Jundishapur Journal of Chronic Disease Care
Volume:11 Issue: 2, Apr 2022

Takayasu is a form of large vessel vasculitis that mainly affects the aorta and its branches. It is a chronic disease, and the long-term prognosis depends on arterial complications and its progressive stage.

This project is a single-center descriptive study of Takayasu’s arteritis patients in Arak city aimed to determine these demographic patterns, which can help physicians in early diagnosis.

All Takayasu’s arteritis patients referred to the rheumatology center of Amir Al-Momenin subspecialty clinic were studied from 2009 to 2019. Imaging methods were used for diagnosis, and SPSS version 23 was used for statistical analysis.

Out of 17 registered patients, information of nine patients was available from the beginning of diagnosis. Constitutional signs and symptoms indicated an inflammatory process in 77.78% of the patients. All patients in this study received a steroid-sparing drug as a part of the treatment, and the most commonly used drug was methotrexate, which was used in all patients at the onset.

This study reports the details and the characteristics of patients with Takayasu’s Arteritis in Arak, Iran. Although the number of patients was small, these results can inform the physicians about the signs, symptoms, and complications of delayed diagnosis of this disease. One of the most important points in the diagnosis of Takayasu is the delay between the onset of symptoms and the diagnosis of the disease. This delay may lead to irreversible complications and increased morbidity.

Nurses frequently encounter terminally ill patients, indicating the need for knowledge about palliative care. Also, their life satisfaction is affected by various factors.

This study aimed to identify the association between nurses’ knowledge about palliative care and their life satisfaction.

Following a cross-sectional design, 64 volunteer nurses working in various surgery units were studied. Data were collected using the “Socio-demographic Form”, “Satisfaction with Life Scale (SWLS)”, and the “Palliative Care Knowledge Test (PCKT)”.

PCKT total score was 10.09 ± 4.78, and SWLS total score was 19.58 ± 7.02. Also, the pain sub-scale mean score was higher than the philosophy, dyspnea, psychiatric problems, and gastrointestinal problems sub-scale mean scores (P < 0.01). There was a significant association between PCKT and sub-scale total scores (P < 0.01).

Nurses’ knowledge about palliative care and its management enables them to control symptoms such as pain and dyspnea successfully.

Visiting the family can have a great impact on hospitalized patients. Investigation of these effects is necessary to provide better care for patients admitted to the cardiac care unit (CCU).

This randomized clinical trial study was performed in the Golestan Hospital in Ahvaz, Iran, in 2021. Sixty-two CCU patients were randomly allocated to intervention and control groups. The scheduled family visit was performed twice a day, 60 minutes each time, for 3 days in the evening and night shifts for the intervention group. The routine family visit was used for the control group. Data were collected by a satisfaction questionnaire and a checklist on vital signs. Data were analyzed using the chi‑square, t-test, and generalized estimating equations (GEE).

In the intervention group, unlike the control group, there was a significant difference between the mean heart rate and systolic blood pressure of patients during different times (P < 0.000). Also, the level of satisfaction was higher in the intervention group than controls (P < 0.000).

This study demonstrated that scheduled family visits not only did not interfere with patients' vital signs but also increased their satisfaction. Therefore, it is necessary to design appropriate visitation policies for patients admitted to the cardiac intensive care unit.

Irritable bowel syndrome (IBS) symptoms increase with aggravating psychological factors such as anxiety, mood disorders, depression, and stress caused by nerve stimulation. Effective psychotherapy-based interventions are essential for medical conditions and chronic diseases.

The present study aimed to investigate the effectiveness of cognitive-behavioral stress management (CBSM) for depression, anxiety, cognitive emotion regulation (CER), and quality of life (QoL) in IBS patients.

This quasi-experimental study utilized a pretest-posttest design with a control group. The statistical population comprised all IBS patients visiting Be'sat Gastroenterology Specialist Clinic of Tehran in 2019. A sample of 50 patients was selected and randomly divided into intervention (CBSM, n = 25) and control (n = 25) groups. The experimental group underwent eight sessions (90-minute sessions per week) of CBSM, and the control group did not receive any intervention. The research instruments included the Cognitive Emotion Regulation Questionnaire (CERQ), the State-Trait Anxiety Inventory (STAI), the SF-36 Questionnaire (SF-36), and the Beck Depression Inventory (BDI-II). Multivariate analysis of covariance was used to analyze data.

The participants included 50 IBS patients aged 36.39 ± 7.45 years. The mean posttest scores for depression and anxiety were 24.70 ± 2.34 and 23.80 ± 2.88 in the experimental group and 29.73 ± 2.76 and 29.43 ± 2.77 in the control groups, respectively. The mean posttest score of QoL in the experimental group was 105.93 ± 7.85, which was significantly different from the control group score (92.03 ± 8.39). The CBSM was effective in reducing negative mood (depression and anxiety) and CER and improving QoL of IBS patients (P < 0.001).

The CBSM is a practical therapeutic approach to increase QoL and reduce negative mood in IBS patients. Therefore, the CBSM can be used as an effective intervention to improve the QoL of IBS patients.

Spiritual well-being, social support, health literacy, and resilience may affect the quality of life (QOL) in patients undergoing hemodialysis.

The purpose of this study was to investigate the effect of perceived social support, spiritual well-being, health literacy, and resilience on the QOL in patients under hemodialysis.

This descriptive cross-sectioanl study randomly included 260 patients from three educational hospitals in Ahvaz, Iran. Data were collected using a 36-item QOL questionnaire, Spiritual Health Questionnaire (SHQ), Perceived Social Support (PSS) Questionnaire, Resilience Questionnaire, and Montazeri et al.’s Health Literacy for Iranian Adults (HELIA) Questionnaire. Stata software version 14 was used for data analysis. The results were evaluated using descriptive statistics and a structural equation model (SEM).

In this study, a total of 260 patients (male: 138 vs. female: 122; mean age: 51.73 ± 15.32 years) undergoing hemodialysis were included. Most of the patients were married (76.9%) and had at least one comorbid disease (59.2%). Findings showed that health literacy, spiritual well-being, and social support had a significant correlation with the QOL (P < 0.001). However, resilience was not significantly related to the patients’ QOL (P > 0.58).

To improve the QOL of patients undergoing hemodialysis, health care providers need to improve patients’ health literacy, social relationships, and spiritual well-being.

Coronary stenosis and ectasia are cardiovascular diseases characterized by dysfunction of endothelial cells. Studies have shown that impaired blood flow due to inflammation and deposition in the endothelial cell wall can be effective in disease occurrence and progression. Although the etiologies of these diseases have not been identified accurately, it has been shown that inflammation and coagulation can be the main causes in these patients.

The aim of this study was to evaluate the levels of fibrinogen, Interlukine-17A (IL-17A), and red distribution width (RDW) in patients with coronary artery disease (CAD) and ectasia.

In this study, 140 patients with CAD admitted to Shariati Hospital of Tehran University of Medical Sciences, Iran, were included from from Jun 2020 to October 2021. Based on the severity of CAD, the participants were divided into two equal groups (n = 70 in each) of mild CAD (patients with CAD less than 50%) and multi-vessels CAD (patients with more than 50% stenosis in coronary arteries) according to the number of involved vessels (one, two, or three). Then, 5 cc of peripheral blood was collected from each patient in ethylenediaminetetraacetic acid (EDTA) containing tubes. IL-17A and fibrinogen were measured using enzyme-linked immunosorbent assay (ELISA) kit, and RDW was calculated by cell counter.

The mean age of participants was 63.0 ± 11.0 years in the mild group (35% males vs. 65% females) and 60.1 ± 12.1 years in the multi-vessels group (28% males vs. 72% females). The results showed that IL-17A, fibrinogen, and RDW levels in patients with ectasia and multi-vessels group were significantly higher than those in patients without coronary ectasia and mild CAD, respectively (P-value = 0.01 for fibrinogen; P-value = 0.05 for IL-17A; and P-value = 0.03 for RDW).

According to our results, identification and evaluation of fibrinogen and IL-17A, along with laboratory indices including RDW can be helpful in diagnosing high-risk individuals. Ectasia can be prevented, and it is possible to increase the patients’ survival through using some preventive and therapeutic strategies.

Work-related musculoskeletal injuries and complaints are widespread. Medical staff are exposed to these injuries depending on their duties.

This study aimed to investigate the occupational musculoskeletal complaints and related risk factors among medical staff working in Emam-Reza hospital of Larestan.

Following a cross-sectional, descriptive-analytical design, this study was performed on 124 medical staff working in Emam-Reza hospital of Larestan city in 2021. Participants were selected using convenient sampling. Data collection was performed using questionnaires filled out by participants from August to October 2021. The questionnaires were divided into demographic and musculoskeletal complaints using the Nordic questionnaire. Data analysis was administered using SPSS version 25. Statistical significance was considered when P-value < 0.05.

Of 124 participants, 92 (74.2%) were women. The mean age of participants was 34.97 ± 7.51 years. Most of the musculoskeletal complaints were related to the lumbar region, followed by one or both knees, and neck in the last 12 months and 7 days, respectively. Musculoskeletal complaints in the back during the previous 12 months and lumbar complaints during the previous 12 months and 7 days were significantly higher among nurses than others (P < 0.05). Also, in all body parts, the prevalence of musculoskeletal disorders was significantly higher in women than men (P < 0.05).

Given the musculoskeletal complaints among female nurses participating in this study, the authors recommend training them to prevent and focus attention on appropriate conditions and improving working conditions.

Psychological problems are mainly overlooked in patients with chronic diseases.

The present study aimed to investigate the effectiveness of acceptance and commitment therapy on stress, cognitive-attentional syndrome, and blood sugar indices in patients with type II diabetes.

In this quasi-experimental study, 40 patients with type II diabetes, referred to Birjand Diabetes Clinic in 2019 were selected via convenience sampling method. Later, subjects meeting inclusion criteria were randomly assigned into experimental and control groups. The former received treatment based on acceptance and commitment therapy (ACT) in eight 90-minute weekly sessions. Controls received no intervention. Fasting Blood Sugar (FBS) and glycosylated hemoglobin indices were measured for all participants before and after the intervention. The data were collected, followed by administering DASS scale developed by Lovibond and Lovibond (1995) and Wells cognitive attentional syndrome or CAS (2009) questionnaires and analyzed using SPSS 22. Univariate and multivariate analyses of covariance were also performed at a significance level of 0.05.

The participants’ mean educational level and age were (1.53 ± 2.70) and (6.03 ± 45.58), respectively. Also, the mean values of the variables CAS, stress, HBA1C, and FBS were (22.51 ± 94.09), (09.09 ± 36.30), (0.90 ± 7.34) and (29.09 ± 151.82), respectively. Also, the mean scores of stress (P = 0.002), CAS (P = 0.001), FBS (P = 0.001), and glycosylated hemoglobin (P = 0.001) indices were significantly lower in experimental compared to controls after the intervention.

In general, ACT effectively reduced stress, cognitive attention syndrome, and blood sugar indices among patients with type II diabetes. Experts should consider formality of this training in diabetes care treatment programs.

The prevalence of the COVID-19 pandemic has caused significant psychological and health disorders in individuals, such as some health care behaviors disturbance and anxiety disorder.

This study aimed to assess Iranian medical students’ anxiety level and self-care behaviors during the COVID-19 outbreak.

The anonymous online questionnaire was applied to collect data, including three general sections on the socio-demographical characteristics, COVID-19 self-care behaviors, and coronavirus anxiety scale. Totally, 620 students of the Faculty of Nursing and Midwifery of Mashhad University of Medical Sciences with access to the Internet were surveyed from May 23 to July 7, 2020.

The mean scores of self-care behaviors and anxiety levels were 56.71 ± 7.63 and 16.84 ± 3.75, respectively. The self-care behaviors were higher among female, married, and PhD candidates and infected students living in rural areas than other students (P < 0.05). The level of anxiety was significantly higher among male, single, and infected students living in metropolitan areas (P < 0.05). There was a significant negative relationship between self-care behaviors and anxiety levels (r = -0.922, P < 0.001).

The finding showed suitable self-care behaviors and high anxiety levels in students. The universities should prepare a package of multi-dimensional interventions, such as designing comprehensive software to reduce anxiety and increase preventive behaviors, such as self-care behaviors in students.

The aim of this study was to evaluate subclinical left ventricular (LV) dysfunction by two-dimensional (2D) speckle tracking echocardiography (STE) and three-dimensional echocardiography in patients with systematic lupus erythematosus (SLE).

This case-control study was performed on 106 patients, divided into the two groups of case (53 patients with SLE) and control (53 healthy individuals). All study participants were evaluated by transthoracic echocardiography, as well as Tissue Doppler echocardiography. Accordingly, ventricular dimensions and LV ejection fraction (LVEF) were assessed. Moreover, E velocity, A velocity, E/A ratio, and E/E’ ratio were evaluated in both groups. The LV global longitudinal strain (GLS) was measured by 2D STE in all individuals.

There was no significant difference between the two study groups regarding LVEF based on traditional echocardiography. However, E velocity, A velocity, and the E/e’ ratio were higher in the SLE patients (P < 0.05). In addition, the anti-double-stranded DNA (anti-dsDNA) positivity in SLE patients was associated with the lower levels of LVEF. No significant correlation was found between disease duration, LVEF, and LV GLS (P > 0.05).

Detection of subclinical LV systolic dysfunction by GLS is possible in SLE patients despite normal LVEF in traditional echocardiography. Therefore, LV could be used for the early detection and prevention of cardiac involvement in SLE patients.