Jundishapur Journal of Chronic Disease Care
Volume:7 Issue: 4, Oct 2018

 Spinal cord injury (SCI) is a type of chronic disease with physical and psychological effects on the individual`s life. The disease can have a devastating effect on the life and well-being of patients with SCI. The current study aimed at investigating the role of social support, life meaningfulness, and centrality of religiosity in posttraumatic growth and life satisfaction of people with SCI.  The current study was conducted on 157 subjects with SCI selected by convenience sampling method in the Welfare Organization of Khorramabad city, Iran in 2016. The subjects completed the centrality of religiosity scale, the posttraumatic growth inventory, satisfaction with life scale, the meaning in life questionnaire (short-form), and multidimensional scale of perceived social support. Data were analyzed with stepwise regression method (F test and t test).  The obtained results indicated that the most important predictor of posttraumatic growth was family support and the most important predictor of life satisfaction was friends support. In sum, all predictor variables explained 62% of posttraumatic growth and 38% of life satisfaction.  The current study findings showed that social support, meaningfulness, and religious believes can help people with SCI to adapt with problems related to their illness.

 Addiction as one of the crises in the current century has affected all societies and is one of the most harmful and common phenomena in the family system. Addiction is the cause of many social, familial, and personal disabilities.  The present study was conducted to investigate the effectiveness of acceptance and commitment therapy on the psychological flexibility of drug-dependent women.  A quasi-experimental study was conducted with a pretest-posttest design and a control group. The statistical population included female drug addicts attending addiction treatment camps in Zahedan, who had undergone detoxification. Using a single stage cluster sampling method, 27 drug-dependent women were selected and allocated randomly in either experimental (13 subjects) or control (n = 14) groups. The Dennis cognitive flexibility inventory (CFI) was used in the pre-test and post-test and the data were analyzed using multivariate covariance analysis in the SPSS version 23 software.  The results of the study showed that acceptance and commitment therapy increased psychological flexibility and its dimensions (alternatives, control, and perceived ability) in the experimental group when compared to the control group at the post-test stage (P < 0.05).  Group-based acceptance and commitment treatment is effective in increasing the psychological flexibility of drug-dependent women. This method can be effective in reducing the psychological problems of addicts and decrease their tendency to return to substance use. Therefore, the use of this therapeutic approach is recommended to improve the health status of addicted women.

Asthma and chronic obstructive pulmonary disease (COPD) are the most common chronic respiratory diseases with significant morbidity in the world. Although these diseases have different characteristics, some patients share symptoms and clinical findings of both diseases, so-called asthma-COPD overlap syndrome (ACOS). Although there is no gold standard for the diagnosis of ACOS, it is usually defined as an increased variability of airflow in the respiratory tract. Patients with ACOS are identified with distinct phenotypes such as the increased reversibility of airflow obstruction, eosinophilic bronchial and systemic inflammation, and the increased reaction to inhaled corticosteroids compared to COPD patients. The evidence indicates that ACOS patients are likely to have more dyspnea and cough, more serious symptoms, more hospital admissions, and higher mortality rate. Despite these complex conditions, ACOS patients have been eliminated from clinical trials of asthma and COPD and there is little evidence about their clinical decisions. The current study was conducted to review the epidemiology, clinical symptoms, diagnosis, and treatment of ACOS as the first stage of correct diagnosis and appropriate management of this syndrome in databases such as PubMed, Elsevier, Google Scholar, SID, Magiran, Google search engine, and so on.

 As a novel adipokine, visfatin is associated with obesity exerting an insulin mimetic effect. Nevertheless, it is not clear whether an aquatic exercise program causes variations in the adipose tissue and lipids in the blood reduce plasma visfatin or not.  The present research aims to investigate the influence of an eight-week aquatic exercise program on plasma visfatin level and some blood factors in non-athletic obese men.  This study was conducted as a semi experimental design with a pretest-posttest and with a control group. After a public call, the subjects who met the research criteria were selected. Then, 24 eligible, healthy, non-athletic obese men (30 ≤ BMI ≤ 32), aged 35 - 45 years, were selected randomly and assigned into an experimental and a control group, each comprising of 12 subjects. The experimental group was subjected to an intervention period of eight weeks, three days per week, at an intensity of 60% - 70% of maximum heart rate for 40 to 55 minutes. The independent t-test and the paired t-test were employed to determine variations in the variables. For the purposes of statistical analysis, the software SPSS-21 was used at the level of significance of P < 0.05.  The results showed that body mass index or BMI (P < 0.003), the ratio of waist to hip (P < 0.012), and body fat percentage (P < 0.001) in the experimental group, decreased significantly subsequent to aquatic exercise training. The results obtained from the independent t-test also demonstrated that HOMA-IR (P = 0.001) and visfatin plasma (P = 0.001) was significantly reduced in the experimental group in comparison with the control group.  It appears that the aquatic exercise program with weight loss induced changes in adipose tissue decreased plasma visfatin and insulin resistance in non-athletic obese men.

 HCV is one of the most important causes of chronic liver disease and liver cirrhosis. This study was designed to evaluate the efficacy of HCV treatment with sofosbuvir plus ribavirin regimen among HCV patients regardless of cirrhotics or relapse status in Khuzestan province.  In this cross-sectional study, during a six-month period, all HCV patients including those who complicated with liver cirrhosis and/or experienced treatment failure were registered and treated with sofosbuvir 400 mg plus ribavirin for 24 weeks. Their viral load was controlled at weeks 0, 12, and 24, and followed every six months thereafter with PCR.  Overall, 93 cases were included. The average age of the participants was 46.1 ± 12.3 years (range: 27 to 80 years) and 66.7% were male. The most common genotypes were 1a (51.6%) and 3a (23.7%). At the end of the study period, 87 patients (93.5%) achieved SVR. 16 patients (17.2%) complained of minor side effects without any major complication. There was no significant relationship between the response to treatment and the age or sex of the participants, the type of HCV genotype, and the history of previous treatment (relapser or non-responder) (P < 0.05). 96.8% of the participants completed the course of therapy and 96.7% of them achieved SVR. There was no major complication during the study protocol but three patients did not complete the course of therapy due to the liver decompensation of CVA.  It seems that a 24-week course of sofosbuvir plus ribavirin with ITT 93.5% and PP 96.7% is highly effective for the treatment of HCV even cirrhotics or relapsers in the southwest of Iran, with a high rate of safety profile even for the treatment of genotype 3a.

 The quality of life of patients with multiple sclerosis (MS) is one of the important variables that can play an important role in coping with the disease. Therefore, studying the role of the interference factors in quality of life of patients with MS is important; hence, the current study aimed at investigating the effect of group spiritual therapy on quality of life and spiritual health of patients with MS in Ahvaz city, Iran.  The current semi-experimental study with the experimental, control, and follow-up groups was conducted on 80 patients with MS. Subjects were selected based on the inclusion criteria, and randomly divided into two groups of experimental (n = 40) and control (n = 40). The study tools were Msis-29 and the Paloutzian-Ellison spiritual health scale. Data analysis including descriptive statistics (frequency, average, standard deviation) and inferential statistics (repeated measures ANOVA) were performed with SPSS version 19.  The findings of the study showed that the mean of quality of life and spiritual health of the patients were moderate. The mean score of the physical aspect of quality of life was higher than that of the mental one. There was a significant difference between the quality life, aspects of quality of life (physical and mental), and spiritual health of the experimental and control groups (P < 0.05) in the post-test and follow-up stages.  The current study showed that group spirituality training can be effective on improving the quality of life and spiritual health of patients with MS.

 The chest pain is a very common complaint among patients with acute coronary syndrome (ACS). The local thermotherapy can reduce or relieve the heart pain by suppressing metabolites as pain mediators.  This study aimed to determine the effect of local thermotherapy on the chest pain in patients with ACS.  This clinical trial was conducted on 78 patients with ACS hospitalized in the ICU of Golestan Hospital of Ahvaz in 2016. Based on the sample size and inclusion criteria, and by a convenience sampling, the eligible patients were enrolled and randomized into two equal-sized groups, namely control and intervention, each containing 39 participants. During the local thermotherapy sessions, the patients received local heat by using a hot pack warmed to 50°C for five days. The control group only received the routine treatment. Data collection instruments included a demographic questionnaire and the Numerical Rating Scale (NRS). The NRS was completed by the participants before the intervention and five days after it. Data were analyzed using the descriptive tests, correlation coefficient, independent t-test, Chi-square, and logistic regression in SPSS 20.  The mean pain severity in the case group before the intervention was 3.22 ± 0.86 and after the intervention, it decreased to 2.61 ± 0.7, indicating the effect of local thermotherapy. However, it was not statistically significant (P > 0.05). There was no significant relationship between age, gender, diabetes, hypertension, and hyperlipidemia, and the pain severity in this study (P > 0.05). Logistic regression analysis showed that women experienced more pain than men did.  This study suggested the slight effectiveness of local thermotherapy in reducing the severity of pain in these patients. As a result, further studies are recommended.

 Cardiac insufficiency is one of the leading causes of mortality in the world and affects quality of life more than other chronic diseases. Cardiac self-efficacy can be considered for improving the quality of life of patients with this disease.  The purpose of this study was to determine the relationship between quality of life and cardiac self-efficacy in patients with heart failure.  This descriptive correlational study was performed on 227 patients with heart failure who referred to the cardiac clinics of Isfahan University of Medical Sciences affiliated hospitals, Iran, 2016-17. Sampling was done in a simple random way. The data gathering tool was comprised of three parts: demographic data questionnaire, Sullivan cardiac self-efficacy questionnaire, and Quality of Life questionnaire. Data were analyzed by SPSS software version 22.  The mean score of self-efficacy was 58.45 ± 25.92 and the mean score of satisfaction and importance of quality of life was 69.73 ± 18.72 and 82.76 ± 15.46, respectively. The results of this study showed that the importance of quality of life and satisfaction with quality of life are related to cardiac self-efficacy (P < 0.001). Pearson correlation coefficients showed a direct correlation between the scores of quality of life dimensions and the score of cardiac self-efficacy (in all cases, P < 0.001).  There is a positive and significant relationship between quality of life and cardiovascular self-efficacy in patients with heart failure.