مجله مطالعات علوم پزشکی
سال سی و چهارم شماره 7 (مهر 1402)

Movement coordination disorder is a chronic neurological disorder that starts from childhood in which, the brain messages are not accurately transmitted to the body, and movement planning and coordination are affected. These disorders cause problems that negatively affect the emotions, learning ability and memory of a person at the same time as they grow, and not only cause patients to be ineffective, but also severely affect their families. Therefore, this research was conducted with the aim of comparing the effectiveness of emotion regulation training based on Gross and Linehan's models on the mental health of mothers of children with Developmental Coordination Disorder (DCD).

The research method was semi-experimental with a pre-test-post-test design and follow-up with a control group. The research population included all the mothers of children suffering from developmental coordination disorder in day welfare rehabilitation centers of Isfahan who referred to the rehabilitation centers and filed a case in the second 6 months of 2011, and from them, 3 groups of 12 people were selected by available sampling method. They were randomly divided into two experimental groups (emotion regulation skill training based on Gross and Linehan models) and one control group. They filled the Depression, Anxiety and Stress Questionnaire of Lavibond and Lavibond (1995) in two phases of pre-test - post-test and follow-up. The subjects of the experimental groups were trained in emotion regulation skills based on the Gross and Linehan models (in the form of training and skills), for 2 months, 1 session of 60 minutes per week, however during this period, no training was given to the control group. The data were statistically analyzed using the two-sided multivariate covariance test and a significance level of p < 0.05 and using SPSS version 23 software.

The results of the study showed that emotional regulation skills training based on Gross and Linehan models is effective on depression, anxiety and stress with a significance level of less than 1% (P≤0.01). There was no significant difference between the two methods of emotion regulation training based on the Gross and Linehan models on the mental health of mothers of children with motor coordination disorder, but it was effective compared to the control group.

Therefore, emotional regulation skill training based on Gross model and Linehan model has been effective on mothers' mental health due to the nature of skills training.

For hernia surgery and to induce general anesthesia in children, pediatric venipuncture is needed. The venipuncture process in the children can lead to damage (destroy) of the vein due to many reasons, including fear, restlessness and the child's excessive movements. The aim of this study was to compare the results of inhalation anesthesia in children undergoing inguinal hernia repair surgery under general anesthesia.

In this randomized, single-blinded, prospective clinical trial study, 70 children aged 2 to 6 years who volunteered for inguinal herniorrhaphy were divided into two groups of 35 people in the children's operating room of Shahid Motahari Medical Training Center in Urmia. In the intervention group, peripheral venous catheterization was performed with induction of inhalation anesthesia by 8% soflurane along with oxygen and nitrous oxide, but in the control group, peripheral venous catheterization was performed without induction of inhalation anesthesia and awake. Randomization of intervention and control groups was done with Random Allocation software. Chi-square test was used to compare the frequency of studied variables between two groups. Independent t-test was used to compare the average intensity of restlessness between the two groups. Data analysis was done using SPSS 20 software and the significance level was considered less than 0.05.

The average time of intravenous insertion in the group receiving soflurane was 25.03 ± 21.996 and in the group not receiving soflurane was 254.21 ± 154.913. The difference in the average time of intravenous insertion of the patients in the study between the two groups receiving soflurane and not receiving soflurane was statistically significant, and this average value was much higher in the group not receiving soflurane than in the group receiving soflurane. There was a significant difference between the two groups in the variable of intravenous insertion time (P=0.0001).

Children induced with soflurane need more sedative drugs such as midazolam or combination of midazolam with other drugs. In terms of nausea and vomiting, soflurane has little nausea-causing properties, although is more common in soflurane compared to some drugs such as propofol.

Dysfunction in the autonomic nervous system causes secondary complications in the elderly with type 2 diabetes. The aim of the present study was to survey the effect of walking exercise on insulin resistance, lipid profile, and heart rate variability in the elderly with type 2 diabetes.

The present research method was semi-experimental with a pre-test-post-test design. The statistical population of the present study was made up of all type 2 diabetic elderly in Tehran. 30 male judo players were randomly divided into 2 groups, the first group (walking exercise) and the second group (control). Blood and heart variables were taken from the subjects before (24 hours before) and after the implementation of exercise programs (72 hours). The exercise protocol consisted of an 8-week walking program, which was based on Kao's (2007) article and also the suggestions of experts regarding the design and implementation of an exercise program in elderly and diabetic people who exercise three days a week and the intensity of 35% of the maximum oxygen consumption or 45% of the suggested heart rate was designed.

The results of the intergroup test showed that there was a significant difference in cholesterol (P=0.020) and insulin resistance (P=0.006) in the two training and control groups. SDNN (P=0.013), rMSSD (P=0.005), HF Power (P>0.001) and LF/HF Ratio (P=0.001) had significant differences in the two training and control groups. The results of the intra-group test showed that insulin resistance (P=0.009) and LF/HF ratio (P=0.020) in the training group decreased significantly in the post-test phase compared to the pre-test. SDNN (P=0.003), rMSSD (P=0.004) and HF Power (P=0.004) in the training group increased significantly in the post-test phase compared to the pre-test.

According to the research results, it can be concluded that a period of walking training can lead to improvement of insulin resistance and heart rate variability in the elderly with type 2 diabetes. Therefore, these exercises are recommended as a measure to reduce cardiovascular complications in the elderly with type 2 diabetes.

The precise knowledge of laboratory diagnostics such as the association between the cycle threshold (Ct) or the SARS-CoV-2 virus load can be used as a predictor of the infection risk with new strains of the SARS-CoV-2 virus for patients with Covid-19. This study was conducted based on the hypothesis that the Ct value of SARS-CoV-2 can also serve as a biomarker of disease severity, clinical outcome, and patient mortality.

In this cross-sectional study, the SARS-COV-2 qRT- PCR results of 443 hospitalized patients during 2019-1400 were examined, then the association between Ct with high viral load (Ct≤25) and lower viral load Ct >25 was determined.

Ct values in dead patients were significantly lower than discharged patients (P=0.005); Also, Ct values in the patients hospitalized in ICU were significantly lower than the patients hospitalized in Infection Control Units of the hospitals (P=0.002). Based on the adjusted analytical results, a high viral load (Ct≤25) increase chance of in-hospital death (OR=5.16, 95% CI: 2.36-11.28) and hospitalization in ICU (OR=6.87, 95% CI: 2.36-11.28).

In hospitalized patients with Covid-19, SARS-CoV-2 viral load was associated with mortality and hospitalization in the ICU. These findings show that the Ct value can be used as a tool to help identify patients who are at higher risk for severe outcomes of Covid-19 disease.

Consumption of mouthwashes is effective in reducing ventilator-associated pneumonia in the patients hospitalized in the Intensive Care Unit. Considering the importance of controlling and preventing the occurrence of ventilator-associated pneumonia, it was decided to compare the effect of chlorhexidine mouthwash with Dinah herbal mouthwash in preventing ventilator-associated pneumonia in patients hospitalized in the Intensive Care Unit.

In this clinical trial study, 80 patients hospitalized in the intensive care unit were included in the study in two groups of receiving chlorhexidine gluconate 0.2% and Dineh mouthwash. The frequency, time, and method of mouthwash in both groups were performed three times a day (every eight hours) for 5 days. The incidence of ventilator-associated pneumonia and mortality in the patients after taking drugs were investigated. Finally, the information was entered into SPSS 23 software and analyzed.

There were 21 female patients (52.5%) and 19 male patients (47.5%) in the chlorhexidine group, and 18 female patients (45%) and 22 male patients (55%) in the Dina group (p=0.655). The average age in the chlorhexidine group was 60.85±7.92 years and in the Dineh group was 57.68±6.93 years (p=0.060). The incidence of ventilator-associated pneumonia was 10% in the chlorhexidine group and 12.5% in the Dinah group (P=0.999). The outcome of the patients in the chlorhexidine group was 62.5% complete recovery, 32.5% recovery with complications, and 0.5% death, and in the Dina group, 70% complete recovery, 20% recovery with complications, and 10% death (p=0 /363).

In the patients under mechanical ventilation, Dinah mouthwash was not superior to chlorhexidine mouthwash in preventing ventilator-associated pneumonia.

Pregnant women are at a higher risk of contracting COVID-19 due to their weakened immune systems. There are various related factors for severe COVID-19 in pregnant women. This study aimed to assess the severe COVID-19 rate and its associated factors among Iranian pregnant women.

In this multi-center cross-sectional study from 21 March 2020-21 March 2021, all pregnant women (N=488) with COVID-19 who were admitted to healthcare centers in three counties (Mahabad, Miandoab, Bukan) in Iran were enrolled. Patients were categorized into two groups; hospitalized (severe COVID-19) and non-hospitalized. Data were collected through medical records using a researcher-made questionnaire. Statistical analysis was performed using multivariate logistic regression.

The mean age of pregnant women was 29.8±6.37 years and 19.9% were hospitalized(N=89). The COVID-19 hospitalization in pregnant women was significantly associated with fever (temperature ≥38 C) [aOR = 3.59, (95%CI; 2.08-6.17)], shortness of breath [aOR = 2.12, (95%CI; 1.24-3.61)], diagnosis of COVID-19 in the second trimester [aOR = 4.48, 95%CI; 1.48-13.58)], residence in the urban area [aOR = 0.45, (95%CI; 0.24-0.84)], and diploma and more education level [aOR = 0.58, (95%CI; 0.33-0.98)].

Urban residency and higher education level were protective factors. Fever, shortness of breath, and diagnosis of COVID-19 in the second trimester of pregnancy were related factors for hospitalization. Early diagnostic and therapeutic interventions for pregnant women with positive COVID-19 tests are essential in disease control. a longitudinal study with appropriate follow-up time to identify factors related to severe COVID-19 among pregnant women is needed.