Jundishapur Journal of Chronic Disease Care
Year:2016 | Volume:5 | Issue:2|Papers Count:10

Background: Khuzestan province has faced a sharp increase of leukemia incidence and mortality during the recent years. Many studies have investigated the risk factors associated with leukemia, but inconsistent findings have been reported. To the best to our knowledge, no other study has assessed the association between lifestyle and incidence of leukemia in Ahvaz province, Iran.Objectives: This study was conducted to investigate the association between lifestyle and incidence of leukemia in adults in Ahvaz, located in southwest Iran.Patients and Methods: This case-control study was conducted on 80 adult patients with leukemia (referred to Shefa and Golestan hospitals in Ahvaz, Iran in 2014 - 2015) and 80 healthy individuals matched by gender and age. The data was collected by a researcher-created questionnaire assessing individual demographics and some lifestyle-related factors, and was analyzed by descriptive statistics and a chi-square test, using SPSS16.Results: Exposure to radiation (P=0.0001), chemicals (P=0.02), pesticides (P=0.01), and contact with pets or livestock (P=0.0001) were associated with the risk of leukemia, but a history of smoking (P=0.19) and drinking alcohol (P=0.59), as well as living close to power transmission and distribution lines (P=0.25), showed no association with leukemia.Conclusions: This study showed that some lifestyle factors, particularly exposure to radiation, chemicals, pesticides, and contact with pets or livestock, can play an important role in etiology of leukemia.

Background: Esophageal cancer is of major concern worldwide, ranking sixth as the most common cause of cancer mortality.Lifestyles such as cigarette smoking, alcohol consumption, and poor dietary habits have been suggested to be associated with the carcinogenesis of esophageal cancer.Objectives: This study aimed to determine the factors affecting and associated with esophageal cancer in Khorramabad city from 2012 to 2014.Patients and Methods: This is an analytical study of 48 patients with esophageal cancer, including 80 controls. The patients were selected on the basis of a census. The data were collected using a questionnaire, and Chi-square, t-test, and one way ANOVA analyses were performed using SPSS 19.Results: In this study, 57.8% males and 42.2% females participated, while the mean age of the patients was 68.46 years old, and the mean age of the healthy individuals was 59.79 years old. The findings of this study showed a family history of cancer, anemia, and smoking, and associations with education, occupation, socioeconomic status, blood group, consumption of hot drinks, as well as a history of gastroesophageal reflux. In addition, there was a significant relationship, but no significant association, between alcohol consumption and esophageal cancer.Conclusions: According to the results of this study, the necessary measures to modify the risk factors, such as educational programs and changing food consumption patterns in the subjects, are effective, and can reduce the risk of esophageal cancer.

Background: Autism is a neurological disorder that limits communication, socialization, and participation of children in symbolic play. Sensory processing disorders are common characteristics (45% to 96%) of children with pervasive development disorders, including. Sleep disorders are also more prevalent in autistic children than in normal children.Objectives: This study aimed to investigate the relationship between sensory processing disorders and sleep disturbances in school-aged autistic children.Patients and Methods: This study is quantitative, observational, and cross-sectional. 35 school-aged autistic children in Shiraz, Iran were selected using cluster sampling. A demographic questionnaire, short sensory profile (SSP), and the sleep disturbance scale for children (SDSC) were used. The Pearson correlation coefficient and Pearson chi-square were used during data analysis.Results: Results shows that autistic children show clear differences from normal function (74.3%), possible differences with normal function (20%), and normal function (5.7%) in their total sensory processing scores. 95.3% of autistic children had some degrees of abnormal sensory processing disorder. Also, 68.6% of the participants suffered from sleep disorders. However, there was no relationship between sensory processing disorders and sleep disturbances in children with autism (P value = 0.83). Also, there was no correlation between the subscales of sensory processing disorders and the subscales of sleep disturbances.Conclusions: The results showed that despite the simultaneous high prevalence of sleep disturbances and sensory processing disorders in children with autism, there isn’t a significant relationship between the two conditions among these children.

Background: The patients undergoing coronary artery angioplasty should be motivated to adhere to lifestyle modifications. One of the factors affecting this issue is cardiac self-efficacy. Cardiac self-efficacy motivates individuals to select a lifestyle related to their cardiovascular diseases through creating the desire to adjust with such behaviors.Objectives: The current research aimed to determine the cardiac self-efficacy predictors after coronary artery angioplasty.Patients and Methods: In this cross-sectional study, 193 patients undergoing coronary artery angioplasty in Dr. Heshmat educational therapeutic center were selected through convenience sampling. The data were collected by a questionnaire consisted of two sections, including socio-demographic factors and cardiac self-efficacy after oral consent of the subjects. Then data were analyzed via descriptive (frequency distribution, mean and standard deviation) and inferential statistics (Pearson, ANOVA and independent t-test). To define cardiac self-efficacy predictors, multi-linear regression model was applied.Results: Based on the obtained results, the mean age of subjects was 58.35 ± 9.97 years, the majority were male (60.6%) and the underlying diseases history (57.5%) and the mean time interval between repeated angioplasty was 17.48± 25.2 months. Also the mean score of cardiac self-efficacy among these patients was 8.43±4.5. Also, based on the results of the statistical tests, there was a significant relationship between age (P<0.001), gender (P=0.024), education (P<0.0001), hypertension history (P=0.006), living conditions (P=0.03), job (P=0.001) and monthly income (P=0.003) with cardiac self-efficacy. As the multi-linear regression test results suggested, age was the only cardiac self-efficacy predictor.Conclusions: The current study results implied low cardiac self-efficacy score in the study units; then it is recommendedto consider care plans to improve the cardiac self-efficacy.

Context: Many nursing educational approaches have been applied on patients with heart failure (HF) to improve their outcomes.The results of these approaches on outcomes of patients with HF remain controversial.Evidence Acquisition: The aim of this study was to highlight the importance of nursing education to improve the outcomes of patients with HF, such as self-care behaviour, quality of life, mortality, readmission and hospitalization rates. A systematic review was conducted in the MEDLINE database on investigations punished from 2000 to 2012. The search terms used were self-care, heart failure, nursing, and education. A total of 22 studies complied with the eligibility criteria for this review.Results: The findings of the reviewed studies showed that self-care behaviour of patientswhoreceived nursing education improved significantly. No significant improvement was noticed in the health-related quality of life. Additionally, there was no significant reduction in readmission, hospitalization and mortality rates of patients after implementing this educational process.Conclusions: The effectiveness of nursing education on self-care behaviour of HF patients was clearly demonstrated. Methodological differences in development and implementation of education programs, made the comparison between the results of the studies difficult.

Background: Non-alcoholic fatty liver disease (NAFLD) is a growing diagnosed condition which causes a wide spectrum of liver disorders. There is a lot of evidence introducing NAFLD as a risk factor for coronary artery disease (CAD) but there is substantial challenge on the independency of this correlation.Objectives: The current study aimed to evaluate the prevalence of NAFLD among patients with CAD.Patients and Methods: Patients referred for coronary angiography due to suspected coronary heart disease were included in the study. First, the demographic characteristics were extracted. Alanine aminotransferase (ALT), lipid profile and fasting blood glucose were measured and also liver sonography and coronary angiography were performed on all subjects. According to the angiography results, subjects were divided into three groups: 1- normal angiography; 2-mild CAD and 3- sever CAD. The prevalence of suspected NAFLD was evaluated in all of the groups. Suspected NAFLD was defined as elevated ALT accompanied with fatty liver on liver sonography.Results: A total of 314 subjects were eligible for the study, out of which 161 (51.3%) were male and 153 (48.7%) female; 236 (75.1%) subjects had coronary artery disease and 78 (24.9%) subjects had normal coronary arteries. After ranking the subjects according to the degree of coronary artery stenosis; in subjects with normal coronary arteries, 13 subjects (16.7%) were suspected of NAFLD; 172 subjects had mild CAD that 17.44% of them were suspected of NAFLD which was not significant compared to the subjects without CAD (P=0.046).There was a significant difference in the prevalence of suspected NAFLD among the subjects in the sever CAD group based on finding 64 subjects of NAFLD (P=0.003). Mean values of total and low-density lipoproteins (LDL) cholesterol, triglyceride and fasting blood sugar (FBS) were significantly greater in subjects with CAD. Subjects with NAFLD had significantly greater means of triglyceride and LDL cholesterol level than subjects without NAFLD (P=0.03 and 0.0, 1 respectively). A significantly greater proportion of subjects in the NAFLD group had hypertriglyceridemia, hypercholesterolemia and low high-density lipoproteins (HDL) level in comparison with the subjects without NAFLD.Conclusions: According to the results of the current study, the prevalence of NAFLD among the subjects with severe CAD was significant; however, further studies are necessary to clarify the importance of the role of NFLD as an independent risk factor for mild CAD.

Background: Medication errors are the most common medical errors, and are one of the major challenges threatening the healthcare system, which is inherently susceptible to error.Objectives: In this study, we aimed to compare the occurrence of errors between two methods of entering orders: manual and digital.Patients and Methods: In this perspective study, 350 files in the Baqiyatallah hospital in Tehran, Iran, were evaluated in 2014. The files were divided into two groups, including manual and digital methods, with 175 members each. In both groups, the presence of errors in the administration, registration, and execution of orders was compared.Results: Overall, 350 cases underwent analysis; 175 files were evaluated manually and 175 were evaluated digitally. Of the 69 errors (19.7%) that occurred, 65 errors (18.6%) were in the manualfiles versus 4 (1.1%) in the digital files (P<0.001). Themeanage of the nurses making errors was 32.42±7.13 years old, and for the others it was 35.15±7.76 years old (P=0.008). Additionally, the mean age of the physicians with errors was 37.52±7.97 years old versus 34.48±6.82 years old in the others. Moreover, significant differences were observed between the two groups in terms of age (P=0.002). Of the 69 errors, 80% were because of bad handwriting (P<0.001), 50 errors (14.3%) were pharmaceutical, 2 errors (0.6%) were related to the procedure, and 17 (4.9%) were related to the tests.Conclusions: It can be concluded that electronic health records lead to a reduction in medication errors and increase patient safety.

Background: Most hospitals have restricted visitation time in intensive care units (ICUs) for various reasons. Given the advantages of family presence and positive effect of emotional touching, talking and smiling on nervous system stimulation and vital signs of the patients.Objectives: The present study aimed to determine the effect of increased visitation time on physiological indices of the patients hospitalized in ICUs.Materials and Methods: This clinical trial study was conducted in the ICUs of Vail-e-Asr hospital in Arak city, Iran. A total of 60 subjects were randomly assigned to the intervention and control groups with visitation time for 10 minutes 3 times a day and 10 minutes once a day, respectively. Then, the patients’ physiological indices were measured before, during, and 10 and 30 minutes after the hospital visiting hours. Data were analyzed using SPSS version 20.Results: Findings showed no statistically significant differences among mean values of all physiological indices in measurement stages before, during, and 10 and 30 minutes after the visitation times in the control group (P>0.05). While, in the intervention group, systolic blood pressure (SBP) measurements at 9 (previous mean: 126.9, 30 minutes later: 111.9), 12: 00 PM (previous mean: 126.9, 30 minutes later: 114.9), and 3: 00 PM (previous mean: 125.2, 30 minutes later: 105.8), diastolic blood pressure (DBP) measurements at 9: 00 AM (previous mean: 87.4, 30 minutes later: 83.2), 12: 00 PM (previous mean: 86.6, 30 minutes later: 81.7), and 3: 00 PM (previous mean: 87.1, 30 minutes later: 85.0), heart rate (HR) measurements at 9: 00 AM (previous mean: 90, 30 minutes later: 78.4), 12: 00 PM (previous mean: 89.8, 30 minutes later: 78.6), and 3: 00 PM (previous mean: 89.3, 30 minutes later: 78.3), repertory rate (RR) measurements at 9: 00 AM (previous mean: 20.9, 30 minutes later: 15.0), 12: 00 PM (previous mean: 20.6, 30 minutes later: 15.4), and 3: 00 PM (previous mean: 21.0, 30 minutes later: 15.9) showed statistically significant differences (P<0.05). However, no statistically significant differences were observed among Oxygen saturation (OS) measurements at 9: 00 AM, 12: 00 PM and 3: 00 PM in this latter group as well (P>0.05).Conclusions: Increasing visitation time leads to reduced physiological indices’ mean values. Hence, it is recommended to extend hospital visiting times in order to improve the condition of patients admitted to ICU.

Background: Thalassemia is among the most common hematological diseases, but it has no definitive cure. The self-concept in adolescents with thalassemia major changes due to changes in their facial form. Among the factors affecting the patient’s selfconcept is social capital.Objectives: The study aims to examine the relationship between social capital and self-concept in adolescents with thalassemia major, using a sample of patients admitted to Shafa hospital in Ahvaz, Iran in 2014.PatientsandMethods: This descriptive-analytical studywasperformedon146 adolescents (age range, 13 - 18 years) with thalassemia majorwhowere referred to the hemoglobinopathy ward of Shafa hospital in Ahvaz, Iran to receive blood. The sampling method was a census. Data collection was completed using the Onyx and Bullen social capital questionnaire and Piers Harris’s children’s selfconcept scale. After obtaining the informed consent of the patients’ parents, questionnaires were handed to patients in different shifts and answered in the presence of the researcher. To analyze the data, descriptive statistics and analytical statistics (mean, std.deviation, and Pearson correlation) were carried out (CI 95%).Results: Themeanand standard deviation of patients’ age was 1.7615.88.53.4% were male.58.7% of the sample had an average selfconcept and 63.2% had average social capital. The mean score of the total sample’s self-concept was 11.5053.36, which is moderate.The average social capital of all adolescents with thalassemia major was 17.02 87.38, i.e. in the mid-range. Among the aspects of self-concept, about 70% of participants had an average or poor appearance, attitude, and anxiety. For social trust, more than 90% of participants were average or weak and 75.2% had poor social participation. The dimensions of fame and popularity, appearance, and happiness all had maximal correlation with social capital (P=0.0001). All aspects of social capital except for relations with neighbors and pioneering in social activities had a significant relationship with self-concept (P<0.05). This study shows that a statistically significant relationship exists between social capital and self-concept (P=0.001 and r=0.280).Conclusions: The results of this study indicate a significant relationship between social capital and self-concept and its dimensions; therefore, self-concept can be increased in adolescent patients by promoting their social capital components.

Introduction: Epilepsy is a prolonged disorder characterized by repeated violent epileptic seizures. Its managements depend on proper classification of the seizure category and the epileptic pattern. Levetiracetam (Keppra®) has been approved as monotherapy or for adjunctive management of partial onset seizures, juvenile myoclonic epilepsy, and idiopathic generalized epilepsy. Case reporting of levetiracetam polypharmacy shows adverse effects linked to evidence-based clinical and laboratory data in two patients with epilepsy. Case reporting of levetiracetam polypharmacy, based on evidence-based clinical and laboratory data was of interest that investigated.Case Presentation: Two cases were studied, one patient was a 32-year-old male and the other was a 14-year-old female. The key words relevant to search topics were surveyed using PubMed (United States national library of medicine). Articles related to the levetiracetam prescription in epileptic patients were selected and considered separately. Pharmacotherapy based on levetiracetam, primidone, phenytoin, and topiramate in a 32-year-old epileptic male showed a decrease in white blood cell count (3400 cells/mcL), red blood cell count (4.4 mil/mm3) hemoglobin (11.8 g/dL) and hematocrit (36.7%). The drug regimen for the 14-year-old epileptic female was a levetiracetam polypharmacy in combination with primidone and sodium-valproate simultaneously. In this patient, there was a decrease in hemoglobin (10.4 g/dL) and hematocrit (34%). An increase in lymphocyte (84%) was also observed.Conclusions: Administration of AEDs in general and levetiracetam in particular should be based on attention to pharmacokinetic behavior in terms of monotherapy or polypharmacy.