Jundishapur Journal of Chronic Disease Care
Volume:6 Issue: 2, Apr 2017

Birth weight is the most important indicator of infant’s health, and this critical index is directly related to mother’s health. Hence, knowledge of the maternal chronic disease before and during the pregnancy can be considered as an effective factor in maintaining the infant’s ideal weight. Babies with low birth weight are more susceptible to risks such as disabilities of neurological, respiratory diseases and sudden infant death syndrome. Therefore, identifying and modifying the risk factors can control and prevent low birth weight.
This study was performed to determine the association between mothers’ chronic diseases and low birth weight in infants.
In this descriptive study, 1500 infants from 12 health centers in east and west areas of Ahvaz were selected using the random cluster sampling method. The developed researcher checklist was used for data gathering. The data was analyzed with SPSS version 20, using descriptive indexes and Chi-square, t-test and ANOVA while P ≤ 0.05 was considered as significant.
The prevalence of LBW in Ahvaz from the beginning to the end of the year 2015 has been 9.5%. There is a significant relationship between the cardiovascular disease before pregnancy (P ≤ 0.003), anemia before pregnancy (P ≤ 0.001), hypertensive pregnancy (P ≤ 0.001), urinary tract infection during pregnancy (P ≤ 0.001), gestational diabetic in the mother (P ≤ 0.003) and LBW.
Our study showed that many mothers'' schronic disease such as cardiovascular disease, anemia, hypertensive, gestational diabetic and UTI have relationship with LBW. Therefore it seems essential to design and implement a detailed antenatal care program for mothers with chronic disease to reduce LBW, infant mortality and defects.

Using Assisted Reproductive Technologies (ART) is a stressful experience marked by lengthy and invasive medical procedures, high financial cost and relatively low success rate. Adoption is considered as one of the infertility treatment methods that can have great impact on healing emotional problems of infertile couples and can improve their relationship.
The current study aimed to investigate infertility-related stress and adoption in Iranian Infertile females with a history of ART failure, during year 2015.
This was a cross sectional study in which 30 Iranian infertile females, 30 to 45 years old, with primary infertility of five years or more, and history of ART failure, were investigated. Data collection instruments included the questionnaire of infertility and demographic factors, fertility problem inventory (FPI) and adoption questionnaire. The data were analyzed by SPSS V22, using descriptive statistics and Pearson test to assess possible correlations.
The mean of the total score of infertility stress of the participants was 186.1 ± 29.46 (moderate to high). All participants showed some level of infertility stress. The mean score of adoption was 38.4 ± 3.73 (moderate acceptance), 53.33% of which showed moderate acceptance. There was no relationship between infertility stress and adoption (correlation = - 0.13, P = 0.48).
Infertile females with a history of unsuccessful ART had a high level of infertility stress and moderate acceptance of adoption. We must pay more attention to psychological aspects of infertility and failure of treatment. There is an obvious need to increase society awareness about adoption and promote “adoption” as a sensible choice to form a family.

Chronic kidney disease is a threatening condition for the health, economic and social status of the affected person, his/her family and society.
With regard to the mental and health issues that patients undergoing dialysis encounter, the current study aimed to examine the role of religious coping in perception of suffering among these patients.
The current correlational study had a statistical population including all patients undergoing dialysis referred to Ali-ibn-Abi-Talib (AS) hospital in Zahedan, Iran, in 2015. The sample included 50 individuals selected using the convenience sampling method. To collect data, the perception of suffering scale and the religious coping scale were used and the obtained data was analyzed using the Pearson correlation coefficient and stepwise regression analysis via SPSS.
The correlation results showed that religious activities (a dimension of religious coping) and psychological suffering (a dimension of perception of suffering) were significantly and inversely correlated (P The increase in religious and spiritual activities can lead to a decrease in psychological pain among patients undergoing dialysis.

Sleep disorder is one of the most common complaints of pregnancy that can lead to maternal and fetal complications.
The main purpose of this study is to investigate the correlation between sleep disorders of pregnancy and abortion.
This study is conducted using a case-control method on 218 women in the age range of 18 - 35 years old with singleton-pregnancy passing their first or second pregnancy in Ahvaz, Iran. Continuous sampling was conducted on the basis of characteristics of the research unit. The case group (n = 109) included women hospitalized because of an abortion, and the control group (n = 109) consists of pregnant women above 22 weeks, who were referred to healthcare centers to get pregnancy cares. The data collection was done using a demographic questionnaire and pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS-22 and t-test for quantitative variables and Chi-Square for qualitative variables.
Obtained results from the study showed that there is a significant relationship between abortion and sleep duration (P = 0.000), subjective sleep quality (P = 0.000), sleep latency (P = 0.000), habitual sleep efficiency (P = 0.000), sleep disturbances (P = 0.000), daytime dysfunction (P = 0.000), and total valued of sleep disorder (P = 0.000). However, the correlation was insignificant in case of use of sleeping medication (P = 0.233).
According to the obtained results, there is a significant correlation between sleep disorder and abortion. Therefore, training sleep health and suitable consultations during pregnancy would be effective in field of preventing abortion and with the aim of achieving to safe pregnancy.

Investigation of various aspects of care in ostomy patients is of clinical importance, as the level of knowledge and skills of nurses directly influences the quality of patient education and satisfaction with received care.
The purpose of this study was to determine knowledge of nurses in general surgery wards regarding fecal intestinal ostomies.
This cross-sectional study was performed during year 2015 at teaching hospitals (Ghaem, Imam Reza and Omid hospitals) affiliated to Mashhad University of Medical Sciences, Iran. We used census for sampling, and the study population included all nurses, who were working in intestinal ostomy surgery wards. Inclusion criteria were having an undergraduate degree in nursing and at least one-year work experience at the surgical ward. Data collection tools were a demographic information questionnaire and a researcher-made survey of “assessment of knowledge of nurses in ostomy care”. Data were analyzed using SPSS software version 11.5.
Overall, 83.9% of participants were female and mean work experience at the surgical ward was 4.23 (SD = 3.73). More than half of the nurses gave incorrect answers to questions related to the use of powders and sprays associated with skin itching and sensitivity (64.3%), and how to care for ostomy with a rod (66.1%). Nurses also showed low and very low levels of knowledge on symptoms and control of obstruction (57.1%), change duration in the size of ostomy (66%), sexual intercourse (57.1%), colostomy complications (51.8%) and ileostomy (57.1%) and authorized or unauthorized activities (50%) as well as how to perform bowel irrigation (75%).
According to the results of this study, the knowledge of nurses was not enough to provide primary care for ostomy; thus due to the importance of adequate knowledge and because of needs assessments, it is recommended for nursing managers to conduct retraining courses and other educational approaches for nurses.

To assess the waiting time, number of delays, and correlations of non-commitment to the systematic referral to the outpatient cardiac rehabilitation (CR) among coronary artery bypass surgery (CABG) patients.
The cross-sectional study data were gathered through evaluations related to 1,187 CABG patients who were referred to the outpatient CR of 1 hospital in western Iran during 2010 to 2014. The instruments included were demographics and actual risk factors checklist, single item of perceived risk factors, and Beck depression inventory (BDI). Data was analyzed via chi-square test, ANOVA, Bonferroni post hoc test, and binary logistic regression analysis.
Among 1 187 patients (830 male), 27% had delayed referral, and the number of delays decreased from 2010 (49.3%) to 2014 (7.6%) (P Despite the progressive process of patients’ admittance and acceptability of the present waiting time, especially after 2014, it seems that more attention to diabetic patients and patients without a family history of cardiac, and modification of attitudes about multiple risk factors can associate the self-care with more responsibility and it may also be affective in the control of harm consequences through commitment to the systematic referral.

The evaluation of acute abdominal pain must be efficient to prevent any delay in the treatment of patients, who are seriously ill, and over treatment of patients with self-limited disorders. One of the uncommon reasons that should be considered in the differential diagnosis of acute abdominal pain, especially among elderly patients, who are under anti-coagulation therapy, is abdominal wall hematoma.
The case was a 60-year-old female with abdominal pain in the left upper and lower quadrant, which was followed by a series of coughs. She was receiving subcutaneous heparin, which was then changed to warfarin. The patient also had an episode of similar pain, one month ago and was diagnosed as abdominal hematoma based on ultrasonography report. An abdominal CT scan showed a mass lesion and the patient was diagnosed as acute on chronic abdominal wall hematoma.
Anterior abdominal wall hematoma should be considered in the differential diagnosis of acute abdominal pain among elderly patients, especially those who are under anti-coagulation therapy. Conservative treatment is conceivable in most cases and early diagnosis is compulsory to avoid morbidity or unnecessary surgery.

Crohn’s disease (CD) is an inflammatory disease with an increasing incidence and can involve any part of the gastrointestinal tract. Most cases are seen in young adults presenting with abdominal pain and diarrhea. This condition may lead to complications such as stricture and fistula. Besides, there is an increased risk of colorectal cancer and some extraintestinal cancers in these patients, due to chronic inflammation. One of the therapeutic options for Crohn’s patients is the use of immunomodulators. Such agents can induce remission and limit the usage of steroids. According to some literature, this treatment can increase the risk of colorectal cancer as well as extraintestinal cancers, of which skin cancers and lymphoma are the most prevalent. Lymphoma can be a result of chronic inflammation or use of immunomodulators such as azathioprine and 6-mercaptopurine (6-MP).
In this literature, we describe a young man with rectorrhagia who is diagnosed with Crohn’s disease and a coexistence of lymphoma at the time of diagnosis, without a history of immunomodulator therapy.
With attention to the increased risk of colorectal and extraintestinal cancer in Crohn’s patients, assessment for early diagnosis should be considered