Jundishapur Journal of Chronic Disease Care
Year:2021 | Volume:10 | Issue:2|Papers Count:9

Background: Non-alcoholic fatty liver disease (NAFLD) has an increasing trend in the world and can lead to liver failure and death if left untreated. Lifestyle modification is very important in the treatment of this disease. Objectives: This study aimed to determine the comparison of body mass index (BMI), smoking, vitamin E consumption, and type of oil consumed by patients with NAFLD with non-alcoholic patients. Methods: The present study was a retrospective case-control study that was performed on 120 patients referred to the ultrasound unit of Shohaday Ashayer Hospital in Khorramabad. The participants were divided into two groups, including case (61 people) and control (59 people). The questionnaire consisted of three parts: (1) the first part was related to demographic information; (2) the second part was related to liver ultrasound results; (3) and the third part was related to height, weight, BMI, weekly vitamin E intake, daily smoking status, and type of oil consumed. Data were analyzed using SPSS-23 software and descriptive and inferential statistical methods. Results: Most of the participants in the study were 69 (55. 8%) and 92 (76. 66%) were married. The mean BMI of patients with NAFLD was significantly higher than non-alcoholic patients (P = 0. 003). There was no statistically significant difference in daily smoking and weekly intake of vitamin E in patients with and without non-alcoholic fatty liver disease (P < 0. 05). According to Fisher's exact test, it was found that there was a statistically significant difference in the frequency by patients with NAFLD and non-alcoholic (P = 0. 014). Also, a statistically significant difference was observed in the frequency of the type of oil consumed by patients with NAFLD (P = 0. 014). Conclusions: Consumption of olive and sesame oil along with weight loss is recommended. Smoking as a risk factor, as well as the use of vitamin E to prevent and treat NAFLD, require further studies with a larger sample size.

Objectives: This study aimed to assess the role of carotid ultrasonography and measure the carotid artery intima-media thickness (CIMT) and its correlation with hemoglobin A1c (HbA1c) to observe cardiovascular disease (CVD) risks in patients with type 2 diabetes mellitus (T2DM). Methods: In this observational study, 205 consecutive patients with T2DM from Golestan Hospital, Ahvaz, Iran, were included. We performed HbA1c measurements using high-pressure liquid chromatography (HPLC) with a thermo-system. Carotid arteries ultrasonography was performed with an Aloka SSD 5500 apparatus with a 7. 5 MHz transducer. The CIMT was measured in the supine position with a slight neck extension. Results: There was no statistically significant difference between the two study groups in the duration of diabetes with CIMT (P = 0. 425), while the differences in creatinine, HbA1c, and urine albumin were statistically significant (P = 0. 020, P = 0. 041, and P = 0. 016, respectively). There was no correlation between CIMT and age (r = 0. 19, P = 0. 792) and duration of diabetes (r = 0. 125, P = 0. 081). Furthermore, there was no remarkable association between CIMT and weight (r = 0. 12, P = 0. 881) and FBS ( r = 0. 062, P = 0. 405). There was also a non-significant negative correlation between HbA1c% and CIMT (r =-0. 127, P = 0. 127). Conclusions: Ultrasound measurement of CIMT is a safe and relatively cost-effective way of diagnosing atherosclerosis. Thus, the ultrasound's predictive value as a safe and non-invasive examination may alert the related field experts early enough to intervene to prevent major cardiovascular complications.

Background: Tumor metastasis, as one of the most important prognostic factors in solid tumors, affects survival remarkably. Cervical lymphadenopathy (LAP) reflects an advanced-stage disease and changes the tumor-node-metastasis (TNM) staging of tumor, resulting in a multidisciplinary approach to the management of cancer. Objectives: This study aimed to assess the importance of neck sonography in monitoring primary tumors. Methods: Records of 166 patients with distant primary cancers who underwent neck sonography from February 2019 to February 2020 were studied. Abnormal lymph nodes were reported, and then the patients underwent neck sonography and fine needle aspiration (FNA) or core needle biopsy (CNB) under direct US guidance. Thirty-two patients who were confirmed for malignant cervical LAP underwent neck lymph node biopsy as an easy and safe way to provide tissue diagnosis instead of providing biopsy from the primary source of tumor. Results: Malignant cervical LAP was confirmed in 32 patients (19. 2%) by neck sonography. Seventy-seven patients (46. 4%) were male and 89 patients (53. 6%) were female. The patients were 22 to 88 years old (mean age = 57. 7 years; standard deviation = 12. 7). Thirty-two patients (19. 2%) had pathological cervical lymph nodes and 134 patients (80. 8%) did not have. Conclusions: Metastatic cervical LAP found by neck ultrasound will change pretreatment TNM staging of disease to provide optimal treatment on a case-by-case basis. According to the result of this study, routine neck sonography in patients with distant primary tumors is recommended.

Background: Patients with COVID-19 have shown a wide variety of symptoms and mortality rates in different communities. Objectives: This study aimed to compare the epidemiological, clinical, and paraclinical features of patients with COVID-19 who have overcome the disease with patients who died. Methods: All hospitalized patients admitted to Special Corona Hospital who had a positive real-time PCR test for SARS-CoV-2 from January to March 2020 were included in the study. Clinical characteristics, date of disease onset, hospital admission date, and the severity of COVID-19 were obtained from each patient's medical records. Independent sample t-test was used to compare continuous variables between the groups of the discharged and expired patients. The independence between categorical variables and the outcome was assessed by Chi-square or Fisher's exact tests. Results: The order of essential variables for admission as the starting time are pH, WBC count, loss of consciousness, neutrophil count, base excess (BE), HCO3, age, BUN, O2 saturation, and lymphocyte count. Conclusions: In the current study, the mortality rate of COVID-19 was 30% and was significantly associated with critical disease intensity, fever, chills, loss of consciousness, ischemic heart disease (IHD) history, Parkinson's disease, invasive O2 therapy, and troponin level.

Background: Chronic pain is recognized as an important public health concern that leads to significant economic and social problems. Thus, identifying variables affecting the psychological adaptation of patients with chronic pain is necessary to prepare an effective intervention and treatment program. Objectives: This study investigated the mediating role of sexual self-esteem in the relationship between marital quality and psychological adaptation to disease in women with chronic pain. Methods: This descriptive-analytic study of correlation type was conducted on 200 women with chronic pain admitted to orthopedic centers in Ardabil City, Iran. The participants were selected using the available sampling method. The Psychological Adaptation questionnaire, the Sexual Self-Esteem scale, and the Marital Relationship Quality questionnaire were used to collect data. The standard mean, standard deviation, Pearson correlation, and multiple regressions were used for data analysis. Results: The findings revealed significant positive relationships between marital quality (r = 0. 49) (P < 0. 01) and sexual self-esteem (r = 0. 60) (P < 0. 01) with psychological adaptation. Moreover, significant positive relationships were found between marital quality and sexual self-esteem (r = 0. 48) (P < 0. 01). Sexual self-esteem also mediated the relationship between marital quality and psychological adaptation ( = 0. 23) (P < 0. 01). Conclusions: The study revealed that sexual self-esteem served a fully mediating role between marital quality and psychological adaptation in women with chronic pain. Therefore, it is of utmost importance to pay attention to sexual self-esteem's role in therapeutic interventions related to these women.

Objectives: This study aimed to investigate the effects of multiple drilling technique on therapeutic outcomes of patients with osteochondritis dissecans (OCD) of the knee. Methods: This controlled clinical trial was conducted on 24 patients aged 13-45 years with OCD types II and III according to the Dipaola classification and magnetic resonance imaging (MRI) assessments. The patients were classified into two groups (n = 12), including multiple drilling and control. Assessments including radiographic examinations, Tegner-Lysholm knee score, knee injury and osteoarthritis outcome score (KOOS), and visual analog scale (VAS) were performed before, three, and six months after treatment (surgery or conservative) for all patients, and the results were compared between the two groups. Results: After three months, Lysholm score was "good" and "fair" in the intervention and control groups, respectively. After six months, this index was "excellent" in the intervention group and "poor" in the control group. The KOOS score was significantly higher, and pain intensity was significantly lower in the intervention group three and six months after follow-up (P < 0. 05). The union was obtained in all patients of the intervention group in the last follow-up, and no surgical failure was reported in the patients. Conclusions: Significant improvements in the functional level and pain reduction were observed in patients treated with multiple drilling technique. Our results also showed high rates of union healing with low complication rates using multiple drilling technique.

Background: Allergic diseases are among the most common chronic conditions in pediatrics. Objectives: This study aimed to evaluate the relative frequency of allergic rhinitis (AR) in children with adenotonsillar hypertrophy. Methods: In this descriptive study, 175 patients with adenotonsillar hypertrophy referred to the Imam Khomeini hospital of Ahvaz from March 2019 to March 2020 were enrolled. Allergic rhinitis was diagnosed based on the Score for AR (SFAR) questionnaire. The questionnaire, including the expert-designed SFAR, has eight main components that evaluate eight quantitative features of AR, and each was designated with a specific weighted score based on previous clinical studies. The total score could vary from 0 to 16. Frequency and percentage were used to describe the data. The chi-square test and Fisher's exact test were used to analyze the data. Results: One hundred seventy-five patients with adenotonsillar hypertrophy in the age range of 1 to 17 years were studied. Ninetyone patients (52%) were male, and 84 patients (48%) were female. Based on the score obtained from the questionnaire, 146 patients (83. 4%) had a score of less than seven, indicating susceptibility to AR. Twenty-nine patients (16. 6%) had a score equal to or higher than 7, confirming the diagnosis of AR. The Chi-square test showed that AR was significantly associated with all the components of the questionnaire, except for cigarette smoking (P-value < 0. 001). Conclusions: This study showed the strong association of AR with some demographic factors. Allergic rhinitis could potentially increase the risk of adenotonsillar hypertrophy in children.

Background: Psoriasis is a relatively common inflammatory skin disease characterized by red, scaly plaques in different parts of the body. Although the etiology of the disease is not fully understood, psychological stress is mentioned as a potential factor in developing the disease. Objectives: In this study, in response to the lack of sufficient information obtained from assessing the influence of psoriasis on mental health, an attempt has been made to evaluate the prevalence of mental health problems in a sample of patients with psoriasis. Methods: This study was conducted following an applied, descriptive-correlational study design. A total of 104 patients with psoriasis were selected using the census sampling method. Data were collected using the standardized Symptom Checklist-90 (SCL-90) questionnaire. This self-administering questionnaire contains 90 items. The reliability and validity of the questionnaire were confirmed. Results: The mean score of mental health was 177. 51-69. 35, which indicates moderate psychiatric disorders. The positive symptom distress index (PSDI) was 0. 22-0. 08. There was a significant association between all dimensions of mental health and the total score of mental health with gender (P < 0. 05). Also, a significant association was found between paranoid ideation and marital status (P = 0. 024). There was no significant association between obsessive-compulsive, anxiety, and the total score of mental health with income level (P > 0. 05), but there was a significant association between other dimensions of mental health and income level (P < 0. 05). Conclusions: Although in the present study, psychiatric disorders in patients with psoriasis were moderate, psychological counseling and psychiatric consultation are key to reduce the consequences of the disease and its progression.

Context: The outbreak of the highly infectious COVID-19 has led to a global public health and economic crisis, especially in developing countries. Due to the global burden and spread and the high mortality rate of the virus, as well as an inadequate mental health care system in Nigeria, inhabitants often experience fear, depression, and anxiety that, if left unaddressed, may lead to longterm consequences. Although depression was a concerning issue in Nigeria before COVID-19, the pandemic has caused a surge in depression cases. This review highlighted the possible causes of depression among Nigerians during the COVID-19 pandemic and identified potential mitigating interventions to prevent depression. Evidence Acquisition: We searched PubMed for the articles published from January 2019 to September 2020 using the terms of "depression", "COVID-19", and "Nigeria". The articles resulting from these searches and the relevant references cited in those articles were reviewed. Results: Nigerians are likely to fall into depression due to the challenges and limitations affecting the economy and development of Nigeria. Conclusions: During the COVID-19 struggle, providing sound mental health services for individuals is imperative to maintain nations' mental health for a more rapid recovery across various measures of societal well-being post-COVID-19.