مراقبت بیماریهای مزمن جندی شاپور
سال:1391 | دوره: | شماره: |تعداد مقالات:8

Background: Psoriasis is a chronic skin disease which continually causes other systemic disorders such as, hypertension and diabetes for unknown reasons. The aim of this study was to determine the epidemiology of psoriasis and concomitant diseases among patients referred to the dermatology clinic of Imam Khomeini Hospital of Ahvaz during 2006-2011.Materials and Methods: This descriptive study was performed on 854 patients with skin psoriasis referred to Ahvaz’ Imam Khomeini Hospital during 2006 to 2011. Medical records pertaining to the patients were studied in terms of features such as age, gender, family history, disease onset, disease duration, clinical form, location of the lesion, and concomitant diseases, e.g. hypertension, diabetes, depression, hypothyroidism, lupus, vitiligo and arthritis. Data were analyzed by SPSS software and reported as percent, mean and standard deviation.Results: Of 854 patients in vestigated during 5 years, 489 (57%) were male and 365 (43%) were female. The mean age of patients was 31.2±15.6 years; the mean age of disease onset was 26.7±11.7 years.Mean duration of disease was 12.3±6.9 years in men and women; 254 (29.8%) of patients had a positive family history of the disease.Most parts in the body which affected were feet (42%) and hands (34%). The most common clinical form of psoriasis was vulgaris (71.4%). Furthermore, other disease which observed with psoriasis were including; hypertension (32.7%), diabetes type 2 (25.6%), depression (16.9%), arthritis (9.4%), hypothyroidism (6.2%), vitiligo (5.1%) and lupus (4.1%).Conclusion: Given the high percentage of diseases associated with psoriasis in the study, it is necessary to improve the patients' awareness about the concomitant diseases, how to deal with them and doing further screening for better and earlier identification of these problems.

Introduction: Chronic obstructive pulmonary disease is currently the fourth cause of mortality worldwide. Patients with chronic obstructive pulmonary disease experience periods of dyspnea and disability, which lead to a worsening of their quality of life. This study aimed to evaluate correlation between quality of life and disease severity in patients with chronic obstructive pulmonary disease.Materials & Methods: In this cross-sectional study, 40 patients with chronic obstructive pulmonary disease referred to the hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences were recruited. St. George's quality of life questionnaire was applied to collect data. Data was analyzed using descriptive and analytical statistics in SPSS software version 16.Results: The result revealed that the quality of life in patients with chronic obstructive pulmonary disease is low in all levels of disease.There was a significant relationship between total scores of the quality of life and its two dimensions (activity and symptom) with disease severity (p<0.05). Whereas no significant relations were observed between the impacting dimension and disease severity.Conclusion: The quality of life in patients with chronic obstructive pulmonary disease deteriorates by increasing disease severity.

Introduction: Awareness of pregnant women about HIV/AIDS can play an important role in prevention of disease in the society. This study aimed to evaluate the effect of educational program on knowledge of pregnant women about HIV/AIDS.Material and Method: This was a randomized controlled trial on which, 120 pregnant women referred to health centers of Ahvaz for their routine follow-ups during pregnancy were selected on the basis of inclusion criteria in 2011. A questionnaire about sociodemographic and knowledge about HIV/AIDS was provided and completed using interview. Women were randomly classified into two groups (intervention and control).Individuals in control group only received routing care during pregnancy. But intervention group received two educational sessions and a booklet regarding HIV/AIDS transmission and prevention.Knowledge of participants was assessed at the beginning and at the end of study using the same questionnaire. Data analyzed using the SPSS ver 16 and descriptive, chi-square, independent, paired t-test and Pearson test were used for statistical purposes.Results: The findings revealed that; 33% of individuals had enough knowledge about transmission ways and 28% had enough knowledge about how to prevent disease. Majority of women (80%) did not receive any education about HIV/AIDS.There was significant difference between both of groups after accomplishment of educational program and mother’s knowledge in intervention group was significantly increased.Conclusion: Considering the educational classes for pregnant women and encouraging them to participate in these classes can be an effective way to reduce the rate of transmission of HIV/AIDS.

Introduction: Multiple Sclerosis (MS) is one of the most common diseases of central nervous system. Being chronic, having no certain cure, the nature of progressive of disease, the plight of the disease in youth and increasing number of patients with MS, explain that paying attention to this disease is essential. This study aimed to compare the different featres of MS disease between men and women in Ahvaz, Iran.Materials & Methods: In this descriptive study, 180 patients with MS (90 men, 90 women) who reffered to Ahvaz MS clinic in 2011 were enrolled. Data was collected by a questionnaire. Patients were selected randomly among all MS patients who had medical records in MS clinic. Data were analyzed with SPSS ver 18 and descriptive and analytical statistics including Chi-Square and Independent t-test were used for statistical purposes.Results: Mean age of participants was 37.8 yrs. Most male participants (61.1%) were employed and 38.9% were unemployed.Numbness and visual problems were the most common presenting symptoms of the disease. Over the past year, the average number of attacks inpatients was 1.2.Cinnovex and Betaferon were the medicines which were most used by patients.Conclusion: According to results, disease was started about age of 30 and 9.38% of male patients lost their work due to multiple sclerosis, these two factors, namely multiple sclerosis and unemployment may affect other aspects of patient's lives. In order to evaluate patients for mention above factors to a greater extent considering further research is vital for others related important life style features to improve patients' health.

Introduction: Many sexually active women with sickle-cell anemia can be pregnant and tend to use contraceptive methods. Access to an effective family planning is important for women with sickle-cell anemia, because their pregnancy can be more problematic.Objective: This study aimed to evaluate the different methods of family planning among women with sickle-cell anemia and their relationship with the crisis's onset of these diseases.Methods: This is a cross-sectional study which was conducted on 50 reproductive age women with sickle-cell anemia referred to Shafa hospital in Ahvaz during 2011-2012. Demographic data and patients' telephone numbers were extracted by referring to the medical records archive of patients. Data pertaining to the blood tests and electrophoresis of patients were extracted from the records. A questionnaire pertaining to the demographic data, history of midwifery and disease and sickle-cell anemia crises was completed via a telephone interview with the patient. Data were analyzed using the descriptive statistics, chi-square and Spearman's Rho test for assessing the relationship between sickle-cell anemia crises and contraceptive methods.Results: The most common contraceptive methods used by patients were; withdrawal (34%), barrier method (30%), tubal ligation (16%), oral contraceptive pills (12%), intra uterine device (2%) and Depot-Medroxy Progesterone Acetate (DMPA) (2%) respectively. Four percent of women did not use any contraceptive method. There was not any significant relationship between sickle-cell anemia crises and contraceptive methods.However, when we classified contraceptive methods to two groups of hormonal and non- hormonal methods, a significant relationship was found between crises of sickle-cell anemia and hormonal and nonhormonal methods.Conclusion: Results of this study showed that there is no relationship between contraceptive methods and sickle-cell anemia crises, but showed a significant relationship between crises and hormonal and non- hormonal methods. These findings require confirmation in other studies with larger sample size.

Introduction: Myocardial infarction is one of the most common diseases in Iran. Cardiac arrhythmia has been reported as the most common cause of death in patients with acute myocardial infarction.Given the importance of arrhythmias, this study aimed to determine the prevalence of cardiac arrhythmia in patients with acute myocardial infarction admitted to the CCU of Vasei hospital in Sabzevar, Iran Materials & Methods: This cross-sectional study was conducted on 132 patients with myocardial infarction, which were admitted to the CCU of Vasei hospital in Sabzevar city during 24 months from 2009 to 2011. Patients were selected by convenient non- randomly sampling. Demographic data and medical history of patients were collected using a questionnaire. A check list was applied for recording infarction and arrhythmias diagnosed by electrocardiogram, the 24-hour monitoring of the patients and72 hours after hospitalization. Data was analyzed by SPSS ver11.5; descriptive and analytical statistics including Chi-square test, ANOVA and Kruskal-Wallis test were used for statistical purposes.Results: A total number of 59.1% of patients had arrhythmia; where 19.6% of them had ventricular premature beats and 17.4% had episodes of ventricular tachycardia. The results showed that there was a significant relationship between the location of heart attack and type of arrhythmias (X2 14.4, p=0.002), there was no statically significance relationship between age, gender and type of arrhythmias (P>0.05).Conclusion: Because of the higher incidence of premature ventricular arrhythmia than others, hence, more awareness of the risk factors and treatment of these arrhythmias are necessary for medical and nursing staff.

Introduction: Approximately 80 million people in the world suffer from infertility. Laparoscopy is a golden standard method which helps diagnose peritoneal and the fallopian tube problems. It is also provides the opportunity to examine all the pelvic organs. The aim of this study was to assess the pregnancy rate after laparoscopy in the infertile women referred to the Paymanieh hospital, Jahrom.Materials & Methods: In this cross-sectional study, 162 infertile women referring to the Honari Clinic of Jahrom from 2008 to 2010 were enrolled. Laparoscopy was applied for these women due to other unsuccessful treatments. Information about patients including age, job, number of marriages, type of infertility, results of hysterosalpingography and rate of pregnancy after surgery was collected. Data was analyzed using descriptive statistics including frequency, mean and standard deviation by SPSS 16.Results: The mean age was 27.2±5.31 (16-43 years). The rate of pregnancy after laparoscopic surgery was 54.9%, which most of them (84.6%) had happened after cauterization of polycystic ovaries. All of these pregnancies were spontaneous, of which 83.15% had led to termination and 16.85% has ended in abortion. None of the cases were ectopic pregnancy or any other problem.Conclusion: The most common cause of women's infertility in Jahrom is polycystic ovaries, 89 out of 162 cases were conceived, which most of them (84.26%) conceived after electro-cautery, ovarian cyst removals or treatment of polycystic ovaries. This shows that the spontaneous ovulation after ovarian cauterization have been very satisfactory, which in turn is comparable to other similar studies. Hence cauterization of ovaries by laparoscopy has proved as an effective treatment for infertility.

Introduction: Diabetes is a chronic medical disease in which self management through a social support network for good prognosis is necessary. Anxiety and depression in people with diabetes are much more common in the healthy population.Panic anxiety disorder is also more common in people with diabetes than in non-patient population. Panic attacks worsen diabetes for different reasons. Not paying attention to the presence of anxiety disorder can have a detrimental effect on the treatment trend. The following case report deals with optimal control on diabetes mellitus by a successful treatment for panic attacks.Case report: A 45-year-old woman who had a history of diabetes from eight years ago, and was treated with insulin since two years ago, and was hospitalized because of lack of blood sugar control despite taking insulin. In the psychiatric interview with patient, depressive symptoms were found. The patient also complained of dyspnea attacks, which happened at different times of day and night and had the characteristics of panic attacks and consequently and consequently, patient imagining low blood sugar, took sugary drinks and sweets. Given the age of the patient, organic matters were considered, and recommendations were to be treated with clonazepam and citalopram. The patient was released in on the 7th day with suitable general conditions and without any asthma, of course, she was recommended to take psychiatric medications and insulin as well as to visit the clinic of psychiatry and endocrinology.Conclusions: simultaneous signs of the weakness, appetite disturbance, and autonomic nervous system stimulation, even in the absence of the patient’s complaints about psychiatric problems, the respectful internal and general practitioners must consider psychiatric counseling.