPI), Normal ICP in CT- scan, no sedation, no previous neurological disorder, aged 18-59 suffering from sever traumatic brain injury were selected and divided in to 3 groups. First group (early onset) was received intervention (tactile, acoustic, visual, R.O.M and smell as stimulation) from 7th DPI to 15th DPI. The second (late onset) was received the intervention as same as early group but from 15th DPI to 21th DPI. The last one (control group) had no intervention. Level of consciousness evaluated by GCS and CRS-R in all of them every other day during the first month after injury. Data were analyzed by use of paired T test, Pearsonian correlation and repeated measurement analysis.

Results: Repeated measurement analysis showed significant increase of GCS and CRS-R scores over the time (P<0.001). Significant changes were identified in CRS-R score between early and control group by post hoc test (P<0.05). Nevertheless, the increase of GCS score was different between groups, but this increase wasn’t statically significant (P=0/15).

Conclusion: One week intervention of sensory stimulation on the 7-15 DPI can accelerate the trend of improvement in these patients. One thing many experts agree on is that starting rehabilitation early is of paramount importance to increase level of consciousness.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is the most common psychiatric disorders of childhood and adolescence. Psychosocial interventions such as group parent management training are needed, for children's behaviors and parent – child interaction. The aim of this study is to investigate the effect of group parent management training on behavioral disorders among children with Attention Deficit Hyperactivity Disorder.
Materials & Methods: In this interventional and quasi experimental study, fifty four children with ADHD were selected from seven mental occupational therapy clinics of Tehran city.They were assigned into two Equal groups and all of them received routine occupational therapy and medication. Parent management training program by using positive parenting program (triple p) manual (Sanders 2005) was added to the Intervention Group program. These sessions lasted 2 hours a week for 8 weeks. Data collection tools were 2 questionnaires: Demographic questionnaire and Conners Parent Rating Scale (CPRS 48). Statistical snalysis of data was done by chi square ,Independent T test, Paired T test and analysis of covariance.
Results: Although both groups showed significant improvement in all subscales of behavioral questionnaire (CPRS) pretest, improvement of intervention group score was more significantly than control group in conduct subscale (P<0.001), anxiety (P<0.001), hyperactivity index (P=0.016) and total score (P<0.001). But in psychosomatic subscale (P=0.526 ), learning subscale (P=0.052) and impulsion and hyperactivity subscale (P=0.267) there was no significant difference between two groups.
Conclusion: Group parent management training is significantly effective in decreasing behavioral disorders and anxiety status of children with attention deficit hyperactivity disorder and this psychosocial intervention could be used as an effective complementary method beside medication and occupational therapy programs.

Objective: Gross motor activities ability or disability influence on children cognitive performance and their social behavior. This study is aimed to investigation the effect of gross motor activities on attention process (sustained attention, attention shift) of boy students with Down syndrome who are 8 – 12 years old.
Materials & Methods: In this interventional and experimental study, 26 boy students with Down syndrome from 4 schools (Shahid Beheshti, Ahya, Peydayesh and Piroozi) were selected and administered by attention tests(sustained attention , attention shift) and Lincoln Oseretsky development scale. Then they were assigned into two groups randomly. Intervention group received gross motor activities programs for 8 weeks (2 times in a week). Then two groups were administered by attention tests and Lincoln Oseretsky development scale again. Data were analyzed by using paired T-test and Independent T- test.
Results: There was no significant difference in control group in attention tests between before and after intervention (sustained attention P=0.654, attention shift P=0.163) and Oseretsky development scale (P=0.337), but significant differences were observed in intervention group (P<0.001). Score of decreasing interruption of task revealed that there were significant differences in intervention (P<0.001) and control group (P<0.001).
Conclusion: Gross motor activities interventions significantly affect on the process of attention (sustained attention , shift attention) in students with Down syndrome.

Objective Communication deficiency is one of the diagnostic criteria for autism, which leads to difficulty in learning speech and linguistic skills. Nowadays, it is common to use play therapy for supporting children with autism. Play therapy is an active approach that helps a child to reveal his conscious and unconscious feelings through playing. The present study aimed to determine the effectiveness of group play therapy on the communication skills of children with high functioning autism.
Materials & Methods The present research was an experimental study, including a pretest and posttest design with a control group. Twelve 5-8 years old boys with high functioning autism were selected purposively from the Autism Charity Foundation in Tehran in 2013. All subjects were included according to get a diagnose of high functioning autism, literacy of parents to complete the questionnaire, lack of sensory disorders such as visual or auditory disorders, lack of physical or motor disorders such as cerebral palsy, not attending to the same play therapy intervention program simultaneously. All subjects were assigned randomly to the experimental and control groups (6 children in each group). The experimental group participated in 20 sessions (three times a week; 45 to 60 minutes for each session) and received group play therapy along with the routine program (mental and physical occupational therapy, and speech therapy). However, the control group received only the routine program. The communication skills of all the children were evaluated using the Gilliam Autism Rating Scale (GARS) before, at 20th session, and 2 months after the intervention. The collected data from two situations (pre-test, post-test) were analyzed by analysis of covariance. Repeated measure test was used to determine the lasting effect of group play therapy on the communication of boys after two months follow-up.
Results The findings of the analysis of covariance showed that the group play therapy significantly influenced the communication of male children with high functioning autism. In addition, it was found that the effects of the group play therapy lasted significantly on the communication skills of the children even at two months follow-up (P<0.001). 
Conclusion It is concluded that the group play therapy can help the children to understand and communicate well. This therapy can be used as a complementary training and therapeutic method for children with high functioning autism to help improve their communication deficiencies.