Jundishapur Journal of Chronic Disease Care
Volume:13 Issue: 3, Jun 2024

 Despite advancements in medical and nursing care, the mortality rate among hemodialysis patients remains unexpectedly high.

 This study aimed to evaluate the survival rates and identify mortality predictors among hemodialysis patients in Qazvin Province, Iran, over a five-year period from March 2015 to March 2020.

 This historical cohort study involved 378 hemodialysis patients from seven hospitals in Qazvin province, including Bu Ali Sina, Velayat, Razi, Alvand, Valiasr, Bueen Zahra, and Avaj, covering the period from March 21, 2015, to March 20, 2020. The study was based on data extracted from the patient's medical records, offering a detailed overview of their medical history and treatments during this timeframe.

 The study revealed a median survival time of 38.5 months, with survival rates at 1, 2, 3, 4, and 5 years being 84.3%, 68.1%, 53.2%, 39.8%, and 18.0%, respectively. Cox regression analysis identified several key predictors of mortality. Mortality rates increased with age, higher levels of blood urea nitrogen, and when hemoglobin levels fell below 10 g/dL or calcium levels exceeded 9.5 mg/dL. Conversely, patients who underwent hemodialysis three times a week had higher levels of education, used fistula access, and experienced significantly lower mortality rates.

 The study highlighted the need for targeted interventions to improve both the survival rates and quality of life for hemodialysis patients in Qazvin Province. It emphasized the importance of careful monitoring and effective management of factors such as age, blood urea nitrogen, hemoglobin, and calcium levels, as well as the patients' educational background, frequency of dialysis sessions, and type of vascular access. By focusing on these aspects, healthcare professionals in the region could significantly enhance patient outcomes and prognoses in hemodialysis care.

 Inborn errors of metabolism (IEMs) are a group of congenital and chronic diseases that cause many difficulties for children and their parents.

 This review aims to identify the needs that they are faced in caring.

 This is an integrative review using the method of Whittemore and Knafl (2005). The databases of PubMed, Web of Science (ISI), SID, and Google Scholar were searched in English and Persian without any time and methodology restrictions in October and November 2022.

 After screening the documents, 19 articles, consisting of 9 quantitative, 7 qualitative, and 3 review studies, were retrieved. Three categories of needs, including children, parents, and the healthcare system, were identified. The most reported needs were related to diet, psychological, social, and financial support dimensions and the necessity of implementing a multidisciplinary and coordinated care approach.

 Children with IEMs and their parents have many needs that can be satisfied through a multidisciplinary, patient-centered, and coordinated care approach.

 There is evidence that maternal near miss (MNM) may adversely affect sexual function later in life.

 This study aimed to evaluate the effect of cognitive-behavioral therapy (CBT) on the sexual function of women with MNM.

 Forty-eight women with MNM were randomly assigned to 2 groups: CBT (n = 24) and control (n = 24). Women in the CBT group received 8 counseling sessions based on CBT. Data were collected using a demographic questionnaire and the Female Sexual Function Index (FSFI). Women were requested to complete the FSFI questionnaire before and after the 8-session intervention. A total score of > 26 was considered normal sexual function. The intervention started in June and was completed in October 2021. The Shapiro-Wilk test, independent t-test, Chi-square test, and Mann-Whitney test were used to analyze the data.

 The scores of all components of sexual function improved in the CBT group compared to the control group as follows: Sexual desire (3.77 ± .64 vs. 2.25 ± .53, P < 0.001), sexual arousal (3.72 ± .45 vs. 2.40 ± .48, P < 0.001), lubrication (3.13 ± .35 vs. 2.60 ± .36, P < 0.001), orgasm (3.11 ± .45 vs. 1.0 ± .42, P < 0.001), sexual satisfaction (4.25 ± .52 vs. 2.83 ± .81, P < 0.001), pain (2.36 ± .80 vs. 4.21 ± .54, P < 0.001), total score of sexual function (20.37 ± 1.44 vs. 15.3 ± 1.40, P < 0.001).

 While CBT significantly improved the sexual function of women with MNM, their sexual performance score still did not fall within the normal range. Our results indicate that women with a near miss may require additional counseling sessions or alternative interventions.

 Ischemic heart disease stands as the foremost cause of death among cardiovascular conditions. The most commonly employed revascularization method for treating ischemic heart disease is percutaneous coronary intervention (PCI). An improvement in the patient's quality of life frequently serves as the primary measure of PCI's success.

 The purpose of this study was to assess the impact of an educational program grounded in the information-motivation-behavioral skills (IMB) model on the quality of life of patients who have undergone PCI.

 This quasi-experimental study involved 84 patients selected from those referred to the Cardiovascular Clinic of Razi Hospital in Birjand city, located in eastern Khorasan. Participants were required to fill out a demographics form and the Short Form of the Quality-of-Life Questionnaire (SF-12). They were then divided into an intervention group (n = 42) and a control group (n = 42) through the use of the permuted block method. Those in the intervention group participated in a 6-week educational program (meeting once weekly) designed around the IMB model. The control group received the standard care available at the Cardiovascular Clinic. Both groups were asked to return to the Cardiology Clinic 6 weeks after the initial test to complete the SF-12 (posttest). All participants were surveyed again one month after the second questionnaire completion (follow-up).

 The intervention group showed a significant increase in the mean score of physical health immediately and one month after the intervention, compared to the pretest scores (P = 0.001 and P = 0.004, respectively). Furthermore, the mean posttest score for psychological health in the intervention group significantly improved compared to the pretest (P < 0.001), and their follow-up score improved significantly compared to the posttest score (P = 0.02). There were no significant changes in the mean scores for physical and psychological health in the control group over time (P > 0.05).

 This study indicates that the quality of life for patients post-PCI can be significantly improved through participation in an educational program based on the IMB model. This research provides a foundation for the development of interventions with more enduring effects on post-PCI patient outcomes.

 There is a paucity of research investigating the changes in thyroid hormones in individuals affected by coronavirus disease 2019 (COVID-19).

 This study aimed to evaluate the levels of thyroid hormones in individuals affected by COVID-19 infection in Ahvaz, Iran.

 This was a comparative cross-sectional study on 78 patients with COVID-19 infection and 80 individuals without infection. Thyroid-stimulating hormone (TSH), triiodothyronine (TT3), and tetraiodothyronine (TT4) were measured in hospitalized patients at baseline and one month after recovery and in participants without infection. The data were analyzed using a paired t-test, the Chi-square test, the Wilcoxon test, and the analysis of covariance (ANCOVA).

 The level of TSH at baseline in the hospitalized patients was significantly lower than that in the control group (1.24 ± 1.08 vs. 2.05 ± 1.02 mlU/L, respectively, P < 0.0001). The mean level of TT3 was 1.20 ± 0.24 and 1.28 ± 1.25 ng/dL in the case and control groups, respectively (P = 0.188). The level of TT4 in the case group was high at baseline in comparison to the control group (8.48 ± 2.27 vs. 7.76 ± 1.43 ng/dL, P = 0.076), which was reduced in the follow-up period. Thirty-five (44.8%) patients had severe disease and were admitted to the intensive care unit (ICU). The level of TSH was non-significantly lower in patients with severe disease than those with moderate disease.

 Patients with COVID-19 infection showed abnormalities in thyroid hormones, such as decreased levels of TSH and TT3. Patients with severe COVID-19 showed lower levels of TSH and unchanged levels of TT3 and TT4 in comparison to the patients with moderate disease. Further investigation into thyroid function in patients with COVID-19 is recommended.

 Since the beginning of mobile phone addiction, alexithymia, depression, anxiety, and stress have been mentioned as complications of Internet addiction in various studies; however, the relationship between these variables has not been well investigated.

 This study was conducted to investigate the relationship between alexithymia and mobile phone addiction, emphasizing the mediating role of anxiety, stress, and depression.

 In this descriptive-analytical study, 412 students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, were included using an available sampling method in 2019. Data collection tools were the demographic questionnaire, Toronto Alexithymia Scale (TAS-20), Depression, Anxiety, Stress Scale (DASS-21), and Mobile Phone Addiction Index (MPAI). Statistical analysis was carried out using SPSS software (version 22) and Amos software (version 16). A significance level of less than 0.05 was considered.

 Alexithymia was a predictive factor for mobile phone addiction. Additionally, it had a direct and significant effect on depression (β = 0.540, P < 0.001), anxiety (β = 0.500, P < 0.001), and stress (β = 0.53, P < 0.001). Depression (β = 0.452, P < 0.001), anxiety (β = 0.408, P < 0.001), and stress (β = 0.460, P < 0.001) had a positive and significant effect on cell phone addiction.

 In this study, alexithymia was a predictive factor for mobile phone addiction. Moreover, the variables of depression, anxiety, and stress play the role of a relative mediating variable between alexithymia and mobile addiction.

 Comprehension and visual-motor integration skills are still widely used in the psychological assessments of children. Recent evidence suggests that children with autism spectrum disorder (ASD) might have a general impairment in visual motion perception.

 This study aimed to evaluate the effects of motion imagery on visual motor perception in children with ASD.

 In a before and after clinical trial study, 30 children with ASD were divided into two groups of 15 subjects, test and control. The intervention group received 3 sessions of 60 minutes per week for 15 weeks with movement visualization exercises. Before and after the intervention and after the follow-up period, visual motor perception and motor imagery questionnaires were completed and implemented. The data were analyzed using SPSS22 software (P ≤ 0.05). The Kolmogorov-Smirnov test was used to determine the normality of the data, and variance analysis was used to compare the averages of the two groups before and after the intervention and follow-up.

 The results obtained in all subscales of motor imagery with P = 0.001 indicated that there was a statistically significant difference between the two groups in the pre-test and post-test scores. Additionally, the results obtained concerning visual motor perception showed that in all the subscales with P < 0.001, statistically significant differences could be observed after the intervention and in the 3 months of follow-up.

 Motion visualization is an easy and accessible method that has positive and effective effects on visual-motor perception skills. Treatment practitioners can use this method to improve ASD children.

 Patients with Multiple Sclerosis (MS) often experience varying levels of social stigma, which can impact their health.

 This study aimed to explore the relationship between perceived stigma and coping strategies among MS patients.

 Conducted from December 2019 to June 2020, this cross-sectional and correlational study involved 100 MS patients. Participants were recruited from a neurologic clinic in Qazvin, Iran, using convenience sampling. Data collection employed the Lazarus Coping Strategies Questionnaire and the Korean version of the Stigma Scale for Chronic Illness 8-item (SSCI-8). Patients completed these questionnaires at the clinic. Data analysis utilized Pearson’s and Spearman’s correlation coefficients.

 The average age of participants was 35.93 ± 7.20 years. Mean scores for internal and external stigmas were 6.47 ± 2.03 and 8.73 ± 3.48, respectively. Problem-focused strategies were most commonly used by MS patients. Pearson correlations revealed a significant positive relationship between internal stigma and escape-avoidance (r = 0.391, P < 0.000), seeking social support (r = 0.215, P = 0.031), confronting (r = 0.240, P = 0.016), and self-controlling strategies (r = 0.222, P = 0.026). Significant associations were also noted between external stigma and escape avoidance (r = 0.322, P = 0.001) and confronting strategies (r = 0.240, P = 0.016). Inverse correlations were found between educational level and internal stigma (r = -0.273, P = 0.006) and between MS duration and external stigma (r = -0.296, P = 0.003).

 Multiple sclerosis (MS) patients experiencing higher levels of stigma tended to use more negative coping strategies. Implementing programs to reduce stigma and promote effective coping strategies may enhance the physical and psychological well-being of these patients.

Context:

 Due to the chronic nature of cancer, screening programs were a set of sequential decisions taken over time. Markov decision process (MDP) and partially observable Markov decision process (POMDP) models were the mathematical tools applied in studies, including sequential decision-making such as screening protocols for medical decision-making.

 The main goal of this study was to investigate optimal policy for cancer screening using MDP and POMDP models.

 We performed a review of articles published within July 2000 to November 2022 in PubMed, Web of Science, and Scopus databases. The stopping age, the type of optimal strategy, the benefits of the optimal policy, and the relationship between age and risk threshold were extracted. Studies that did not use MDPs and POMDPs as the mathematical maximization models in cancer screening, review articles, editorials or commentaries, non-English articles, and those that did not focus on optimization were excluded.

 From 532 articles, 6 studies met the study criteria. All studies suggested that the optimal policy was control-limit, and the cancer risk threshold was a non-decreasing function of age. Three studies specified a stopping age for cancer screening. In five studies, the optimal policies outperformed the guidelines or no screening strategy.

 Two essential factors in screening decisions were cancer risk and age, which were individual variables. The control-limit policy included these factors in decision-making for cancer screening. These policies highlighted personalized screening and showed that this type of screening could outperform cancer screening guidelines regarding economic and clinical benefits.

 The enhancement of happiness in patients undergoing hemodialysis is positively associated with improved physical and mental health outcomes.

 This study was conducted to identify predictive factors of happiness among a group of Iranian hemodialysis patients.

 In 2021, a descriptive study was carried out involving 200 hemodialysis patients from a center in Qazvin province, Iran. The census method was utilized to select eligible patients. Data collection was conducted using a socio-demographic checklist, the Oxford Happiness Questionnaire, and Snyder’s Hope Scale. A multivariate regression model was employed to ascertain the predictors of happiness.

 The average age of the patients was 59.23 ± 14.43, with an age range from 18 to 86 years. The majority were male (n = 122, 61.0%) and married (n = 134, 67.0%). A significant portion of the patients (69%, n = 138) reported moderate levels of happiness. The study also discovered that educational level (β = 0.248, P ≤ 0.001), marital status (β = -0.268, P ≤ 0.001), adequacy of hemodialysis (β = 0.268, P ≤ 0.001), and hope (β = 0.231, P ≤ 0.001) were significant predictors of happiness in patients undergoing hemodialysis.

 The findings indicate that the majority of hemodialysis patients in Qazvin experience a moderate level of happiness. Factors such as hope, educational level, marital status, and adequacy of hemodialysis were linked to their happiness. These insights can inform health strategies developed by decision-makers aimed at enhancing the happiness of this patient group.

 The relationship between various blood glucose-lowering treatments for type 2 diabetes mellitus (T2DM) and the mortality and complication rates of COVID-19 infection holds significant relevance.

 This retrospective study aimed to investigate the clinical progression of COVID-19 in T2DM patients previously treated with sitagliptin, metformin, or a combination of both.

 The study reviewed the medical records of T2DM patients with COVID-19 who had received treatment with sitagliptin, metformin, or both. Participants were selected from those admitted to Naft Hospital in Ahvaz, Iran, from March 2020 to March 2022. Data on mortality and adverse outcomes related to COVID-19 were gathered from the medical records.

 The study included 529 diabetic patients treated with metformin (n = 197), sitagliptin (n = 231), or both (n = 101) for a minimum of three months. The overall mortality rate among diabetic patients was 15.1%, with the metformin group showing the highest mortality rate at 28.9% (P < 0.0001). Significant differences were observed among the three treatment groups in terms of the frequency of acute respiratory failure (P < 0.0001), stroke (P = 0.002), pulmonary embolism (P < 0.0001), and the necessity for ICU admission (P < 0.0001). Nonetheless, the incidence of myocardial infarction did not significantly differ between the groups.

 The findings suggest that sitagliptin use for blood sugar control in T2DM patients may help reduce adverse outcomes and the risk of death due to COVID-19. Mortality and morbidity rates were found to be higher in patients treated with metformin compared to those in the other groups.

 Recent evidence suggests the potential efficacy of modafinil in addressing specific symptom domains associated with schizophrenia, particularly negative and cognitive symptoms. However, it's important to note that findings in this area have been inconsistent.

 This study was done to assess the impact of modafinil on improving negative symptoms in schizophrenia patients.

 In this clinical trial, 40 individuals diagnosed with schizophrenia and referred to Golestan Hospital were selected. Patients received a daily dose of 100 to 200 mg of modafinil in addition to their ongoing antipsychotic treatment with either Risperidone or Olanzapine. In the control group, patients received a placebo along with their prescribed antipsychotic therapy. The duration of the follow-up was 4 weeks. Both the evaluator and the patients were blinded to the administered medication. The Scale for the Assessment of Negative Symptoms (SANS) was utilized to measure negative symptoms before the intervention, and at 2 and 4 weeks following the intervention.

 The mean age of participants in the intervention and control groups was 34.00 ± 6.60 and 36.90 ± 6.88 years, respectively. Two weeks after the intervention, the average SANS score was lower in the intervention group compared to the placebo group (99.70 ± 10.24 vs. 111.24 ± 7.08, P = 0.04). At 4 weeks post-intervention, the average SANS score in the intervention group was significantly reduced compared to the placebo group (84.39 ± 3.54 vs. 113.79 ± 3.75, P = 0.002).

 This study suggests that modafinil may be an effective adjunctive therapy for schizophrenia, particularly for treating anhedonia symptoms.

 There is evidence supporting the effectiveness of mirror therapy (MT) in improving pain and function in the upper limbs. However, there are limited studies that validate its effectiveness in enhancing function and reducing pain among individuals with chronic back pain.

 This study aimed to assess the effect of motor correction exercises with and without MT on pain intensity and disability in patients with chronic low back.

 This randomized clinical trial study was conducted on 72 participants with chronic back pain referring to physiotherapy centers affiliated with Jundishapur University of Medical Sciences, Ahvaz. Specific exercises using MT were performed in the intervention group (36 participants) and without it in the control group (36 participants) for 10 weeks. The condition of the patients before and after the intervention and 3 months after the intervention was evaluated using a chronic pain questionnaire, pain intensity, and Oswestry index. The data were analyzed using SPSS version 22, employing descriptive and inferential statistical methods. A significance level of P ≤ 0.05 was used.

 A significant difference was observed between the groups for the variables that showed pain intensity after treatment (P = 0.001) and the difference remained in the follow-up (P = 0.003) Chronic pain after treatment and the difference at follow-up [-0.41 (-3.45 to 2.47), P = 0.001] and disability remained after treatment [-2.6 (-5.6 to 0.5); P = 0.02] which indicates the effectiveness of MT.

 Based on the results, MT was effective in reducing the pain intensity and disability experienced by patients with chronic back pain. As a result, considering its affordability and ease of access, patients can perform the exercises independently after receiving proper instruction and guidance.

 Spiritual health has been linked to the mental health of adolescents. Yet, the impact of the coronavirus pandemic on the spiritual health of adolescents with chronic diseases, as opposed to the mental health of their healthy counterparts in Iran, has not been explored.

 The aim of this study was to examine the association between spiritual health and COVID-19-induced anxiety among adolescents, both with and without chronic diseases.

 This descriptive cross-sectional study involved 85 adolescents with chronic diseases (selected through convenience sampling) and 80 adolescents without chronic diseases (selected through cluster random sampling) in Tehran, Iran. The Spiritual Well-Being Scale (SWBS) and the Corona Disease Anxiety Scale (CDAS) were utilized for data collection.

 The findings indicated that anxiety levels related to COVID-19 were significantly higher among adolescents with chronic diseases compared to their healthy peers (P = 0.001). Additionally, spiritual well-being was significantly lower in adolescents with chronic diseases than in healthy adolescents (P = 0.001).

 The COVID-19 pandemic appears to be linked to psychological and spiritual vulnerabilities in adolescents with chronic diseases, suggesting a need for psychological support and special consideration for these individuals.

 Urinary stones rank as the third most common disease of the genitourinary system, following urinary tract infections and prostate diseases. Their incidence is influenced by various demographic, environmental, and genetic factors.

 This study aimed to explore the association between Body Mass Index (BMI), blood lipids, and kidney stones.

 This cross-sectional study utilized the baseline data of 10 133 participants aged 35 - 70 years from the Fasa cohort study. The dataset included demographic information, biochemical laboratory results, anthropometric measurements, behavioral data, and the presence or absence of kidney stones. Data analysis employed t-tests, chi-square tests, and logistic regression models.

 Among the 10 133 participants, 54.9% were women, with a mean age of 48.63 ± 9.57 years. The prevalence of kidney stones was 17.3%. The findings indicated a correlation between BMI and triglyceride levels (TG) with kidney stones. Elevated BMI and triglyceride levels were associated with increased odds of developing kidney stones, with odds ratios of 1.048 (95% CI: 1.025 - 1.048) and 1.006 (95% CI: 1.001 - 1.006), respectively.

 The study revealed a significant relationship between BMI, triglyceride levels, and kidney stones. Individuals with kidney stones exhibited higher mean BMI and TG levels compared to those without. These findings from the Fasa PERSIAN (Prospective Epidemiological Research Studies in Iran) cohort suggest that kidney stone disease is linked to elevated triglyceride levels and BMI. Given that a high-fat diet contributes to increased BMI and elevated serum triglyceride levels, measures to reduce weight, combat obesity, and manage triglyceride levels are warranted to mitigate the risk of kidney stone formation.