Chronic Diseases Journal
Year:2023 | Volume:11 | Issue:1|Papers Count:8

BACKGROUND: Hypertension (HTN) has become the costliest public health problem. After performing educational interventions, blood pressure (BP) of patients with this disease can be significantly reduced. The adaptation of the educational method to the individual learning style can be more effective on the patients' learning and thus better control of their BP with better educational effectiveness. The aim of this study was to compare educating based on visual, aural, reading/writing, and kinesthetic (VARK) learning style versus lecture method on BP level of patients with primary HTN. METHODS: This study was a semi-experimental and pretest-posttest study conducted on patients with primary HTN referred to the comprehensive health service centers in Bandar Abbas, Iran, from January 2019 to December 2019. 88 patients were selected by convenience sampling method and divided into two groups of education based on VARK learning style and lecture. The training sessions were presented for the members of education based on VARK learning style group based on their learning style and as a presentation for lecture group. Patients' BP was measured before and after the intervention as a measure of the effectiveness of training on patients' learning. Data analysis was done by SPSS statistical software and using descriptive indices, chi-square test, t-test, Mann-Whitney, paired t, and Wilcoxon test. RESULTS: Before the intervention, there was no significant difference between the average systolic BP (SBP) and diastolic BP (DBP) of the two groups (P < 0. 05). After the intervention, the difference between the average SBP and DBP before and after the intervention between the two groups was not significant (P > 0. 05). CONCLUSION: Education based on VARK learning style does not have more effect in reducing SBP and DBP of patients than lecture method.

BACKGROUND: This study aimed to investigate the effectiveness of intervention based on emotion regulation on fear of negative evaluation and cognitive emotion regulation strategies in university students with social anxiety. METHODS: This was a quasi-experimental study with pretest-posttest design and a control group. The study population consisted of all university students with social anxiety in Islamic Azad University, Sari Branch, Sari, Iran during 2019. After screening, the sample consisted of 30 (15 for each group) university students with social anxiety that were selected by the voluntary method and randomly recruited to each of the groups. Then, the participants in the experimental group participated in 8 sessions of 90-minute intervention based on emotion regulation, while the control group did not receive any therapy. Instruments for gathering data were Fear of Negative Evaluation Scale-Short Form (Leary, 1983) and Cognitive Emotion Regulation Questionnaire (Garnefski and Kraaij, 2009). Then, the data were analyzed using SPSS software and statistical tests such as multivariate analysis of covariance (MANCOVA). RESULTS: The intervention based on emotion regulation had significant impact on fear of negative evaluation and cognitive emotion regulation strategies in university students with social anxiety. CONCLUSION: Based on the findings of this study, intervention based on emotion regulation improves fear of negative evaluation and cognitive emotion regulation strategies in university students with social anxiety and could be used as an effective interventional method.

BACKGROUND: During the COVID-19 pandemic, grief and bereavement have been the most prevalent psychological problems experienced. Therefore, the aim of the present study was to compare the effectiveness of grief counseling and God-oriented spiritual counseling on death anxiety and spirituality in people with COVID-19 grief. METHODS: The present quasi-experimental study was conducted with a pretest-posttest design, a control group, and follow-up. The population consisted of all inhabitants of Shahr-e-Rey who had lost a member of their family due to COVID-19 in 2021. Participants (n = 51) were selected through purposive sampling based on their acceptance to participate in the study and the inclusion criteria, and were randomly assigned to 2 experimental groups (n = 34) and 1 control group (n = 17). Data were collected using Templer’, s Death Anxiety Scale (DAS) and the Spiritual Perspective Scale (SPS) in the pretest, posttest, and follow-up stages. The collected data were analyzed in SPSS software using repeated measures ANOVA. RESULTS: The results showed that both methods of intervention were effective in reducing death anxiety and increasing perceived spirituality. However, God-oriented spiritual counseling was more effective in reducing death anxiety and increasing perceived spirituality compared to grief counseling (P < 0. 05). CONCLUSION: The results strongly support the effectiveness of grief counseling and God-oriented spiritual counseling on death anxiety and perceived spirituality. Policymakers and mental health experts can use both counseling approaches (based on cognitive-behavioral therapy and complex bereavement therapy) in designing individual and community-oriented interventions related to bereavement, provided they pay attention to the needs of the target community.

BACKGROUND: There is a higher prevalence of oral health problems among people with rheumatoid arthritis (RA) than the general population. Receiving and continuing dental treatment is challenging for this patient group for many reasons. Therefore, the purpose of this study was to identify the most common oral concerns and the barriers and facilitators of access to dental health care through a qualitative evaluation. METHODS: In this study, an interpretative/hermeneutic approach was used. Through purposive sampling, 50 RA patients (38 women and 12 men) who referred to 3 rheumatology centers in Yazd, Iran, between May and July 2021 were recruited. Sampling was continued until data saturation was reached. To determine the main oral concerns of patients, unstructured interviews and an audio recorder were used for face-to-face interviews. RESULTS: The information extracted from the questionnaires and recorded information were classified into 4 main themes: 1) physical limitations of RA patients in chewing, swallowing, or following oral hygiene instructions,2) pain and discomfort that RA patients reported in their mouth and teeth,3) social and psychological limitations,and 4) barriers and facilitators of dental treatments. CONCLUSION: Due to differences in the level of awareness and unique systemic conditions of each interviewee, they had different oral health-related concerns. It seems that a comprehensive approach is necessary to adapt oral health services to the needs of this population. We hope that our findings can help determine the priorities of oral and dental care in these patients and simplify their access to dental services.

BACKGROUND: Patients with diabetes mellitus (DM) have a high risk of atherothrombotic events, with 80% of patients with DM dying a thrombotic death and 75% of these deaths being due to cardiovascular complications. This study aims to evaluate glycated hemoglobin [hemoglobin A1c (HbA1c)] with other parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, and complete blood count (CBC) indices] and compare various hematological parameters between people with DM and people without complications. METHODS: This cross-sectional study was conducted at Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra, India, over period of 2016 to 2018 on those diagnosed as a case of type II DM (T2DM) with or without complication. Blood samples from all 108 cases were collected. Statistical analysis was performed by Student’, s unpaired t-test, Bonferroni multiple comparison test, one-way analysis of variance (ANOVA) test, and chi-square test. RESULTS: In T2DM cases, mean PT was 12. 25 ±,1. 22 seconds and APTT in total T2DM cases was 30. 12 ±,3. 05 seconds (P ≤,0. 005). Hemoglobin (Hb) and hematological parameters like mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were decreased significantly in DM cases compared to the control group, while red cell distribution width (RDW) and total white blood cell (WBC) counts were found to be significantly increased in DM group (P = 0. 021, t = 3. 37,P = 0. 001, t = 3. 51, respectively). The correlation of HbA1c with PT, APTT, international normalized ratio (INR), and fibrinogen was statistically significant (P = 0. 005, P = 0. 0001, P = 0. 005, and P = 0. 0001, respectively). The mean fibrinogen level was 422. 22 ±,119. 77 mg/dl and was statistically significant (P = 0. 0001). CONCLUSION: There was a shortening of PT and APTT, indicating a hypercoagulable state in T2DM. Glycemic control affects the PT, APTT, INR, and fibrinogen levels.

BACKGROUND: Chronic abdominal pain is a frequent cause of surgical consultation. This study is conducted to evaluate usefulness of laparoscopy in diagnosis of chronic abdominal pain so as to reduce suffering and depression associated with condition. This study aims to define the role of diagnostic laparoscopy in chronic abdominal pain. METHODS: A hospital-based prospective study was conducted in the Department of Surgery, Shri Vasantrao Naik Government Medical College, Yavatmal, India, a tertiary care center in the rural area from January 1, 2016 to June 30, 2017 with 50 patients to evaluate the role of laparoscopy in patients with chronic abdominal pain. All the patients underwent diagnostic laparoscopy with methodical inspection of the whole abdominal cavity. Statistical analysis was done using SPSS software. RESULTS: The majority of the patients (36%) were in the age group of 21-30 years with women affected more (66%). The most common symptom was pain (100%) for more than 4-5 months. Laparoscopic findings were appendicitis (30%) followed by Koch’, s abdomen (26%), adhesions (24%), sub-acute intestinal obstruction (SAIO) (8%), ovarian cyst (4%), and hernia (2%) which were treated accordingly. Resolution of pain was seen in 94% of the patients over a follow-up period of 3 months. CONCLUSION: Diagnostic laparoscopy is a safe and effective procedure in the evaluation of patients with chronic abdominal pain in a rural area. It also provides an opportunity to perform the therapeutic procedure in the same setting thereby reducing the overall cost of treatment.

BACKGROUND: Tuberculosis (TB) of the spine if neglected can give rise to deformities and neural compromise. Early diagnosis and management can prevent these complications. In this series, we study the clinical-radiological presentation and present trends of spinal involvement in spinal TB (STB) in our Himalayan population. METHODS: This study was conducted from March 2017 to February 2020. Patient demography, clinical signs, and radiological parameters of the disease were recorded. RESULTS: 80 diagnosed patients with a mean age of 37. 6 ±,19. 1 years were included. Para-discal variety was the most common type (86. 25%) with the lumbar region the most common region involved (46. 9%). Cold abscess, deformity, and neural deficit were present in 11. 25%, 36. 25%, and 21. 25% of patients, respectively. CONCLUSION: The results of this study and the world literature suggest a global trend of the lumbar spine being involved more often in the twenty-first century than the thoracic spine. Besides, our Himalayan belt population had a lower incidence of clinically evident cold abscesses, discharging sinuses, spine deformities, and associated neural deficits, which is suggestive of the early presentation of our patients to the healthcare facilities.

BACKGROUND: Pneumomediastinum is defined as open-air in the mediastinum. Spontaneous pneumomediastinum (SPM) occurs when air leaks into the surrounding vascular sheath through small alveolar ruptures. CASE REPORT: We want to introduce 4 different cases with different outcomes. The first case was a 60-year-old man with a history of psychological disorders, the second case was a 41-year-old man with a history of hypertension (HTN) and asthma, the third case was a 50-year-old heavy smoker with no history of an underlying disease, and the fourth case was a 60-year-old man with a history of schizophrenia. They suddenly developed an exacerbation of cough, dyspnea, chest pain, and a severe decrease in oxygen saturation during hospitalization. Antibiotic therapy, corticosteroids, and high-dose oxygen therapy were administered to the patients. One of these patients died. CONCLUSION: All patients can potentially be at risk for this complication and have a good prognosis if diagnosed early and treated properly overall.